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CPE-009 · Missing data
B12-MISS-01: B12 needed
B12 needed. Evaluates macrocytosis, neurologic features, anemia or a higher-risk group.
Condition
- macrocytosis, neurologic features, anemia or a higher-risk group
- vitamin B12 not entered
What it reports
- The question cannot be answered without a vitamin B12 level
Diagnostic boundary
- Names what is needed.
Evidence
- EV-BSH-2014Devalia V, Hamilton MS, Molloy AM; British Committee for Standards in Haematology. Guidelines for the diagnosis and treatment of cobalamin and folate disorders. Br J Haematol. 2014;166(4):496-513.Supports: Diagnostic approach with serum B12, MMA and homocysteine Neurologic involvement means treatment should not wait for confirmation Folic acid alone must not be given while B12 deficiency is unexcluded
Cases where this rule fires
Open a case to see this rule fire with real inputs, then change the values until it stops.
B12-FX-04
Macrocytic anemia, folic acid ordered, no B12
A safety situation.
B12-FX-07
Macrocytosis in a patient with alcohol use disorder
MCV 104, B12 not measured.
B12-FX-12
A PPI for 30 months at age 72
Acid suppression and age.
B12-FX-14
Strict vegan diet
No B12 on file.
B12-FX-15
Bariatric surgery
No B12 on file.
B12-FX-24
Numb feet and unsteady, B12 never measured
Neurologic features without a level.
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