Evaluation of selected laboratory components of a comprehensive periodic health evaluation for veterans with spinal cord injury and disorders

OBJECTIVE: To evaluate selected laboratory components of a comprehensive periodic health evaluation program for patients with spinal cord injury and disorders (SCI/D). DESIGN: A retrospective study. SETTING: A Department of Veterans Affairs spinal cord injury center. PARTICIPANTS: Community-dwelling male veterans with SCI/D (N=350). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Proportion of laboratory tests that resulted in new diagnoses (diagnostic yield) and proportion of laboratory tests that resulted in changes in management (therapeutic yield). RESULTS: Although abnormality rates for many routine laboratory tests were high (up to 31.5%), diagnostic and therapeutic yields were low (<1.5%), with the exception of glucose (therapeutic yield, 3.4%) and lipid tests (up to a 4.1% diagnostic and 15.2% therapeutic yield). CONCLUSIONS: Our data revealed that diagnostic and therapeutic yields for many laboratory components of the annual PHE program for veterans with SCI/D were low, consistent with findings in the general ambulatory population. Further data collection, particularly prospective longitudinal data, may help optimize the selection and frequency of laboratory tests performed as part of this program.