A Test-Ordering Algorithm Can Reduce Laboratory Test Use

Carson, K.S.; Murillo, Pamela; Runge, Alice; Vogel, D.; Baum, Linda G.

doi:10.1093/labmed/26.4.277

Cited by 2 publications

(2 citation statements)

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Section: Introductionmentioning

confidence: 99%

“…Testing algorithms use patient and laboratory data to identify the optimal testing strategy for a particular patient. They have reduced the utilization of a wide variety of tests (Carson et al 1995;Ness et al 1981;Roberts et al 1991) but can also increase laboratory utilization (Bell et al 1998;Randall & Jones 1997). Hepatitis serology testing is an ideal setting for a testing algorithm since the appropriate combination of antigens and antibodies required for diagnosis varies with both the virus and the stage of the infection.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The effect of a hepatitis serology testing algorithm on laboratory utilization

Walraven¹,

Goel²

2002

Evaluation Clinical Practice

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The effect of a hepatitis serology testing algorithm on laboratory utilization

Walraven¹,

Goel²

2002

Evaluation Clinical Practice

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show abstract

Influence of educational, audit and feedback, system based, and incentive and penalty interventions to reduce laboratory test utilization: a systematic review

Kobewka¹,

Ronksley

McKay

et al. 2015

Clinical Chemistry and Laboratory Medicine (CCLM)

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Laboratory and radiographic tests are often ordered unnecessarily. This excess testing has financial costs and is a burden on patients. We performed a systematic review to determine the effectiveness interventions to reduce test utilization by physicians. The MEDLINE and EMBASE databases were searched for the years 1946 through to September 2013 for English articles that had themes of test utilization and cost containment or optimization. Bibliographies of included papers were scanned to identify other potentially relevant studies. Our search resulted in 3236 articles of which 109 met the inclusion criteria of having an intervention aimed at reducing test utilization with results that could be expressed as a percent reduction in test use relative to the comparator. Each intervention was categorized into one or more non-exclusive category of education, audit and feedback, system based, or incentive or penalty. A rating of study quality was also performed. The percent reductions in test use ranged from a 99.7% reduction to a 27.7% increase in test use. Each category of intervention was effective in reducing test utilization. Heterogeneity between interventions, poor study quality, and limited time horizons makes generalizations difficult and calls into question the validity of results. Very few studies measure any patient safety or quality of care outcomes affected by reduced test use. There are numerous studies that use low investment strategies to reduce test utilization with one time changes in the ordering system. These low investment strategies are the most promising for achievable and durable reductions in inappropriate test use.

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A Test-Ordering Algorithm Can Reduce Laboratory Test Use

Cited by 2 publications

References 0 publications

The effect of a hepatitis serology testing algorithm on laboratory utilization

The effect of a hepatitis serology testing algorithm on laboratory utilization

Influence of educational, audit and feedback, system based, and incentive and penalty interventions to reduce laboratory test utilization: a systematic review

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