ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2013
Temporal growth and geographic variation in the use of laboratory tests by NHS general practices: using routine data to identify research priorities.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Cost-Effectiveness of Routine Monitoring of Long-Term Conditions in Primary Care: Informing Decision Modelling with a Systematic Review in Hypertension, Type 2 Diabetes and Chronic Kidney Disease.PharmacoEconomics - open · 2024Pooled it
- Prevalence and outcomes of incidental imaging findings: umbrella review.BMJ (Clinical research ed.) · 2018Pooled it
- Trial
- Establishment and application of a preset dilution factor strategy for human chorionic gonadotropin testing in clinical laboratory.Frontiers in molecular biosciences · 2025Article
- Revolutionising Quality Management in the Oral Pathology Laboratory: A Deep Dive Into the Six Sigma Methodology.Cureus · 2024Review
- Trends in diagnostic tests ordered for children: a retrospective analysis of 1.7 million laboratory test requests in Oxfordshire, UK from 2005 to 2019.Archives of disease in childhood · 2023Article
- Data-driven approach to identifying potential laboratory overuse in general internal medicine (GIM) inpatients.BMJ open quality · 2023Article
- The Effect of the COVID-19 Pandemic on HbA1c Testing: Prioritization of High-Risk Cases and Impact of Social Deprivation.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2023Article
- Variation in laboratory testing for patients with long-term conditions: a longitudinal cohort study in UK primary care.BJGP open · 2023Article
- Choosing which in-hospital laboratory tests to target for intervention: a scoping review.Clinical chemistry and laboratory medicine · 2023Article
- Why Test study protocol: a UK-wide audit using the Primary Care Academic CollaboraTive (PACT) to explore the reasons for primary care testing.BJGP open · 2022Article
- Efficiency over thoroughness in laboratory testing decision making in primary care: findings from a realist review.BJGP open · 2021Article
- GP's perspectives on laboratory test use for monitoring long-term conditions: an audit of current testing practice.BMC family practice · 2020Article
- What methods are being used to create an evidence base on the use of laboratory tests to monitor long-term conditions in primary care? A scoping review.Family practice · 2020Article
- Determinants of Medical Practice Variation Among Primary Care Physicians: Protocol for a Three Phase Study.JMIR research protocols · 2020Article
- Educational intervention to optimise serum immunoglobulin test use in Irish primary care: an interrupted time series with segmented regression analysis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Article
- Practice variation in the use of tests in UK primary care: a retrospective analysis of 16 million tests performed over 3.3 million patient years in 2015/16.BMC medicine · 2018Article
- Temporal trends in use of tests in UK primary care, 2000-15: retrospective analysis of 250 million tests.BMJ (Clinical research ed.) · 2018Article
- Explaining variations in test ordering in primary care: protocol for a realist review.BMJ open · 2018Article
- Variation in diagnostic test requests and outcomes: a preliminary metric for OpenPathology.net.Scientific reports · 2018Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundLaboratory tests are extensively used for diagnosis and monitoring in UK primary care. Test usage by GPs, and associated costs, have grown substantially in recent years.
aimThis study aimed to quantify temporal growth and geographic variation in utilisation of laboratory tests. DESIGN AND
settingRetrospective cohort study using data from general practices in the UK.
methodData from the General Practice Research Database, including patient demographics, clinical details, and laboratory test results, were used to estimate rates of change in utilisation between 2005 and 2009, and identify tests with greatest inter-regional variation, by fitting random-effects Poisson regression models. The study also investigated indications for test requests, using diagnoses and symptoms recorded in the 2 weeks before each test.
resultsAround 660 000 tests were recorded in 230 000 person-years of follow-up. Test use increased by 24.2%, from 23 872 to 29 644 tests per 10 000 person-years, between 2005 and 2009. Tests with the largest increases were faecal occult blood (121%) and C-reactive protein (86%). There was substantial geographic variation in test utilisation; GPs in some regions requested tests such as plasma viscosity and cardiac enzymes at a rate more than three times the national average.
conclusionIncreases in the use of laboratory tests have substantial resource implications. Rapid increases in particular tests may be supported by evidence-based guidelines, but these are often vague about who should be tested, how often, and for how long. Substantial regional variation in test use may reflect uncertainty about diagnostic accuracy and appropriate indications for the laboratory test. There is a need for further research on the diagnostic accuracy, therapeutic impact, and effect on patient health outcomes of the most rapidly increasing and geographically variable tests.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.