The admission urinalysis

Abstract

Although urinalysis is one of the most frequently ordered tests in primary care, its usefulness in screening has not been demonstrated. A retrospective review of 1,607 admission urinalyses for inpatients in a referral/community hospital identified 861 as clinically indicated and 746 as routine. Routine urinalyses were abnormal less frequently than clinically indicated urinalyses (18.1% vs 39.6%) and when abnormal, were responded to less often (33.3% vs 75.4%). Forty-five (6.0%) of the routine urinalyses yielded an abnormality that led to diagnostic action. Of these, 18 were normal on repeat testing and 17 were considered unlikely to represent significant disease. Therefore, only ten (1.3%) of the routine urinalyses affected patient therapy. In eight of these cases, the abnormality was pyuria, of which six proved to be asymptomatic bacteriuria. The admission urinalysis as a routine test had little impact on patient care in the authors' institution.

A Multicenter Cluster Randomized Controlled Trial of Strategies to Improve Thyroid Function Testing

“…Future research should now focus on the impact of TRF on under-prescription, ie, its potential for discouraging appropriate test use. 39 …”

Cost‐effective management of colon and rectal cancer

“…In a similar study Romfh [45] estimated that up to $330,000 could be saved in 15 military hospitals by eliminating unindicated tests. Routine tests that have been shown to be unnecessary except when clinically indicated include electrocardiograms [46], test of hemostatic function [44,45,47], biochemistry panels [44,46], urinalyses [48,49], and intravenous pyelograms [50,51]. Physicians must ask what they will learn from a given test, whether there is a simpler, less expensive way to learn the same thing and whether that knowledge will alter the approach to the patient.…”