Use of Troponin T Testing in Familiy Practice
Nutzung und Nutzen des Tests auf der Basis einer Befragung bayerischer Hausärztegerman translation / full article
Use and Benefit of Troponin T Testing Based on a Census of Bavarian Family Doctors
Background: Since 1994 troponin T testing can be used to identify myocardial damage as soon as a few hours after onset and is therefore a well established diagnostic tool in clinical laboratory findings. In addition special test kids allow a preclinical easy troponin T testing at the bed side, but it is not widely used in ambulant medical care. Aim of the present study is to detect the implementation of this additional diagnostic tool in Bavarian familiy practices (Germany).
Methods: During a meeting of Bavarian familiy doctors attendants were asked to describe their use of troponin T testing in their family practice. Further observed details where age, sex, duration of clinical experience and working time as general practitioner, the medical specialisation and location of medical practice. The result was compared with settlement data of the Association of Statutory Health Insurance Physicians in Bavaria 2007/08.
Results: 133 of 157 dispensed questionaires were returned (78 %). 75.9 % of the general practitioners applied troponin T testing in ambulant medical care. The use of TNT testing by general practitioners in cities over 100.000 residents was significantly reduced as compared to the application by their colleagues in smaller villages (p = 0,002). The use of troponin T testing was independent from age, sex, medical specialisation, duration of clinical experience and working time as general practitioner. In contrast only 35.5 % of the family physicians charged troponin T testings in 2007/08.
Conclusion: The troponin T testing is not extensively used in Bavarian family practices. However it is used more commonly in rural areas and smaller cities, which points out to a diagnostic relevance of troponin T testing in areas with a longer distance to cardiologists or to hospitals. Therefore subsequent controlled studies should be performed to establish the role of routine troponin T testing in a preclinical setting.