Evidence map›Paper›PMID 28808509›Full record

ArticleJournal of community hospital internal medicine perspectives2017

An educational intervention to increase awareness reduces unnecessary laboratory testing in an internal medicine resident-run clinic.

Erika Leung, Shuang Song, Omar Al-Abboud, Shahed Shams, John English, Wisam Naji, Yafei Huang, Leon Robison, Fred Balis, Hameem I Kawsar

Open access · goldAbstract read
In one paragraph

Article in Journal of community hospital internal medicine perspectives, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
3.0field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Pooled it
  2. The cost of unnecessary test orders: a retrospective study.Malawi medical journal : the journal of Medical Association of Malawi · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Erika LeungDepartment of Internal Medicine, St. Luke's Hospital, Chesterfield, MO, USA.
Shuang SongDepartment of Internal Medicine, St. Luke's Hospital, Chesterfield, MO, USA.
Omar Al-AbboudDepartment of Internal Medicine, St. Luke's Hospital, Chesterfield, MO, USA.
Shahed ShamsDepartment of Internal Medicine, St. Luke's Hospital, Chesterfield, MO, USA.
John EnglishDepartment of Internal Medicine, St. Luke's Hospital, Chesterfield, MO, USA.ORCID 0000-0003-0085-8114
Wisam NajiDepartment of Internal Medicine, St. Luke's Hospital, Chesterfield, MO, USA.
Yafei HuangDepartment of Internal Medicine, St. Luke's Hospital, Chesterfield, MO, USA.
Leon RobisonDepartment of Internal Medicine, St. Luke's Hospital, Chesterfield, MO, USA.
Fred BalisDepartment of Internal Medicine, St. Luke's Hospital, Chesterfield, MO, USA.ORCID 0000-0003-3360-7805
Hameem I KawsarDepartment of Internal Medicine, St. Luke's Hospital, Chesterfield, MO, USA.
St. Luke's Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

At our resident-run clinic in an underserved community, laboratory test costs in 2013 exceeded the government subsidy by $400 000. To optimize limited resources and improve patient care, an education program to reduce testing was implemented. Between November 2014 and January 2015, residents attended lectures on utilization of laboratory testing, focusing on standard practice guidelines, and analyses of unnecessary tests. Multivariate nonparametric statistical methods and subgroup analysis were used to evaluate cost reduction. There were 453 clinic visits during the intervention period and 471 visits during the control period. Lectures were independently associated with a significant laboratory cost reduction. Median laboratory cost per visit decreased from $106.00 to $74.00. Total cost in the study period decreased from $79 403 to $51 463. There were similar reductions of laboratory costs in two subgroups: age groups of <50 years and ≥50 years, new encounters, and follow-up visits . In the analysis of individual tests, the cost of TSH and Vitamin D tests had the greatest reduction ($8176 and $5088 respectively). An appropriate physician education program can reduce laboratory tests and costs. Screening tests with inadequate evidence support were reduced most, whereas those with proven benefits did not decrease significantly.

Indexed as

behavior modificationcost reductioneducational interventionLaboratory testingpatient careresidency

Identifiers

PMID28808509
PMCPMC5538247
OpenAlexW2736252485

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.