Evidence map›Paper›PMID 37975596›Full record

ArticleAmerican journal of clinical pathology2024

To test or to not test: A retrospective cross-sectional study on potentially inappropriate use of pathology testing in South Australian hospitals.

Twisha R Banker, Marianne H Gillam, Peter O'Loughlin, Wayne Rankin, Richard Ryan, Connie Caruso, Elizabeth E Roughead

Open access · hybridAbstract read
In one paragraph

Article in American journal of clinical pathology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.4field-weighted citation impact, top 38% 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

3 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. Review
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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 2 institutions in 1 country.

Twisha R BankerQuality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, Australia.ORCID 0000-0001-8451-0160
Marianne H GillamQuality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, Australia.ORCID 0000-0003-0169-3964
Peter O'LoughlinSA Pathology, Adelaide, Australia.ORCID 0009-0002-0500-4433
Wayne RankinSA Pathology, Adelaide, Australia.ORCID 0000-0002-4427-9547
Richard RyanSA Pathology, Adelaide, Australia.ORCID 0000-0002-7083-0873
Connie CarusoUniSA Clinical and Health Sciences, University of South Australia, Adelaide, Australia.ORCID 0000-0001-7971-0651
Elizabeth E RougheadQuality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, Australia.ORCID 0000-0002-6811-8991
South Australia Pathology · AUUniversity of South Australia · AU

Funding

Hospital Research Foundation Group
6 · The paper itself

Abstract

objectivesTo measure rates of potentially inappropriate pathology testing in the hospital setting.

methodsRetrospective cross-sectional study in hospital setting from July 2021 to December 2021. We examined 3 potentially inappropriate uses: overordering, selection errors, and unnecessary repeat testing. Overordering included vitamin D and lipids (rarely required in acute hospital care). Selection error was the ratio of iron studies to standalone ferritin requests. Unnecessary repeats included any repeat vitamin D, lipids, iron, or ferritin in an episode of care or C-reactive protein (CRP) repeated within 3 days and N-terminal pro-brain natriuretic peptide (NT-proBNP) within 7 days and repeated previously abnormal CRP and NT-proBNP tests. Costs of inappropriate tests were estimated using the Australian Medicare Benefits Schedules.

resultsAmong 55,904 test requests, 15% (n = 8120) were potentially inappropriate. Vitamin D was frequently ordered (n = 4498), as were lipids (n = 2872). Ratio of iron studies to standalone ferritin was 36. Of 19,233 repeat CRPs, 36% (n = 6947) were within 3 days and 62% (n = 179) of repeat NT-proBNPs were within 7 days of the first test. For initially abnormal tests, 89% of CRPs and 97% of NT-proBNPs remained abnormal. Inappropriate test costs accounted for 12% to 30% of costs.

conclusionsFrequent potential inappropriate use and selection of pathology tests was observed in South Australian hospitals.

Indexed as

National Health ProgramsNatriuretic Peptide, BrainAgedAustraliaBiomarkersC-Reactive ProteinCross-Sectional StudiesFerritinsHospitalsHumansIronLipidsPeptide FragmentsRetrospective StudiesSouth AustraliaVitamin DBiomarkersC-Reactive ProteinFerritinsIronLipidsNatriuretic Peptide, BrainPeptide FragmentsVitamin Dclinical laboratory servicesclinical pathologyeducationhospital careinformaticsmanagement/administrationmedical laboratory sciencequality

Identifiers

PMID37975596
PMCPMC10988106
OpenAlexW4388762665

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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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.