Inefficiencies of ANA Testing Save
The Journal of Rheumatology has published an analysis of antinuclear antibody (ANA) multiplex testing showing its nonspecific utility and poor rate of return in identifying ANA-associated autoimmune rheumatic disease (ARDs).
ANA multiplex assay results from a single center, tertiary healthcare system, over a 1-year period were evaluated. After excluding duplicate tests and a previously established ARD samples, a total of 2499 charts were reviewed for clinical presentation, ordering specialty, ordering rationale, and whether subsequent rheumatology evaluations resulted in a new ARD diagnosis.
ANA multiplex assays were most ordered by primary care and medicine subspecialties for > 100 reasons.
In the ANA–negative group, only 1.66% (37/2228) were diagnosed with a new ARD; most often RA and spondyloarthritis.
In the ANA–positive group, 13.7% (37/271) were diagnosed with a new ARD; most often Sjögren disease, systemic lupus erythematosus, and undifferentiated connective tissue disease.
97% of the ordered ANA assays did not lead to an ARD diagnosis.
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The author has no conflicts of interest to disclose related to this subject
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