Laboratory Request Form Revamped: Pictogram Based Symptoms Afford Adequate Patient’s Clinical Information in High Patient Load Setting

• Main Authors: Mahadevan Ganesan, Ganesan Sucila Thangam, Ramalingam Sekar, Robert Sudha
• Format: Article
• Language: English
• Published: JCDR Research and Publications Private Limited 2019-09-01
• Series: Journal of Clinical and Diagnostic Research
• Subjects: completeness; infographics; symptoms assessment; test request form
• Online Access: https://jcdr.net/articles/PDF/13152/42232_CE[Ra1]_F(SL)_PF1(AJ_KM)_PFA(AJ_OM)_PN(SL).pdf

Introduction: Laboratory Request Form (LRF) offers communication triad involving patient, physician and diagnostic service providers. LRFs with complete patient’s clinical information along with the diagnostic results may be used as predictor tool for emerging diseases. Overcrowding of wards in developing countries, especially in India, may affect physician’s effectiveness causing an appalling lack of clinical symptoms in LRFs or mostly left unattended by form attendees. Solving this problem certainly requires a novel method of data collection with the aim of improving the physician’s attention. Aim: The objective of this study was two-fold: (1) to determine the proportion of unattended and partially filled LRFs; and (2) to evaluate the effectiveness of pictograms over text oriented symptoms. Materials and Methods: A total of 645 Pictogram based LRF (PLRF) were provided as an overleaf along with the Text oriented LRFs (TLRF). The percentages of blank form, total symptoms per form, and individual symptoms per form were calculated. Physicians Attention Index (PAI) was also calculated based on the number of LRFs in which physicians filled the duration of one or more symptoms. The difference in frequencies of categorical responses between two dependent groups was calculated by way of the comparison of proportions and chi-square. A twosided p-value <0.05 was considered as the test of significance for all parameters. Results: A significant proportion of unattended forms decreased upon implementation of PLRFs (23.4% vs. 11.8%; p-value =0.0001). Notably, symptoms such as headache, abdominal pain, rhinorrhea, knee pain showed the most improved proportions of all. During this study period, dengue accounts for >80% of the test request provided with more number of associated symptoms. Interestingly, PAI was 0.125 (21.7%) in PLRFs and this could not be possible in the default TLRF. Conclusion: Revisiting of LRF is need of the hour in order to get maximum attention from form attendees thereby improving adequacy in test requesting information. This will ultimately aid the physician or diagnostic service providers to offer differential diagnosis which in turn improves the quality of patient care.