ArticleClinical biochemistry2023
Targeting repetitive laboratory testing with electronic health records-embedded predictive decision support: A pre-implementation study.
Article in Clinical biochemistry, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- SmartAlert - Implementing Machine Learning-Driven Clinical Decision Support for Inpatient Laboratory Utilization Reduction.NEJM AI · 2026Article
- Predicting Laboratory Test Ordering in Emergency Departments Using Integrated Structured and Unstructured Electronic Health Records: Machine Learning Study.JMIR medical informatics · 2026Article
- [S1 guideline on sustainability in intensive care and emergency medicine].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Review
- Optimizing Intervention Sequences to Reduce Physician Blood Urea Nitrogen Test Overuse: A Multi-Hospital Analysis.Journal of general internal medicine · 2025Article
- Optimizing large language models for detecting symptoms of depression/anxiety in chronic diseases patient communications.NPJ digital medicine · 2025Article
- Real time machine learning prediction of next generation sequencing test results in live clinical settings.NPJ digital medicine · 2025Article
- Expectations of Intensive Care Physicians Regarding an AI-Based Decision Support System for Weaning From Continuous Renal Replacement Therapy: Predevelopment Survey Study.JMIR medical informatics · 2025Article
- Deep learning for cardiovascular management: optimizing pathways and cost control under diagnosis-related group models.Frontiers in artificial intelligence · 2025Review
- The promises and limitations of artificial intelligence for quality improvement, patient safety, and research in hospital medicine.Journal of hospital medicine · 2025Article
- DEPLOYR: a technical framework for deploying custom real-time machine learning models into the electronic medical record.Journal of the American Medical Informatics Association : JAMIA · 2023Article
- Probabilistic Prediction of Laboratory Test Information Yield.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2023Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
introductionUnnecessary laboratory testing contributes to patient morbidity and healthcare waste. Despite prior attempts at curbing such overutilization, there remains opportunity for improvement using novel data-driven approaches. This study presents the development and early evaluation of a clinical decision support tool that uses a predictive model to help providers reduce low-yield, repetitive laboratory testing in hospitalized patients.
methodsWe developed an EHR-embedded SMART on FHIR application that utilizes a laboratory test result prediction model based on historical laboratory data. A combination of semi-structured physician interviews, usability testing, and quantitative analysis on retrospective laboratory data were used to inform the tool's development and evaluate its acceptability and potential clinical impact. KEY
resultsPhysicians identified culture and lack of awareness of repeat orders as key drivers for overuse of inpatient blood testing. Users expressed an openness to a lab prediction model and 13/15 physicians believed the tool would alter their ordering practices. The application received a median System Usability Scale score of 75, corresponding to the 75th percentile of software tools. On average, physicians desired a prediction certainty of 85% before discontinuing a routine recurring laboratory order and a higher certainty of 90% before being alerted. Simulation on historical lab data indicates that filtering based on accepted thresholds could have reduced ∼22% of repeat chemistry panels.
conclusionsThe use of a predictive algorithm as a means to calculate the utility of a diagnostic test is a promising paradigm for curbing laboratory test overutilization. An EHR-embedded clinical decision support tool employing such a model is a novel and acceptable intervention with the potential to reduce low-yield, repetitive laboratory testing.
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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.