“Curiously, the Sunbelt states of Arizona and Nevada have a high testing rate, in the 8.5%-10.7% range,” said Dr. Millard, a family physician who practices at Seaport Community Health Center in Belfast, Me. “Perhaps it’s because of snowbirds coming down from Canada to get tested. I don’t know. There are certainly lots of retirees in those two states. There are also high levels of testing in Illinois, Maryland, Rhode Island, and Delaware. I don’t have a hypothesis as to why there are variations, but that’s about 10% of all encounters associated with a vitamin D test in those states, which seems like quite a high number.”
The greatest proportion of tests occurred in patients over the age of 65 (39%) years, and about 70% of all vitamin D tests were conducted in females.
Fewer than 0.1% of tests were associated with a diagnosis of osteoporosis. The most common diagnoses associated with ordering of a vitamin D test were depression and falls. “This was particularly true in the elderly group, where falls became much more important, and depression slightly less,” Dr. Millard said. He noted that the EHR findings “don’t answer many questions but clearly the cost for [vitamin D] testing itself is significant. The amount of time my colleagues are spending doing tests and interpreting tests for patients [and] deciding what to do about those results is very considerable. In the long run, the research to resolve these issues may not be anywhere near as expensive as continuing to do what we’re doing now.”
Dr. Rosen and Dr. Millard reporting having no financial disclosures.
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