673 To Test or Not to Test? What Bloods are Done at Developmental Clinic?

Abstract

Aims: To audit blood tests performed at a developmental clinic against recognised standards.

Methods: Term children referred to the neurodevelopmental clinic in a busy tertiary paediatric hospital from 2007 to 2009 were included in the study The hospital laboratory database, patient charts and the genetic/chromosomal analysis ledger were interrogated The national metabolic unit was also consulted on all patients to ensure accuracy of results A coding system was devised for whether an investigation was normal, abnormal, not requested or result unavailable and applied to our cohort The information was collated in an Excel spreadsheet and analysed Investigation of children attending the neurodevelopmental clinic is completed in concordance with evidenced based guidelines¹.

Results: 250 term children from that time period were identified and the blood tests performed reviewed The tests most routinely performed are U&E's 54% (136) with 10% of those abnormal and 45% (112) had serum amino acids assessed 30% of which were abnormal Other tests include lactate 35% (89) checked of which 23% (21) were abnormal, 33% (83) had chromosomal analysis, with 1 abnormality identified and27% (68) had Fragile X screening, with no abnormality detected.

Conclusions: This audit has highlighted the lack of concordance with the advised standards and raises questions regarding appropriateness of certain tests These results warrant the introduction of a standardised proforma investigation sheet for these cases followed by repeat audit.

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