Optimal Utilization of Laboratory Testing

Obsolete Tests: Laboratory Directors' Opinions⁷

November 2011

Here's an example of obsolete tests. These are from the American Association of Clinical Chemistry, Clinical Laboratory News, in December of 2007. These are the laboratory directors' opinions. Notice that almost all will agree the LE cell test and the Schilling test are obsolete—65 and 61%, followed by the Free T4 index, prostatic acid phosphatase and Bence Jones Proteins. Notice also though, farther down this graph, you will see some even say that total amylase, AST and total phenytoin are all obsolete.

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• 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?