Establishing benchmarks and metrics for disruptive technologies, inappropriate and obsolete tests in the clinical laboratory

Abstract

Benchmarks and metrics related to laboratory test utilization are based on evidence-based medical literature that may suffer from a positive publication bias. Guidelines are only as good as the data reviewed to create them. Disruptive technologies require time for appropriate use to be established before utilization review will be meaningful. Metrics include monitoring the use of obsolete tests and the inappropriate use of lab tests. Test utilization by clients in a hospital outreach program can be used to monitor the impact of new clients on lab workload. A multi-disciplinary laboratory utilization committee is the most effective tool for modifying bad habits, and reviewing and approving new tests for the lab formulary or by sending them out to a reference lab.

Creatine Kinase–MB

“…However, like many other tests, it has reached the end of its useful life and needs to be retired along with other tests, such as bleeding time, erythrocyte sedimentation rate, hemosiderin cells in urine, and prostatic acid phosphatase. 10,11 Troponins T and I are more cardiac specific than CK-MB and have been shown to be sensitive and specific markers for myocardial injury in general and ACS in particular. [12][13][14][15] Immunoassays for troponin have been adapted for point-of-care testing and have been deployed in emergency departments; however, given that even the point-of-care test is of moderate complexity, not all institutions have adopted this strategy.…”

Development of an Artificial Intelligence–Based Automated Recommendation System for Clinical Laboratory Tests: Retrospective Analysis of the National Health Insurance Database

“…A previous study in the UK reported that pathology investigations are involved in 70%-80% of all health care decisions and cost the UK National Health Service (NHS) £2.5 billion (US $4 billion) annually [19]. Proper utilization of limited resources and curbing numerous unnecessary laboratory tests will help reduce health care costs because approximately 2.9%-56% of all laboratory tests are reported to be likely overutilized [20]. About 30% of the outpatient laboratory tests were found to be inappropriate and ordered just for patient check-ups [21].…”

Pro- and anti-inflammatory response profile modulates Plasmodium falciparum malaria outcomes among subjects from Baiyeku, Ikorodu, Lagos, Nigeria.

“…Thick and thin blood lms for malaria diagnosis were made for each participant and examined under the light microscope for P. falciparum following the World Health Organization [14] procedure. Serum for ELISA assay was obtained by dispensing the blood into plain tube, allowed to clot and the serum separated [2]. Malaria parasite density MPD (Parasite per μl of blood) was calculated using the formula: Parasites per μl = number of parasites x 8000/number of leucocytes.…”

“…Available evidence indicates that the various stages of the malaria parasite life cycle elicit immune responses [1,2]. The pro-in ammatory cytokines tend to play an important role in preventing malaria and killing the parasites.…”