菜单
The skill recommends against routine 25(OH)D testing in adults with dark complexion. Use when a clinician considers ordering a 25(OH)D test for a patient with dark complexion lacking established indications for vitamin D testing.
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基于 SOC 职业分类
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| name | endo-against-25ohd-test-dark-complexion |
| description | The skill recommends against routine 25(OH)D testing in adults with dark complexion. Use when a clinician considers ordering a 25(OH)D test for a patient with dark complexion lacking established indications for vitamin D testing. |
Assess skin complexion (patient self-report, noting that race/ethnicity is an imperfect proxy for dark pigmentation) and review for established indications for 25(OH)D testing (e.g., hypocalcemia, malabsorption syndromes, renal osteodystrophy, anticonvulsant therapy, or history of fragility fractures). If no established indications are present, proceed to next step.
Is there an established indication for 25(OH)D testing?
Classify the scenario as routine 25(OH)D screening in an otherwise healthy adult with dark complexion and no established indications for testing.
Do not order a routine 25(OH)D test; instead, discuss dietary vitamin D sources and safe sun exposure, and consider empiric supplementation only if separate clinical indications exist (e.g., osteoporosis treatment) unrelated to complexion-based screening.
Do not equate race with skin pigmentation; avoid testing based solely on complexion due to high variability within racial groups. Do not use 25(OH)D levels to guide vitamin D dosing in absence of proven benefit. Recognize that low 25(OH)D may be expected but lacks evidence that repletion improves outcomes in this population. Do not apply this recommendation to patients with conditions altering vitamin D metabolism (e.g., chronic kidney disease, gastric bypass) where testing may be warranted.
A 48-year-old patient of West African descent presents for wellness visit, reports no bone pain or fractures, normal serum calcium, and requests a vitamin D level after reading online about deficiency risks. The clinician explains that routine screening is not recommended for dark complexion without indications, discusses dietary vitamin D and sun safety, and does not order the test.
Source: Vitamin D for the Prevention of Disease: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2024, https://doi.org/10.1210/clinem/dgae290