Ata F, Khan AA, Mohammad Nofal MZ, Abdelmahmuod EA, Fawad R, Al Mohanadi D, Dabbous Z. Improving diagnostic accuracy of 72-hour supervised fasting test for hypoglycemia evaluation: A quality improvement project. World J Methodol 2026; 16(2): 115150 [DOI: 10.5662/wjm.v16.i2.115150]
Corresponding Author of This Article
Fateen Ata, MD, MSc, Academic Fellow, Principal Investigator, Department of Internal Medicine, Cleveland Clinic Foundation, 9500 Cleveland Clinic, Cleveland, OH 44118, United States. docfateenata@gmail.com
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Endocrinology & Metabolism
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Opinion Review
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Jun 20, 2026 (publication date) through Apr 23, 2026
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World Journal of Methodology
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2222-0682
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Ata F, Khan AA, Mohammad Nofal MZ, Abdelmahmuod EA, Fawad R, Al Mohanadi D, Dabbous Z. Improving diagnostic accuracy of 72-hour supervised fasting test for hypoglycemia evaluation: A quality improvement project. World J Methodol 2026; 16(2): 115150 [DOI: 10.5662/wjm.v16.i2.115150]
World J Methodol. Jun 20, 2026; 16(2): 115150 Published online Jun 20, 2026. doi: 10.5662/wjm.v16.i2.115150
Improving diagnostic accuracy of 72-hour supervised fasting test for hypoglycemia evaluation: A quality improvement project
Fateen Ata, Adeel Ahmad Khan, Mohammad Zeyad Mohammad Nofal, Elabbass A Abdelmahmuod, Rabia Fawad, Dabia Al Mohanadi, Zeinab Dabbous
Fateen Ata, Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH 44118, United States
Adeel Ahmad Khan, Department of Internal Medicine, Cleveland Clinic Akron General Hospital, Akron, OH 44301, United States
Mohammad Zeyad Mohammad Nofal, Department of Internal Medicine, Hamad Medical Corporation, Doha 00000, Qatar
Elabbass A Abdelmahmuod, Dabia Al Mohanadi, Zeinab Dabbous, Endocrine Division, Hamad Medical Corporation, Doha 00000, Qatar
Rabia Fawad, Department of Medicine, Niazi Medical and Dental College, Sargodha 40100, Punjab, Pakistan
Author contributions: Ata F designed the project; Ata F, Khan AA, Mohammad Nofal MZ, Abdelmahmoud EA, Fawad R, Al Mohanadi D, and Dabbous Z did the literature review; Ata F, Abdelmahmoud EA, and Mohammad Nofal MZ collected data; Ata F and Khan AA analyzed the data; Ata F wrote the paper; Dabbous Z supervised the project. All authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Fateen Ata, MD, MSc, Academic Fellow, Principal Investigator, Department of Internal Medicine, Cleveland Clinic Foundation, 9500 Cleveland Clinic, Cleveland, OH 44118, United States. docfateenata@gmail.com
Received: October 9, 2025 Revised: October 20, 2025 Accepted: December 26, 2025 Published online: June 20, 2026 Processing time: 196 Days and 12.9 Hours
Core Tip
Core Tip: The 72-hour supervised fasting test is the cornerstone in evaluating fasting hypoglycemia, but remains vulnerable to procedural inconsistencies. This quality improvement project improved the diagnostic accuracy of the 72-hour supervised fasting test from 33.3% to 100% within two plan-do-study-act cycles. Key interventions included protocol standardization, an electronic medical records-integrated order bundle, targeted clinician and nursing education, and real-time clinical decision support prompts. These improvements were achieved without extending the length of stay, thus preserving patient flow. This project demonstrated promising sustainability and reproducibility in improving hypoglycemia evaluation, with multimodal effects on healthcare, including enhanced clinical outcomes, improved patient experiences, and potential cost reductions.
