Do platform-specific factors explain microRNA profiling disparities?

difference in low results: t(22) 0.08 (P 0.43). The introduction and enforcement of guidelines produced a dramatic reduction in the number of B12 samples processed, with testing reduced by 70% over the first year. Only 14.3% of the overall reduction was due to rejected samples, indicating that the majority of the reduction was due to compliance with the guidelines by laboratory users. The reduction in testing did not produce a statistically significant reduction in the low B12 results, allowing us to conclude that the introduction of appropriate guidelines reduced testing but did not significantly reduce the number of patients detected with B12 deficiency. This finding indicates that it is possible to control testing without compromising patient care. Before the introduction of guidelines, few requests for B12 testing were accompanied by an indication. That made it impossible to perform a more in-depth analysis of the reduction based on the indication for testing; however, our results suggest that the majority of the B12 testing performed before the guidelines were implemented was likely to have been inappropriate, given the current evidence. The cost of each B12 test in our laboratory is €3.92 per test, which includes direct and indirect costs. Because 29 791 fewer B12 tests were performed in the post-guidelines period, this reduction in testing produced a savings of €116 780.72. The overall laboratory workload for B12 testing was greatly reduced after the introduction of the guidelines, even when the time spent enforcing the guidelines is taken into account. In conclusion, in the current economic climate it is vital that laboratories play an increasing role in ensuring that testing is evidence based. Inappropriate B12 testing is common. The issuing and enforcement of guidelines produce a dramatic reduction in testing without affecting the ability of clinicians to detect clinically relevant B12 deficiency.