What Proportion of Common Diagnostic Tests Appear Redundant?

Bates, David W.; Boyle, Deborah L; Rittenberg, Eve; Kuperman, Gilad J.; Ma’Luf, Nell; Menkin, Valy; Winkelman, James W.; Tanasijevic, Milenko J.

doi:10.1016/s0002-9343(98)00063-1

Cited by 108 publications

(57 citation statements)

References 34 publications

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“…However, virtually all clinicians (92%) reported immediate improvement in this measure at study baseline, which has important implications for clinical efficiency, where lack of access to information often results in redundant test ordering and the resultant substantial cost implications. 30 This very early benefit might be used as a lever to hasten the conversion of clinicians resistant to accepting the electronic health record in the early phases of the implementation.…”

Section: Commentmentioning

confidence: 99%

Trends in Primary Care Clinician Perceptions of a New Electronic Health Record

et al. 2009

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Section: Commentmentioning

confidence: 99%

Trends in Primary Care Clinician Perceptions of a New Electronic Health Record

et al. 2009

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“…While some of this increase has provided clinical benefits, some also reflects inappropriate test ordering. [1][2][3][4] Repeat testing is a major, and growing, component of all laboratory testing, 5 with at least some likely to be unnecessary. 6 Although the repeat testing may be for relatively simple tests, the high volume of such tests makes the issue important.…”

Section: Introductionmentioning

confidence: 99%

The rise of cholesterol testing: how much is unnecessary

Doll

Shine²,

Kay³

et al. 2011

Br J Gen Pract

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Laboratory testing has increased dramatically over recent decades, which is a consequence particularly of repeat testing or monitoring, as either a response to treatment or follow-up. AimTo assess rates of measurement of lipid levels (total cholesterol, high-density lipoprotein, triglyceride) for diagnosis and monitoring over the last 20 years. Design of studyAudit of electronic database. SettingA single region in the UK (Oxfordshire). MethodSpecimens from individual patients were matched over time. All tests that were the third or more in a 3-year period were considered to be for monitoring, while the first and second were considered to be for diagnosis. As recent evidence-based recommendations suggest that frequent monitoring of cholesterol may reflect measurement error rather than true changes, between one and three tests in each 3-year period were considered to be 'necessary'. ResultsOver the 20 years from 1987 there has been a more than 15-fold rise in the overall number of lipid tests requested. After a small decline in the early 1990s, testing rose steadily after publication of several large statin trials, particularly tests requested in primary rather than secondary care. Repeat testing (likely to be for monitoring) rose from 24% of tests (1993-1995) to 61% (2005-2007) ConclusionIn the last decade, the number of cholesterol tests performed in Oxfordshire has risen dramatically. Much of this appears to be for monitoring purposes rather than case finding or risk assessment. The majority of cholesterol tests requested may be unnecessary.

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“…One component of these costs is the wide range and overwhelming number of diagnostic tests (2 ). Laboratory testing of hospitalized patients can be redundant when multiple providers order the same or similar tests for the same patient, contributing needlessly to the total healthcare costs (3)(4)(5).…”

Section: To the Editormentioning

confidence: 99%