Reduction of unnecessary N-terminal pro-brain natriuretic peptide (NT-proBNP) tests: A further lesson in demand management

Reversing a trend towards overtesting in a department of internal medicine in Denmark

“…9 Reports by clinicians too have found substantially wasteful practices when auditing the use of specific biochemistry tests in more select patient populations. [10][11][12] Reports on physicians ordering test for a multitude of other reasons than patient care, 13 14 even ones perceived as unnecessary by themselves when ordered also support the notion of widespread unnecessary biochemistry testing. 15 A survey conducted by Laegevidenskalige Selskaber, the Danish umbrella organisation for Scientific Medical Societies, among the medical scientific societies as well as patient interest groups in May 2020 revealed the widespread conviction, that unnecessary testing is performed in the Danish healthcare system as well.…”

Primum non nocere: Demand management in pathology and preventing harm

“…The measurement of B‐type natriuretic peptide (BNP), currently an expensive assay in clinical biochemistry, has been addressed by previous work by Livingston et al in the UK which suggests that acute emergency units are a common source of these requests accounting for 11% of all BNP requests. However, many patients do not fulfil clinical diagnostic criteria for the presence of heart failure so it is likely these assays also would add to the low value group . All of these factors link back to user education and the likely availability of senior staff to review the appropriateness of requests …”

“…However, many patients do not fulfil clinical diagnostic criteria for the presence of heart failure so it is likely these assays also would add to the low value group. 36 All of these factors link back to user education and the likely availability of senior staff to review the appropriateness of requests. 23,26…”