ArticleBMJ quality improvement reports2017
REDucing Unnecessary Coagulation Testing in the Emergency Department (REDUCED).
Article in BMJ quality improvement reports, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
7 citing papers in PubMed.
- A Retrospective Study of Adult and Pediatric D-Dimer Tests to Identify Opportunities for Improved Utilization.International journal of laboratory hematology · 2026Article
- Reducing unnecessary coagulation screening in ambulatory patients in the emergency departments of a multi-site trust: a quality improvement project.Cost effectiveness and resource allocation : C/E · 2026Article
- Evaluation of hemostasis understanding in medical and pharmacy students from a Parisian university.Research and practice in thrombosis and haemostasis · 2024Article
- Are We Overusing Coagulation Studies in the Emergency Department?Emergency medicine international · 2024Article
- Reducing use of coagulation tests in a family medicine practice setting: An implementation study.Research and practice in thrombosis and haemostasis · 2022Article
- Coagulation test understanding and ordering by medical trainees: Novel teaching approach.Research and practice in thrombosis and haemostasis · 2022Article
- Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The PT/INR (prothrombin time/international normalized ratio) and aPTT (activated partial thromboplastin time) were tests developed in the early 20th century for specific and unique indications. Despite this, they are often ordered together routinely. The objective of this study was to determine if a multimodal intervention could reduce PT/INR and aPTT testing in the emergency department (ED). This was a prospective multi-pronged quality improvement study at St. Michael's Hospital. The initiative involved stakeholder engagement, uncoupling of PT/INR and aPTT testing, teaching, and most importantly a revision to the ED order panels. After changes to order panels, weekly rates of PT/INR and aPTT testing per 100 ED patients decreased (17.2 vs 38.4, rate ratio=0.45 (95% CI 0.43-0.47), p<0.001; 16.6 vs 37.8, rate ratio=0.44 (95% CI 0.42-0.46), p<0.001, respectively). Rate of creatinine testing per 100 ED patients, our internal control, increased during the same period (54.0 vs 49.7, rate ratio=1.09 (95% CI 1.06-1.12); p<0.0001) while the weekly rate per 100 ED patients receiving blood transfusions slightly decreased (0.5 vs 0.7, rate ratio=0.66 (95% CI 0.49-0.87), p=0.0034). We found that a simple process change to order panels was associated with meaningful reductions in coagulation testing without obvious adverse effects.
Identifiers
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Registered trials
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.