ArticleAnnals of medicine and surgery (2012)2020
Inappropriate laboratory testing in internal medicine inpatients: Prevalence, causes and interventions.
Article in Annals of medicine and surgery (2012), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed.
- Clinical decision support improves the appropriateness of laboratory test ordering in primary care without increasing diagnostic error: the ELMO cluster randomized trial.Implementation science : IS · 2020Trial
- Optimization of protein electrophoresis test orders: results after the implementation of a protocol based on scientific recommendations.Advances in laboratory medicine · 2026Article
- SmartAlert - Implementing Machine Learning-Driven Clinical Decision Support for Inpatient Laboratory Utilization Reduction.NEJM AI · 2026Article
- Novel approach to the codesign of a tailored intervention bundle: applying theory with pragmatism.BMJ open quality · 2026Article
- A narrative review of routine haematological and biochemical parameter monitoring in maintenance haemodialysis patients and comparison of clinical guidelines.BMC nephrology · 2026Review
- A multicentric intervention based on nudging for the reduction of potentially unnecessary laboratory tests: insights from a Swiss hospital network.BMC health services research · 2025Observational
- The Value of Enhancing Sonographic Phenotyping to Improve the Diagnostic Yield of Noninvasive Prenatal Diagnosis (NIPD) for Achondroplasia.Prenatal diagnosis · 2025Article
- Criteria for Routine Laboratory Blood Tests in Patients Hospitalized in Cardiology Departments.Diagnostics (Basel, Switzerland) · 2025Article
- Older hospitalised patients with a chief complaint of weakness and nonspecific presentations are not at risk of adverse health outcomes.Journal of evaluation in clinical practice · 2025Article
- A 5-step root cause analysis model for test overutilization: A study on its application to plasma transferrin testing.American journal of clinical pathology · 2024Article
- To test or to not test: A retrospective cross-sectional study on potentially inappropriate use of pathology testing in South Australian hospitals.American journal of clinical pathology · 2024Article
- Do Laboratory Blood Tests Change Medical Care in Patients Hospitalized with Community-Acquired Pneumonia?Diagnostics (Basel, Switzerland) · 2024Article
- Lab testing overload: a comprehensive analysis of overutilization in hospital-based settings.Proceedings (Baylor University. Medical Center) · 2024Review
- Patient, hospital and environmental costs of unnecessary bloodwork: capturing the triple bottom line of inappropriate care in general surgery patients.BMJ open quality · 2023Article
- Probabilistic Prediction of Laboratory Test Information Yield.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2023Article
- Association Between Health System Factors and Utilization of Routine Laboratory Tests in Clinical Teaching Units: a Cohort Analysis.Journal of general internal medicine · 2022Article
- Coagulation test understanding and ordering by medical trainees: Novel teaching approach.Research and practice in thrombosis and haemostasis · 2022Article
- Laboratory Test Utilization Practices in Hamad Medical Corporation; Role of Laboratory Supervisors and Clinicians in Improper Test Utilization; a Descriptive Pilot Study.Journal of multidisciplinary healthcare · 2022Article
- Laboratory Demand Management Strategies-An Overview.Diagnostics (Basel, Switzerland) · 2021Review
- Deep into Laboratory: An Artificial Intelligence Approach to Recommend Laboratory Tests.Diagnostics (Basel, Switzerland) · 2021Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo reduce overutilization of laboratory testing many interventions have been tried, but selecting the most effective intervention for a given setting is challenging. To be sustainable, interventions need to align with healthcare providers' needs and daily practices. This study aimed to assess the extent of overutilization and the perspectives of healthcare providers, which may be used to guide the choice of intervention.
methodsThe extent of inappropriate laboratory testing in internal medicine inpatients was evaluated using a database. Surveys and focus groups were used to investigate healthcare providers' perceptions on its causes and solutions.
resultsOn average, patients had 5.7 laboratory orders done during the first week of admission, whereas guidelines advise performing laboratory testing no more than twice per week. Repeat testing of normal test results occurred in up to 85% of patients. The frequency of laboratory testing was underestimated by survey responders, even though the majority of responders (78%) thought that laboratory tests are ordered too frequently. Residents were considered to be most responsible for laboratory test ordering.The primary causes of overutilization discussed were personal factors, such as a lack of awareness and knowledge, as well as feelings of insecurity. Regarding possible solutions, residents generally recommended educational interventions, whereas specialists tended to favour technical solutions such as lockouts.
conclusionInappropriate laboratory testing is common in internal medicine. The most important causes are a lack of awareness and knowledge, especially in residents. The intervention most favoured by residents is education, suggesting educational interventions may be most applicable.
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