A computer based intervention to reduce unnecessary serologic testing

Journal of Rheumatology

Volumn 26, Issue 12, 1999, Pages 2578-2584

  Solomon, Daniel H ^a,b   Shmerling, Robert H ^c   Schur, Peter H ^a   Lew, Robert ^a   Fiskio, Julie ^b   Bates, David W ^b  

^a Division of Rheumatology   (United States)

^b BRIGHAM AND WOMEN S HOSPITAL   (United States)

^c BETH ISRAEL DEACONESS MEDICAL CENTER   (United States)

Author keywords

Antinuclear antibody; Complement system; Laboratory ordering; Medical informatics; Rheumatoid factor; Sensitivity; Specificity

Indexed keywords

ANTINUCLEAR ANTIBODY; COMPLEMENT; COMPLEMENT COMPONENT C3; COMPLEMENT COMPONENT C4; RHEUMATOID FACTOR;

ADULT; AGED; ALGORITHM; ARTICLE; COMPUTER ASSISTED DIAGNOSIS; CONTROLLED STUDY; FEMALE; HUMAN; LABORATORY TEST; MAJOR CLINICAL STUDY; MALE; MEDICAL DECISION MAKING; MIXED CONNECTIVE TISSUE DISEASE; PRIORITY JOURNAL; PROBABILITY; RHEUMATIC DISEASE; RHEUMATOID ARTHRITIS; SCLERODERMA; SEROLOGY; SJOEGREN SYNDROME; SYSTEMIC LUPUS ERYTHEMATOSUS;

ADULT; AGED; ANTIBODIES, ANTINUCLEAR; COMPLEMENT SYSTEM PROTEINS; DECISION MAKING; DIAGNOSIS, COMPUTER-ASSISTED; FEMALE; HUMANS; INFORMATION SYSTEMS; MALE; MEDICAL STAFF, HOSPITAL; MIDDLE AGED; PREDICTIVE VALUE OF TESTS; PROFESSIONAL PRACTICE; RHEUMATIC DISEASES; RHEUMATOID FACTOR; RHEUMATOLOGY; SENSITIVITY AND SPECIFICITY; SEROLOGIC TESTS; UNNECESSARY PROCEDURES;

EID: 0032751787     PISSN: 0315162X     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (49)

