目的：本研究的目的是检查抗核抗体（ANA）筛查试验与后续亚血清学试验（反射试验）在诊断全身性自身免疫性风湿性疾病（SARD）中的适当利用。
方法：我们于2019年1月至12月在学术教学医院对3003SARD测试订单进行了回顾性图表回顾。测试模式被归类为美国风湿病学会（ACR）推荐的反射测试，面板测试,或单一的亚血清学检测。我们描述了测试模式，评估了他们的诊断准确性，并探讨了与反射测试相关的因素。
结果：反射测试占SARD测试订单的79.7％，而不适当的测试(小组或单一亚血清学)占其他20.3%。与不适当的测试相比，反射测试与SARD诊断显着相关（P=.004）。测试模式与种族/民族显着相关（P=0.008），在西班牙裔和白人中，反射测试比不适当的测试频率低。
结论：总之，1/5(20.3%)的可疑SARD检测模式未遵循ACR推荐的反射检测指南.使用反射测试与SARD诊断频率增加有关。
OBJECTIVE: The aim of this study was to examine appropriate utilization of antinuclear antibody (ANA) screening tests with follow-up
subserology tests (reflex testing) for diagnosing systemic autoimmune rheumatic disorder (SARD).
METHODS: We conducted a retrospective chart review of 3003 SARD-test orders at an academic teaching hospital from January to December 2019. Testing patterns were categorized as American College of Rheumatology (ACR)-recommended reflex testing, panel testing, or single
subserology testing. We described testing patterns, assessed their diagnostic accuracy, and explored factors associated with reflex testing.
RESULTS: Reflex testing accounted for 79.7% of SARD test-ordering, whereas improper testing (panel or single
subserology) accounted for the other 20.3%. Reflex testing was associated with significantly more SARD diagnoses than improper testing (P = .004). Testing patterns were significantly associated with race/ethnicity (P = .008), with reflex testing being less frequent than improper testing in Hispanics and Whites.
CONCLUSIONS: In summary, one-fifth (20.3%) of testing patterns for suspected SARD did not follow the ACR-recommended guidelines for using reflex testing. Use of reflex testing was associated with an increased frequency of SARD diagnosis.
