Exploring Pathology Investigations for Suspected Diabetes in Children Attending General Practice
Ethics: Approval by the Human Ethics Team, Office of Research Ethics and Integrity, The University of Melbourne.
Project aims: This project used the Patron dataset to meet two aims. The first was to determine the proportion of paediatric patients without a diabetes diagnosis that had diabetes pathology tests ordered for them. The second was to obtain odds ratios for the effect of age, sex, socio-economic status, and rurality on whether diabetes pathology was ordered.
Objectives: The objective of this project was to understand the diabetes pathology ordering practices of general practitioners.
Project summary: Three Australian children are diagnosed with type 1 diabetes each day. One will receive their diagnosis too late and present to hospital in Diabetic Ketoacidosis, a life-threatening emergency. The Royal Australian College of General Practitioners recommend same day referral to a specialist team when a child presents to their GP and there is suspicion of diabetes. In situations where referral is delayed, the two most cited reasons for delay include pre-referral laboratory investigations and misdiagnosis. This project aimed to use the Patron dataset to understand diabetes pathology test ordering practices of general practitioners.
Our project assessed the electronic medical records from 113 general practices and 292,865 patients under 18 between 2019 and 2021. It was found that the proportion of patients who had diabetes related pathology ordered for them increased from 2019 (2.71%) to 2021 (5.77%). Sociodemographic analysis revealed that patients over 12, female patients, patients living in lower socio-economic status areas were all significantly (p<0.001) more likely to have diabetes pathology tests ordered.
We found that the number of diabetes related pathology tests ordered for children without a diabetes diagnosis was higher than expected, given the relatively low number of diabetes diagnoses made in this time. The sociodemographic analysis suggested that the increase observed may also be attributed to screening for conditions such as polycystic ovary syndrome and type 2 diabetes.
- Ms Chiara Beccia
- A/Prof Jo-Anne Manski-Nankervis
- Dr Mary White
Insights from this project will assist in tailoring a clinical decision support ‘pop up’ tool to promote same day referrals in general practice.
For further information about this research, please contact the research group leader.
Department / Centre
General Practice and Primary Care
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