Evidence map›Paper›PMID 34861828›Full record

ArticleBMC family practice2021

Effect of a price display intervention on laboratory test ordering behavior of general practitioners.

Dennis M J Muris, Max Molenaers, Trang Nguyen, Paul W M P Bergmans, Bernadette A C van Acker, Mariëlle M E Krekels, Jochen W L Cals

Open access · goldAbstract read
In one paragraph

Article in BMC family practice, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 2 pooled it
–field-weighted citation impact, top 81% 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

2 citing papers in PubMed, 2 syntheses or guidelines pooled it, 3 citations in OpenAlex.

  1. Pooled it
  2. The effect of displaying laboratory test prices on physicians' ordering behaviour: a systematic review of European studies.The European journal of health economics : HEPAC : health economics in prevention and care · 2025
    Pooled it
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

7 authors at 3 institutions in 1 country.

Dennis M J MurisMCC Omnes Centre for Diagnostics and Innovation, Sittard, The Netherlands. dennismuris@mcc-omnes.nl.
Max MolenaersDepartment of Family Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University, PO BOX 616, 6200, MD, Maastricht, The Netherlands.
Trang NguyenDepartment of Family Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University, PO BOX 616, 6200, MD, Maastricht, The Netherlands.
Paul W M P BergmansMCC Omnes Centre for Diagnostics and Innovation, Sittard, The Netherlands.
Bernadette A C van AckerDepartment of Clinical Chemistry, Zuyderland Medical Centre, Sittard, The Netherlands.
Mariëlle M E KrekelsMCC Omnes Centre for Diagnostics and Innovation, Sittard, The Netherlands.
Jochen W L CalsDepartment of Family Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University, PO BOX 616, 6200, MD, Maastricht, The Netherlands.
Maastricht University · NLMedisch Coördinerend Centrum Omnes · NLZuyderland Medisch Centrum · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRedundant use of diagnostic tests in primary care has shown to be a contributor to rising Dutch healthcare costs. A price display in the test ordering system of the electronic health records (EHRs) could potentially be a low-cost and easy to implement intervention to a decrease in test ordering rate in the primary care setting by creating more cost-awareness among general practitioners (GPs). The aim of this study was to assess the effect of a price display for diagnostic laboratory tests in the EHR on laboratory test ordering behavior of GPs in the Westelijke Mijnstreek region in the Netherlands.

methodsA pre-post intervention study among 154 GPs working in 57 general practices was conducted from September 2019, until March 2020, in the Netherlands. The intervention consisted of displaying the costs of 22 laboratory tests at the time of ordering. The primary outcome was the mean test ordering rate per 1.000 patients per month, per general practice.

resultsTest ordering rates were on average rising prior to the intervention. The total mean monthly test order volume showed a non-statistically significant interruption in this rising trend after the intervention, with the mean monthly test ordering rate levelling out from 322.4 to 322.2 (P = 0.86). A subgroup analysis for solely individually priced tests showed a statistically significant decrease in mean monthly test ordering rate after implementation of the price display for the sum of all tests from 67.2 to 63.3 (P = 0.01), as well as for some of these tests individually (i.e. thrombocytes, ALAT, TSH, folic acid). Leucocytes, ESR, vitamin B12, anti-CCP and NT-proBNP also showed a decrease, albeit not statistically significant (P > 0.05).

conclusionsOur study suggests that a price display intervention is a simple tool that can alter physicians order behavior and constrain the expanding use of laboratory tests. Future research might consider alternative study designs and a longer follow-up period. Furthermore, in future studies, the combination with a multitude of interventions, like educational programs and feedback strategies, should be studied, while potentially adverse events caused by reduced testing should also be taken into consideration.

Indexed as

General PracticeGeneral PractitionersDiagnostic Tests, RoutineHumansPractice Patterns, Physicians'Diagnostic testsHealthcare costsPrimary careTest ordering rate

Identifiers

PMID34861828
PMCPMC8639847
OpenAlexW3215398939

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.