• The Hidden Burden of Outpatient Repeat PSA Testing in a Prospective Cohort

      Browne, E; O'Kelly, F; Lundon, D; Daly, P; Galvin, D; Hegarty, N; Connolly, S; O'Malley, K (Irish Medical Journal, 2017-05)
      PSA testing is widespread throughout Europe for diagnostic purposes and follow up. We performed a prospective outpatient cohort study of 250 men (2013-2015) in two hospital sites. Included were those men being followed up by urology with PSA blood testing. First appointments and those men in whom non-PSA tests were ordered by urology were excluded. The median age was 67.2yrs (46-88). Eighty-one point two percent of samples had a combination of 21 different serology tests at an added cost of >€18,000. Abnormal serology resulted in 53 referrals. Twenty-six-six percentof correspondence referenced abnormal serology other than PSA. Follow up of non-PSA test results poses a challenge in an outpatient setting with failure to appropriately follow-up on abnormal results, increased costs, and medico-legal implications. There is currently no Irish legislature in place to safeguard hospital physicians. This study quantifies the levels of expenditure, resources and risk associated with ambulant PSA testing.
    • Transitioning high sensitivity cardiac troponin I (hs-cTnI) into routine diagnostic use: More than just a sensitivity issue

      Lee, Graham R; Browne, Tara CA; Guest, Berna; Khan, Imran; Murphy, Eamon; McGorrian, Catherine; Mahon, Niall G; Fitzgibbon, Maria C (Practical Laboratory Medicine, 2016-04)
      High sensitivity cardiac troponin T and I (hs-cTnT and hs-cTnI) assays show analytical, diagnostic and prognostic improvement over contemporary sensitive cTn assays. However, given the importance of troponin in the diagnosis of myocardial infarction, implementing this test requires rigorous analytical and clinical verification across the total testing pathway. This was the aim of this study.