AIM

The purpose is :

•To observe the “behaviour” of ANA Reflex

•To compare the results for the period

1 May 2013 - 1 May 2014

versus the preceding year ( 1 May 2012 -

30 April 2013)

before the introduction of ANA Reflex) in the

Autoimmune Laboratory of Modena and Parma to

feel our way in an early stage.

ONE YEAR: before AND after ANA REFLEX

ANA testing

Find ANA when it is clinically relevant

Help the clinicians interpret our results

Do the tests in the most appropriate way

7950

50,83%

7690

49,16%

15981

ANA Reflex 2013-2014

ANA 2013-2014

ANA All (2 0 1 3 -2 0 1 4 )

RE

SU

LT

S O

F T

HE

FIR

ST

YE

AR

ANA Modena

4261

(54,42%)

3568

(45,57%)

7861

ANA Reflex 2013-2014

ANA 2013-2014

ANA All (2013-2014)

RE

SU

LT

S O

F T

HE

FIR

ST

YE

AR

ANA Parma

Total numberNegatives

Positives

ENA 2013-2014

ENA 2012-2013

5981

5212

(87,1%)

768

(12,84%)

4741

3903

(82,3%)

774

(16,32%)

ENA 2013-2014

ENA 2012-2013

ENA Modena R

ES

UL

TS

OF

TH

E F

IRS

T Y

EA

R

Total numberNegatives

Positives

ENA 2013-2014

ENA 2012-2013

3715 3371

(90,74%)

344

(9,25%)

2900

2590

(89,31%)

310

(10,68%)

ENA 2013-2014

ENA 2012-2013

ENA Parma R

ES

UL

TS

OF

TH

E F

IRS

T Y

EA

R

ENA TESTS

Report of ENA reduction in Parma Lab.

Report of ENA reduction in Modena Lab. - 1240

- 815

- 20,73%

- 21,94%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Absolute

difference

Percentage

PARMA ENA Differenceamong the two periods

MODENA ENA

Difference among the two

periods

ENA TESTS

POSITIVITY

Modena

12,84% (2012-2013)

16,32% (2013-2014)

Parma

9,26% (2012-2013)

10,69% (2013-2014)

DNA 2013-2014 2539 2200 314 204 71

DNA 2012-2013 3421 3068 353 254 65

DNA Performed Negatives Positives DNA IFA Performed DNA IFA Positives

DNA Modena

DNA 2013-2014 2272 2048 224

DNA 2012-2013 2626 2430 196

DNA Performed Negatives DNA IFA

Positives

DNA Parma

- 882

- 354

- 25,78%

- 13,48%

Absolute difference Percentage

PARMA DNA Difference

among the two periods

MODENA DNA

Difference among the

two periods

Report of DNA reduction in Parma Lab.

Report of DNA reduction in Modena Lab.

DNA TESTS

DIS

CU

SS

ION

During the first YEAR of ANA Reflex application:

we observed the request of ANA Reflex has already

been not inferior of 45% of the total ANA requests

we observed that ENA during the 2013-14 period had

a reduction around the 20% compared to 2012-13 and

a concomitant increase of positivity

DNA showed a reduction always comparing “before

and after “ ANA Reflex, improving the selected positive

cases

we observed more or less the same trend in Modena

and Parma

Summarised

ANA testing

12

Agreed that ANA test is central to the diagnosis of

autoimmune diseases

Highlighted issue with

analytical specificity and sensitivity

clinical specificity and sensitivity

increasing demand for testing

lack of standardisation

changes in technology being introduced

Appropriateness is an important

target for Health Services and

Laboratory can provide useful

diagnostic tools in order to

improve clinical decision making

in the Autoimmune Disease field.

CO

NC

LU

SIO

N