自身免疫/副肿瘤抗体组的选择仍然具有挑战性，因为医疗保健专业人员通常不熟悉特定患者的抗体组内容、推荐的标本类型和抗体组合。不当使用会增加成本，导致不必要的额外检查，并延迟对患者症状真正原因的识别。在本研究中，我们评估了订单输入临床决策支持是否可以提高自身免疫/副肿瘤抗体组的利用率。电子健康记录系统中嵌入了订单输入临床决策支持工具。使用嵌套面板结构，决策支持工具提示临床医生识别患者的临床表现并指导选择适当的测试。此外，该工具还具有重复检查功能，可在 3 个月内发出多个抗体含量基本相似的订单时提醒临床医生。在实施前的 12 个月内对小组订购实践进行了评估，并与实施后的 6 个月进行了比较。临床决策支持将所有可订购产品的每月测试量从实施前的每月 75.8 份显着减少到实施后的每月 54.5 份（发生率 [ IRR]，0.72；95% CI，0.63-0.81；P < .001）。抗体含量基本重叠的面板的多个订单的放置也显着减少，从每月 7.0 个减少到每月 1.2 个（IRR，0.17；95% CI，0.07-0.33；P < .001）。检测到的神经特异性抗体数量保持不变，但总测试量的减少使神经特异性抗体阳性率从4.2%提高到6.8%（IRR，1.61；95% CI，0.94-2.70；P = .075） .订单输入临床决策支持提供了一种高效且有效的方法来提高自身免疫/副肿瘤抗体组的利用率。© 作者 2024。由牛津大学出版社代表美国临床病理学会出版。版权所有。如需商业重复使用，请联系 reprints@oup.com 获取转载和转载的翻译权。所有其他权限都可以通过我们网站文章页面上的权限链接通过我们的 RightsLink 服务获得 - 如需更多信息，请联系journals.permissions@oup.com。

Selection of autoimmune/paraneoplastic antibody panels remains challenging because health-care professionals often lack familiarity with panel contents, recommended specimen types, and antibody combinations for a given patient. Inappropriate use adds cost, prompts unnecessary additional workup, and delays the identification of the true cause of patient symptoms. In this study, we assessed whether order-entry clinical decision support can improve autoimmune/paraneoplastic antibody panel utilization.An order-entry clinical decision support tool was embedded in the electronic health record system. Using a nested panel structure, the decision support tool prompted clinicians to identify their patient's clinical presentation and guided selection of the appropriate tests. In addition, the tool featured a duplicate checking function to alert clinicians when placing multiple orders with substantially similar antibody content within a 3-month period. Panel ordering practices were assessed during the 12 months before implementation and compared with the 6 months immediately following implementation.Clinical decision support significantly reduced the monthly test volume of all orderables from 75.8 per month before implementation to 54.5 per month after implementation (incident rate ratio [IRR], 0.72; 95% CI, 0.63-0.81; P < .001). Placement of multiple orders for panels with substantially overlapping antibody content also decreased significantly, from 7.0 per month to 1.2 per month (IRR, 0.17; 95% CI, 0.07-0.33; P < .001). The number of neural-specific antibodies detected remained unchanged, but the reduction in total test volume increased the neural-specific antibody positivity rate from 4.2% to 6.8% (IRR, 1.61; 95% CI, 0.94-2.70; P = .075).Order-entry clinical decision support offers an efficient and effective approach to improve the utilization of autoimmune/paraneoplastic antibody panels.© The Author(s) 2024. Published by Oxford University Press on behalf of American Society for Clinical Pathology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.