Redundant laboratory testing on referral from general practice to the outpatient clinic: a post-hoc analysis

Abstract

BackgroundInappropriately repeated laboratory testing is a commonly occurring problem. However, this has not been studied extensively in the outpatient clinic after referral by general practitioners.AimThe aim of this study was to investigate how often laboratory tests ordered by the general practitioner were repeated on referral to the outpatient clinic, and how many of the normal test results remained normal on repetition.Design & settingThis is a post hoc analysis of a study on laboratory testing strategies in patients newly referred to the outpatient clinic.MethodAll patients who had a referral letter including laboratory test results ordered by the general practitioner were included. These results were compared to the laboratory test results ordered in the outpatient clinic.ResultsData were available for 295 patients, 191 of which had post-visit testing done. In this group, 56% of tests ordered by the general practitioner were repeated. Tests with abnormal results were repeated more frequently than tests with normal results (65% vs 53%; P<0.001). A longer test interval was associated with slightly smaller odds of tests being repeated (OR 0.97 [0.95–0.99]; P=0.003). Of the tests with normal test results that were repeated, 90% remained normal. This was independent of testing interval or testing strategy.ConclusionLaboratory tests ordered by the general practitioner are commonly repeated on referral to the outpatient clinic. The number of test results remaining normal on repetition suggests a high level of redundancy in laboratory test repetition.