Data from: Extent and cost of inappropriate use of tumour markers in patients with pulmonary disease: a multicentre retrospective study in Shanghai, China

Objectives: The currently implemented healthcare reform in China requires
substantial capital investment. Although overtreatment results in serious
waste, inappropriate laboratory use is widespread, and overuse of tumor
markers (TMs) has attracted increasing attention. Design: Retrospective
study. Setting: The respiratory, thoracic surgery, and oncology
departments of three hospitals in Shanghai, from 2014 to 2015.
Participants: Patients with chronic obstructive pulmonary disease (COPD)
and primary bronchogenic lung cancer (PLC). Based on clinical guidelines
and physician experience, the criteria of suitability of TM examinations
were determined, and the number, cost, and proportion of inappropriate TM
requests were analyzed. Results: The area under the receiver operating
characteristic (ROC) curve for CEA+CYFRA211+SCC+NSE in COPD and PLC
patients was 0.813, in accordance with the cost-effectiveness principle,
indicating good clinical and health economics values. In the 2706
patients, 12,496–16,956 (58.27–79.06%) of TM requests were inappropriate.
Furthermore, the involved expense was 650,200–1,014,156 yuan, accounting
for 7.69–12.00% of examination expenses, and 1.35–2.11% of hospitalization
costs. Conclusions: We found that the inappropriate use of TMs was
widespread for patients with pulmonary disease. Clinicians should use TMs
strictly according to the guidelines to effectively manage laboratory
resources and control costs.