Combined reports on serum calcium and discriminant functions increase the diagnostic rate of hypercalcaemia

Abstract

Hypercalcaemia is a condition easily overlooked by the clinician. Prompted by the observation that computerized reminders could increase the awareness, we have examined whether the combined reporting of increased serum calcium I-esults and the results from diagnostic discriminating calculations could increase i.he clinical awareness of hypercalcaemia. Albumin-corrected serum calcium was estimated in all 4500 patients admitted to the hospital during a period of 2 months. Eighty-seven patients were found with hypercalcaemia and were assigned randomly to 2 groups: A (40 patients) and B (47 patients). In group A. the increased serum calcium and the results of the discriminant functions were reported: in group B, the serum calcium was reported only if requested and the discrimination diagnosis withheld. The clinical records were examined 3 weeks after admission. At this time the records in group A contained a relevant clinical diagnosis explaining the hypercalcaemia in 81% of the cases. This was in contrast to only 31% of the records in group B. We conclude that this combined reporting leads to a considerable improvement in the clinical aware- ness of hypercalcaemia and results in a diagnosis explaining the condition in the majority of cases.

Key Words:

• malignancy
• primary hyperparathyroidism
• transient hypercalcaemia