Optimal Utilization of Laboratory Testing

Use of Algorithms

November 2011

The use of algorithms can be quite helpful. They can provide guidance and they may reduce unnecessary testing. They can lead to actual faster diagnosis sometimes physicians believe if they order everything as once. What I call spaghetti in a bowl approach. Put all your tests in a bowl of spaghetti, throw them against the wall and see what sticks. That actually could be very timely and cost ineffective. Instead if you follow a rational thorough algorithm that has been well thought out, that can help you to rule in or rule out the entity. Our test algorithms are available at www.mayomedicallaboratories.com. There are other algorithms that are locally developed that I'll tell you about later in this presentation.

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Use of Algorithms

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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?