Optimal Utilization of Laboratory Testing

Overused/Misused Tests: Good Literature Support

November 2011

Now, let's take a look at the overuse and misused tests. There is actually good literature support to suggest that bleeding time, single-stranded DNA, Total T4, T3 uptake, thyroid testing in hospitalized patients and the Schilling test for pernicious anemia are no longer indicated. Now, what I'm talking about for thyroid testing in hospitalized patients is not patients who present to your emergency department with suspected thyrotoxicosis or myxedema. What I'm referring to instead is patients who have been hospitalized several days in your hospital and your physicians may request a test or thyroid testing. That's not the time to do thyroid testing.

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Jump to section:

• Introduction
• Objectives
• Assumptions to Forego
• Roger's Adopter Categories Based on Degree of Innovativeness¹
• Changes to Manual Requisitions^2,7
• Is This Test Misused?
• Overused/Misused Tests: Good Literature Support
• Bleeding Time³
• Anti–Single–Stranded DNA: Another Misused Test^4,5,6
• Use of Algorithms
• Laboratory Test Utilization
• Thyroid Testing Guidelines
• Thyroid Function Ordering Algorithm
• Pernicious Anemia Testing Guidelines
• Pernicious Anemia Testing Cascade
• Diarrhea Work Up Guidelines
• Parasitic Investigation of Stool Specimens Algorithm
• Obsolete Tests: Laboratory Directors' Opinions⁷
• Overused/Misused Tests — Opinion
• Frequency of Testing
• Newer Tests and Panels on the Horizon
• Hints on Improving Lab Utilization
• Hints on Improving Lab Utilization (2)
• Interventions to Improve Lab Utilization⁷
• Algorithm for Assessing Send–out Tests
• Improved Test Utilization: Assistance from Clinical Practice Committee
• Other Benefits of Clinical Practice Committee
• Summary
• References
• I Welcome Your Questions
• Questions?