1. Schroeder SA, Kenders K, Cooper JK, Piemme TE. Use of laboratory tests and pharmaceuticals. Variation among physicians and effect of cost audit on subsequent use. JAMA 1973;225:969-73.
2. Eisenberg JM, Williams Steck-Vaughn E, Garner L, Viale R, Smits H. Computer-based audit to detect and correct overutilization of laboratory tests. Med Care 1977;15:915-21.
3. Schoenenberger RA, Tanasijevic MJ, Jha A, Bates DW. Appropriateness of antiepileptic drug level monitoring. JAMA 1995;274:1622-6.
4. Myers LP, Schroeder SA. Physician use of services for the hospitalized patient: a review with implications for cost-containment. Millbank Mem Fund Q 1981;59:481-507.
5. Daniels M, Schroeder SA. Variation among physicians in use of laboratory tests. II. Relation to clinical productivity and outcomes of care. Med Care 1977;15:482-7.
6. Epstein AM, McNeil BJ. Variations in ambulatory test use: what do they mean? Med Clin North Am 1987;71:705-17.
7. Shmerling RH, Delbanco TL. How useful is the rheumatoid factor? An analysis of sensitivity, specificity, and predictive value. Arch Intern Med 1992;152:2417-20.
8. Slater CA, Davis RB, Shmerling RH. Antinuclear antibody testing: a study of clinical utility. Arch Intern Med 1996;156:1421-5.
9. Casscells W, Schoenherger A, Graboys TB. Interpretation by physicians of clinical laboratory results. N Engl J Med 1978;299:999-1001.
10. Berwick DM, Fineberg HV, Weinstein MC. When doctors meet numbers. Am J Med 1981;71:991-8.
11. Gama R, Nightingale PG, Broughton PMG, et al. Modifying the request behaviour of clinicians. J Clin Pathol 1992;45:248-9.
12. Winkens RAG, Pop P, Grol RPTM, Kester ADM, Knottnerus JA. Effect of feedback on test ordering behaviour of general practitioners. BMJ 1992;304:1093-6.
13. Wones RG. Failure of low-cost audits with feedback to reduce laboratory test utilization. Med Care 1987;25:78-82.
14. Schectman JM, Elinsky EG, Pawlson LG. Effect of education and feedback on thyroid function testing strategies of primary care clinicians. Arch Intern Med 1991;151:2163-6.
15. Williams SV, Eisenberg JM. A controlled trial to decrease the unnecessary use of diagnostic tests. J Gen Intern Med 1986;1:8-13.
16. Marton KI, Tul V, Sox HC. Modifying test-ordering behavior in the outpatient medical clinic: a controlled trial of two educational interventions. Arch Intern Med 1985;145:816-21.
17. Schroeder SA, Myers LP, McPhee SJ, et al. The failure of physician education as a cost containment strategy: report of a prospective controlled trial at a university hospital. JAMA 1984;252:225-30.
18. Wachtel TJ, O'Sullivan PO. Practice guidelines to reduce testing in the hospital. J Gen Intern Med 1990;5:335-41.
19. Stiell I, Wells G, Laupacis A, et al. Multicentre trial to introduce the Ottawa ankle rules for use of radiography in acute ankle injuries. BMJ 1995;311:594-7.
20. Groopman DS, Powers RD. Effect of "standard order" deletion on emergency department coagulation profile use. Ann Emerg Med 1992;21:524-7.
21. Zaat JOM, van Eijk JTM, Bonte HA. Laboratory test form design influences test ordering by general practitioners in the Netherlands. Med Care 1992;30:189-98.
22. Sussman E, Goodwin P, Rosen H. Administrative change and diagnostic test use: the effect of eliminating standing orders. Med Care 1984;22:569-72.
23. Tierney WM, McDonald CJ, Hui SL, Martin DK. Computer predictions of abnormal test results: effects on outpatient testing. JAMA 1988;259:1194-8.
24. Eisenberg JM. Physician utilization. The state of research about physicians' practice patterns. Med Care 1985;23:461-83.
25. Axt-Adam P. Wouden JCVD, Does EVD. Influencing behavior of physicians ordering laboratory tests: a literature study. Med Care 1983;31:784-94.
26. Grossman RM. A review of physician cost-containment strategies for laboratory testing. Med Care 1983;21:783-801.
27. Solomon DH, Hashimoto H, Daltroy L, Liang MH. Techniques to improve physicians' use of diagnostic tests. A new conceptual framework. JAMA 1998;280:2020-7.
28. Hlatky M, Botvinick E, Brundage B. Diagnostic accuracy of cardiologists compared with probability calculations using Bayes' rule. Am J Cardiol 1982;49:1927-31.
29. Fryback DG, Thornbury JR. Evaluation of a computerized Bayesian model for diagnosis of renal cyst versus normal variant from excretory urogram information. Invest Radiol 1976;11:102-11.
30. Bates DW, Kuperman G, Teich JM. Computerized physician order entry and quality of care. Qual Manag Health Care 1994;2:18-27.
31. Lee F, Teich JM, Spurr CD, Bates DW. Implementation of physician order entry: user satisfaction and usage patterns. J Am Med Inform Assoc 1996;3:42-55.
32. Bates DW, Kuperman GJ, Rittenberg E, et al. A randomized trial of a computer based intervention to reduce utilization of redundant laboratory tests. Am J Med 1999;106:144-50.
33. Sox HC. Probability theory in the use of diagnostic tests: an introduction to critical study of the literature. Ann Intern Med 1986;104:60-6.
34. SAS Institute. Cary, North Carolina; 1989.
35. Sulcebe G, Morcka K. Diagnostic and prognostic significance of different antinuclear antibodies in more than 1000 consecutive Albanian patients with rheumatic diseases. Clin Exp Rheumatol 1992;10:255-61.
36. Hochberg MC, Boyd RE, Aheam JM, et al. Systemic lupus erythematosus: a review of clinico-laboratory features and immunogenetic markers in 150 patients with emphasis on demographic subsets. Medicine 1985;64:285-95.
37. Reichlin M, Harley JB. Antinuclear antibodies: an overview. In: Wallace DJ, Hahn BH, editors. Dubois' lupus erythematosus. 5th ed. Baltimore, MD: Williams & Wilkins; 1997.
38. Wolfe F, Cathey MA, Roberts FK. The latex test revisited: rheumatoid factor testing in 8287 rheumatic disease patients. Arthritis Rheum 1991;34:951-60.
39. Nimelstein SH, Brody S, McShane D, Holman HR. Mixed connective tissue disease: a subsequent evaluation of the original 25 patients. Medicine 1980;59:239-48.
40. Bloch KJ, Buchanan WW, Wohl MJ, Bunim JJ. Sjögren's syndrome: a clinical, pathological, and serological study of sixty-two cases. Medicine 1965;44:187-225.
41. Subcommittee for scleroderma criteria of the American Rheumatism Association. Preliminary criteria for the classification of systemic sclerosis (scleroderma). Arthritis Rheum 1980;23:581-90.
42. Eisenberg JM. Doctors, decisions, and the cost of medical care. Ann Arbor, MI: Health Administration Press; 1986.
43. Poses RM, Cebul RD, Collins M, Fager SS. The accuracy of experienced physicians' probability estimates for patients with sore throats. Implications for decision making. JAMA 1985;254:925-9.
44. Sox HC, Blatt MA, Higgins MC, Marton KI. Medical decision making. Stoneham, MA: Butterworth Publishers; 1988.
45. Kuperman GJ, Boyle D, Jha A, et al. How quickly are inpatients treated for critical laboratory results? J Am Med Inform Assoc 1998;5:112-9.
46. Tate KE, Gardner RM, Weaver LK. A computerized laboratory alerting system. MD Comput 1990;7:296-301.
47. Green LW, Kreuter MW. Health promotion planning: an educational and environmental approach. 2nd ed. Mountain View, CA: Mayfield Publishing Company; 1991.
48. Gans KM, Jack B, Lasater TM, Lefebvre RC, McQuade W, Carleton RA. Changing physicians' attitudes, knowledge, and self-efficacy regarding cholesterol screening and management. Am J Prev Med 1993;9:101-6.
49. Edwards W. Conservatism in human information processing. In: Kleinmuntz B, editor. Formal representation of human judgment. New York: Wiley; 1968.