Optimal Utilization of Laboratory Testing

Overused/Misused Tests — Opinion

November 2011

Here's another example or overused or misused tests. These are in my opinion and based on the work that I have done with Dr. Fred Plapp who has developed some wonderful algorithms in the Kansas City area. Many sed rates, most uses of CKMB in the USA, most requests for ova and parasites, any low volume tests, especially if you are running more quality control samples than patient samples and large chemistry panels except for Medicare approved panels. Occasionally, you may hear a request from some of your doctors for a SMAC 20. Those are obsolete. Routine ordering of electrolytes, you think about that, if the patient is not on anti hypertensive medications there would be no reason to be checking electolytes in most outpatients. This is simply habit. Routine use of the CBC with differential instead of a CBC and routine use of rapid strep antigen test and throat culture if your physician intends to treat the patient regardless of the results and any other time when your tests add no value in this particular situation.

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Overused/Misused Tests Opinion

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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?