Michael Harrison - Sullivan Nicolaides Pathology -The new RCPA Position Statement on the "Use and Interpretation of Vitamin D testing"
Upcoming SlideShare
Loading in...5
×

Like this? Share it with your network

Share

Michael Harrison - Sullivan Nicolaides Pathology -The new RCPA Position Statement on the "Use and Interpretation of Vitamin D testing"

  • 629 views
Uploaded on

Michael Harrison, Chief Executive Officer & Managing Partner, Sullivan Nicolaides Pathology presented "The new RCPA Position Statement on the "Use and Interpretation of Vitamin D testing"" at the......

Michael Harrison, Chief Executive Officer & Managing Partner, Sullivan Nicolaides Pathology presented "The new RCPA Position Statement on the "Use and Interpretation of Vitamin D testing"" at the National Pathology Forum 2013.

This annual conference provides a platform for the public and private sectors to come together and discuss all the latest issues affecting the pathology sector in Australia. For more information, please visit the conference website: http://www.informa.com.au/pathologyforum

  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Be the first to comment
    Be the first to like this
No Downloads

Views

Total Views
629
On Slideshare
629
From Embeds
0
Number of Embeds
0

Actions

Shares
Downloads
15
Comments
0
Likes
0

Embeds 0

No embeds

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
    No notes for slide

Transcript

  • 1. The new RCPA Position Statement on the "Use and Interpretation of Vitamin D testing” Dr Michael Harrison RCPA VP , CEO SNP
  • 2. Talk outline       Basic Vitamin D biology Dynamics and demand of Vit D testing The funding dilemma Test demand interventions The new RCPA guidelines The path forward
  • 3. Vitamin D biology
  • 4. Vitamin D deficiency
  • 5. Vitamin D tests - Australia 5,000,000 4,500,000 4,000,000 3,500,000 3,000,000 2,500,000 2,000,000 1,500,000 1,000,000 500,000 0 Series1
  • 6. Vitamin D test utilization international comparison 2009
  • 7. Vitamin D tests – state breakdown 1,800,000 1,600,000 1,400,000 1,200,000 1,000,000 800,000 600,000 400,000 200,000 0 State NSW Services State VIC Services State QLD Services State SA Services State WA Services State TAS Services State ACT Services State NT Services
  • 8. Vitamin D tests population utilization Services per capita (per 100,000 popn. rolling 12m. average) - item 66608 VitaminD NSW Vic Qld SA WA Tas ACT NT 1,400 1,200 1,000 800 600 400 200 0 Jul-02 Jan-03 Jul-03 Jan-04 Jul-04 Jan-05 Jul-05 Jan-06 Jul-06 Jan-07 Jul-07 Jan-08 Jul-08 Jan-09 Jul-09 Jan-10 Ed Wilson EW Consulting Ed Wilson EW Consulting P/L
  • 9. Vitamin D Medicare expenditure
  • 10. Vitamin D publications        Google – Vitamin D 60 million Google - Vitamin D deficiency 8.7million Google - Vit D deficiency Aus 1.3 million PubMed – Vitamin D 60,000 PubMed - Last 5 years 16,000 PubMed - Last 10 years 25,000 PubMed –Vitamin D deficiency 21,000
  • 11. Articles VS Vitamin D tests 2002-12 Articles = Major national and international medical journals, General Practitioner (GP) targeted journals and publications, Government funded bodies and associated publications, Guidelines and position statements published by specialist and authoritative medical societies
  • 12. Vitamin D Status in Primates and Early Humans 160 43o Winter N Latitude 120 A 80 Old-World Primates 40 0 Humans exposing full skin surface to Sunshine’s UVB 80 “Normal” Blood Levels when taking 1000 IU/day Northern People Taking Sources, include Cosman, Osteoporosis Int 2000; Fuleihan NEJM 1999; Scharla Osteoporosis Int 1998; Vieth AJCN 1999, 2000 4000 IU/day Physiological adult intake
  • 13. Deviation (% bias) of methods from the NIST
  • 14. Mean inter-laboratory imprecision (CV%)
  • 15. NPS : Program Objectives 1. Increase awareness of risk factors for vitamin D deficiency and appropriate management of high risk groups 2. Improve health professional awareness of the limitations of vitamin D tests 3. Increase the awareness and adoption of lifestyle measures to prevent vitamin D deficiency 4. Increase the appropriate use of vitamin D supplements 5. Increase appropriate use of vitamin D testing
  • 16. RCPA Vitamin D working group     1.Assoc. Prof. James Davidson, Chemical Pathologist, Labplus, Auckland 2.Dr. Zhong Lu, Chemical Pathologist | Melbourne Pathology 3. Professor Howard Morris, Clinical Scientist, Endocrine Bone Research Laboratory, SA Pathology 4. Dr Hans Schneider, Chemical Pathologist, Alfred Health
  • 17. RCPA Vitamin D working group      1. Types of Vitamin D Tests Currently on the Market, Methods, Pitfalls etc. Zhong Lu 2. Who Should Be Tested -Adult and Paediatric James Davidson and Howard Morris 3.How Often Should Retesting occur. Howard Morris and Zhong Lu 4. Interpretation of Results. Paul Glendenning and Hans Schneider 5. Possible Harms of Testing Paul Glendenning
  • 18. RCPA Vitamin D Testing Guidelines 1
  • 19. RCPA Vitamin D Testing Guidelines 2
  • 20. The Vitamin D testing dilemma      Preventive medicine & the value of “screening” for disease Public interest & dealing with scientific uncertainty Evidence based guidelines vs “uncontrolled experiments” Individual vs population intervention measures Cost vs everything else