Authors' objectives: The number of immunohistochemistry (IHC) and electron microscopy tests (EM) carried out in Belgium has increased over the past few years. There is a lack of information on the main indications of such tests and on the basis on which decisions are made. With this in mind, the NIHDI approached KCE with a request to study this field. Our study aims to answer two research questions: 1. How are Immunohistochemistry (IHC) and Electron Microscopy (EM) diagnostic tests currently used in Belgium? A survey among Belgian anatomical pathology laboratories and an analysis of administrative data will be carried out to identify the most frequent clinical indications for these techniques and explore the basis on which decisions are made in this field. 2. What is the clinical value of these types of diagnostic tests? A comprehensive review of the clinical evidence (limited to systematic reviews and guidelines) will be performed for the most common indications. We hope this research will enable us to draw informed conclusions about the use of these techniques in the Belgian healthcare system, increasing transparency and understanding in the field.

Authors' recommendations: • Diagnostic EM use is commonly recommended in a limited number of indications: kidney disease (e.g. glomerulopathies), muscular diseases, and Primary Ciliary Diskinesia (PCD). • Except for PCD, few (high-quality) guidelines or systematic reviews were identified in our searches. • EM is recommended in the PCD diagnostic pathway and for the diagnosis of specific renal diseases (e.g. glomerulonephritis). In muscle pathology high-quality studies are lacking, but existing evidence supports the use of EM, particularly when genetic testing is inconclusive or other pathology techniques (e.g. LM) cannot provide an answer. In addition, EM is (only) recommended as a supportive tool for suspected EDS when first-line diagnostic methods did not yield clear results. When hypermobile EDS is suspected, this should be clinically diagnosed. • EM should be carried out in specialised centres

Project Status: Completed

URL for project: https://kce.fgov.be/en/ongoing-and-planned-projects/ongoing-projects/study-2021-01-hta-use-of-diagnostic-immunohistochemistry-and-electron-microscopy-tests-in-belgium

Year Published: 2024

URL for published report: https://doi.org/10.57598/R384C

URL for additional information: https://kce.fgov.be/en/publications/all-reports/diagnostic-immunohistochemistry-and-electron-microscopy-testing-in-belgium

English language abstract: An English language summary is available

Publication Type: Rapid Review

Country: Belgium

DOI: 10.57598/R384C

Organisation Name: Belgian Health Care Knowledge Centre

Contact Address: Administrative Centre Botanique, Doorbuilding (10th floor), Boulevard du Jardin Botanique 55, B-1000 Brussels, Belgium tel: +32 2 287 33 88 fax: +32 2 287 33 85

Contact Name: info@kce.fgov.be

Contact Email: info@kce.fgov.be

Copyright: <p>Belgian Health Care Knowledge Centre (KCE)</p>