ReviewAnnals of laboratory medicine2018
Reducing Test Utilization in Hospital Settings: A Narrative Review.
Review in Annals of laboratory medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07629219 (Optimization of Low-Value Medical Testing Practices in Hospitalized Patients in Argentina), which is not on this map. Cited by 30 papers, 2 of them syntheses that pooled 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.
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.
Optimization of Low-Value Medical Testing Practices in Hospitalized Patients in Argentina (OPTIMIZAR)
Who cites it
30 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Laboratory test ordering in inpatient hospitals: a systematic review on the effects and features of clinical decision support systems.BMC medical informatics and decision making · 2021Pooled it
- Strategies to reduce the use of low-value medical tests in primary care: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Pooled it
- De-implementation of unnecessary antibiotic use for upper respiratory tract infections in ambulatory HIV care in Mozambique: a two-arm parallel cluster-randomized controlled hybrid type II trial.Implementation science communications · 2026Article
- Article
- A Retrospective Study of Adult and Pediatric D-Dimer Tests to Identify Opportunities for Improved Utilization.International journal of laboratory hematology · 2026Article
- Article
- Clinical laboratory diagnostic stewardship as boundary infrastructure: a multi-stakeholder qualitative study of digital public health governance in two Chinese regional referral hospitals.Frontiers in public health · 2026Article
- Rationalising blood tests in a resource-limited emergency unit: A quality improvement project.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2025Article
- Do Laboratory Blood Tests Change Medical Care in Patients Hospitalized with Community-Acquired Pneumonia?Diagnostics (Basel, Switzerland) · 2024Article
- Interventions to improve appropriateness of laboratory testing in the intensive care unit: a narrative review.Annals of intensive care · 2024Review
- Article
- Managing Resource Utilization Cost of Laboratory Tests for Patients on Chemotherapy in Johns Hopkins Aramco Healthcare.Global journal on quality and safety in healthcare · 2023Article
- The impact of performance feedback reports on physician ordering behavior in the use of computed tomography pulmonary angiography (CTPA).Emergency radiology · 2023Article
- External Validation of a Laboratory Prediction Algorithm for the Reduction of Unnecessary Labs in the Critical Care Setting.The American journal of medicine · 2022Article
- Development and implementation of a clinician report to reduce unnecessary urine drug screen testing in the ED: a quality improvement initiative.Emergency medicine journal : EMJ · 2022Article
- Association Between Health System Factors and Utilization of Routine Laboratory Tests in Clinical Teaching Units: a Cohort Analysis.Journal of general internal medicine · 2022Article
- Article
- Current state of laboratory test utilization practices in the clinical laboratory.Academic pathology · 2022Article
- Effect of a price display intervention on laboratory test ordering behavior of general practitioners.BMC family practice · 2021Article
- Reducing Unnecessary Laboratory Utilization in the Medical ICU: A Fellow-Driven Quality Improvement Initiative.Critical care explorations · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundStudies addressing the appropriateness of laboratory testing have revealed approximately 20% overutilization. We conducted a narrative review to (1) describe current interventions aimed at reducing unnecessary laboratory testing, specifically in hospital settings, and (2) provide estimates of their efficacy in reducing test order volume and improving patient-related clinical outcomes.
methodsThe PubMed, Embase, Scopus, Web of Science, and Canadian Agency for Drugs and Technologies in Health-Health Technology Assessment databases were searched for studies describing the effects of interventions aimed at reducing unnecessary laboratory tests. Data on test order volume and clinical outcomes were extracted by one reviewer, while uncertainties were discussed with two other reviewers. Because of the heterogeneity of interventions and outcomes, no meta-analysis was performed.
resultsEighty-four studies were included. Interventions were categorized into educational, (computerized) provider order entry [(C)POE], audit and feedback, or other interventions. Nearly all studies reported a reduction in test order volume. Only 15 assessed sustainability up to two years. Patient-related clinical outcomes were reported in 45 studies, two of which found negative effects.
conclusionsInterventions from all categories have the potential to reduce unnecessary laboratory testing, although long-term sustainability is questionable. Owing to the heterogeneity of the interventions studied, it is difficult to conclude which approach was most successful, and for which tests. Most studies had methodological limitations, such as the absence of a control arm. Therefore, well-designed, controlled trials using clearly described interventions and relevant clinical outcomes are needed.
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What OpenQuestion holds
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.