SynthesisBMJ quality & safety2022
Overuse of diagnostic testing in healthcare: a systematic review.
Synthesis in BMJ quality & safety, 2022. 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 83 papers, 1 of them a synthesis 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
83 citing papers in PubMed, 1 synthesis or guideline pooled it, 141 citations in OpenAlex.
- Overuse of computed tomography for mild head injury: A systematic review and meta-analysis.PloS one · 2024Pooled it
- Trial
- Requesting Diagnostic Imaging in Nurse Practitioner Practice: Results of a National Survey.Journal of clinical nursing · 2026Article
- Continuous imputation of blood gas and metabolic panel laboratory values in the intensive care unit using machine learning.Journal of clinical monitoring and computing · 2026Article
- De-implementation of routine laboratory testing in a surgical intensive care unit: lessons from a two-phase quality improvement initiative.BMJ open quality · 2026Article
- Between opportunity and equity: navigating medical tourism in Türkiye's public hospitals.BMC health services research · 2026Article
- Global under- and overprescribing of drugs-a scoping review.Naunyn-Schmiedeberg's archives of pharmacology · 2026Review
- CT sinus imaging utilization in Norway: trends over time and variation by region, age, and sex.Research in health services & regions · 2026Article
- Interdisciplinary Occupational Health System for Recovery From Musculoskeletal Injuries in US Army Personnel.JAMA network open · 2026Article
- Worry and Anxiety in the Era of Early Diagnosis and Disease Modifying Treatment for Alzheimer's Disease.Current psychiatry reports · 2026Review
- Inflammatory Stewardship-A Perspective for Active Management of Acute Inflammation.FASEB journal : official publication of the Federation of American Societies for Experimental Biology · 2026Article
- Article
- IMPACT Requests: Evaluating the Effectiveness of IMPACT Education for Emergency Department Referrers to Improve the Quality of CT Requests.Journal of medical radiation sciences · 2026Article
- Derivation and validation of clinical prediction models for viral etiologies of acute diarrhea in North American children presenting for emergency care.medRxiv : the preprint server for health sciences · 2026Article
- Artificial Intelligence in Oncology: A Comprehensive Cross-Cancer Translational Readiness Analysis Across 18 Malignancies.Cancers · 2026Review
- Why Most Australians Consider It Valuable to Find Harmless Abnormalities with Diagnostic Tests: A Mixed-Methods Study.Medical decision making : an international journal of the Society for Medical Decision Making · 2026Article
- Emergency physicians' perceptions and optimization strategies for diagnostic imaging overuse in Somalia.BMC emergency medicine · 2026Article
- Letter to the editor concerning "The burden and management of emergency room neurological consultation in hub and spoke Italian hospitals: the nationwide surveys of the Italian Association for Emergency Neurology (ANEU)".Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Article
- Trends in over- and under-screening for cervical cancer after EMR implementation in rural China.NPJ digital medicine · 2026Article
- Article
23 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOveruse of diagnostic testing substantially contributes to healthcare expenses and potentially exposes patients to unnecessary harm. Our objective was to systematically identify and examine studies that assessed the prevalence of diagnostic testing overuse across healthcare settings to estimate the overall prevalence of low-value diagnostic overtesting.
methodsPubMed, Web of Science and Embase were searched from inception until 18 February 2020 to identify articles published in the English language that examined the prevalence of diagnostic testing overuse using database data. Each of the assessments was categorised as using a patient-indication lens, a patient-population lens or a service lens.
results118 assessments of diagnostic testing overuse, extracted from 35 studies, were included in this study. Most included assessments used a patient-indication lens (n=67, 57%), followed by the service lens (n=27, 23%) and patient-population lens (n=24, 20%). Prevalence estimates of diagnostic testing overuse ranged from 0.09% to 97.5% (median prevalence of assessments using a patient-indication lens: 11.0%, patient-population lens: 2.0% and service lens: 30.7%). The majority of assessments (n=85) reported overuse of diagnostic testing to be below 25%. Overuse of diagnostic imaging tests was most often assessed (n=96). Among the 33 assessments reporting high levels of overuse (≥25%), preoperative testing (n=7) and imaging for uncomplicated low back pain (n=6) were most frequently examined. For assessments of similar diagnostic tests, major variation in the prevalence of overuse was observed. Differences in the definitions of low-value tests used, their operationalisation and assessment methods likely contributed to this observed variation.
conclusionOur findings suggest that substantial overuse of diagnostic testing is present with wide variation in overuse. Preoperative testing and imaging for non-specific low back pain are the most frequently identified low-value diagnostic tests. Uniform definitions and assessments are required in order to obtain a more comprehensive understanding of the magnitude of diagnostic testing overuse.
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Identifiers
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.