Managing inappropriate utilization of laboratory resources

Diagnosis

Volumn 6, Issue 1, 2019, Pages 5-13

  Cadamuro, Janne ^a   Ibarz, Mercedes ^b   Cornes, Michael ^c   Nybo, Mads ^d   Haschke Becher, Elisabeth ^a   Von Meyer, Alexander ^e   Lippi, Giuseppe ^f   Simundic, Ana Maria ^g  

^a PARACELSUS MEDICAL UNIVERSITY   (Austria)

^b HOSPITAL ARNAU DE VILANOVA   (Spain)

^c WORCESTERSHIRE ACUTE HOSPITALS NHS TRUST   (United Kingdom)

^d ODENSE UNIVERSITY HOSPITAL   (Denmark)

^e Kliniken Nordoberpfalz AG   (Germany)

^f UNIVERSITY OF VERONA   (Italy)

^g Sveti Duh General Hospital   (Croatia)

Author keywords

inappropriateness of laboratory utilization; overutilization; postanalytics; preanalytics; test demand management

Indexed keywords

ADULT; ARTICLE; CAUSE OF DEATH; CLINICIAN; DELAYED DIAGNOSIS; DRUG SAFETY; HUMAN; LABORATORY TEST; MEDICAL ERROR; PATIENT CARE; PATIENT SAFETY; DIAGNOSTIC TEST; ECONOMICS; HEALTH CARE PLANNING; HEALTH SERVICE; LABORATORY;

DIAGNOSTIC TESTS, ROUTINE; HEALTH RESOURCES; HUMANS; LABORATORIES; MEDICAL OVERUSE;

EID: 85061140932     PISSN: 21948011     EISSN: 2194802X     Source Type: Journal    
DOI: 10.1515/dx-2018-0029     Document Type: Review

References (65)

1. Lippi G, Plebani M. The add value of laboratory diagnostics: the many reasons why decision-makers should actually care. J Lab Prec Med 2017;2:1-4.
2. Orth M, Averina M, Chatzipanagiotou S, Faure G, Haushofer A, Kusec V, et al. Opinion: redefining the role of the physician in laboratory medicine in the context of emerging technologies, personalised medicine and patient autonomy ('4P medicine'). J Clin Pathol 2017:1-7. doi: 10.1136/jjclinpath-2017-204734.
3. Roffi M, Patrono C, Collet JP, Mueller C, Valgimigli M, Andreotti F, et al. 2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: task force for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J 2016;37:267-315.
4. American Diabetes Association. Standards of Medical Care in Diabetes - 2015. Diabetes Care 2015;38(Suppl 1):S1-S93.
5. de Koning TJ, Jongbloed JD, Sikkema-Raddatz B, Sinke RJ. Targeted next-generation sequencing panels for monogenetic disorders in clinical diagnostics: the opportunities and challenges. Expert Rev Mol Diagn 2015;15:61-70.
6. Plebani M, Panteghini M. Promoting clinical and laboratory interaction by harmonization. Clin Chim Acta 2014;432:15-21.
7. Cadamuro J, Gaksch M, Wiedemann H, Lippi G, von Meyer A, Pertersmann A, et al. Are laboratory tests always needed? Frequency and causes of laboratory overuse in a hospital setting. Clin Biochem 2018;54:85-91.
8. Meidani Z, Farzandipour M, Farrokhian A, Haghighat M. A review on laboratory tests' utilization: a trigger for cutting costs and quality improvement in health care settings. Med J Islam Repub Iran 2016;30:365.
9. van Walraven C, Naylor CD. Do we know what inappropriate laboratory utilization is? A systematic review of laboratory clinical audits. J Am Med Assoc 1998;280:550-8.
10. Rao GG, Crook M, Tillyer ML. Pathology tests: is the time for demand management ripe at last? J Clin Pathol 2003;56: 243-8.
11. Larsson A, Palmer M, Hulten G, Tryding N. Large differences in laboratory utilisation between hospitals in Sweden. Clin Chem Lab Med 2000;38:383-9.
12. Salinas M, Lopez-Garrigos M, Diaz J, Ortuno M, Yago M, Laiz B, et al. Regional variations in test requiring patterns of general practitioners in Spain. Ups J Med Sci 2011;116:247-51.
13. Freedman D. Towards better test utilization - strategies to improve physician ordering and their impact on patient outcomes. eJIFCC 2015;26:15-30.
14. Zhi M, Ding EL, Theisen-Toupal J, Whelan J, Arnaout R. The landscape of inappropriate laboratory testing: a 15-year metaanalysis. PLoS One 2013;8:e78962.
15. Lippi G, Mattiuzzi C, Plebani M. Stat testing utilization in clinical laboratories. National survey of Italian Society of Clinical Biochemistry and Molecular Biology (SIBioC). Clin Chem Lab Med 2014;52:e79-84.
16. Gandhi TK, Kachalia A, Thomas EJ, Puopolo AL, Yoon C, Brennan TA, et al. Missed and delayed diagnoses in the ambulatory setting: a study of closed malpractice claims. Ann Intern Med 2006;145:488-96.
17. Singh H, Meyer AN, Thomas EJ. The frequency of diagnostic errors in outpatient care: estimations from three large observational studies involving US adult populations. BMJ Qual Saf 2014;23:727-31.
18. Slawomirski L, Auraaen A, Klazinga N. The economics of patient safety - strengthening a value-based approach to reducing patient harm at national level: Organisation for Economic Cooperation and Development - OECD; 2017. Available at: https:// www.oecd.org/els/health-systems/The-economics-of-patientsafety- March-2017.pdf. Accessed: 15 Jan 2018.
19. Makary MA, Daniel M. Medical error-the third leading cause of death in the US. Br Med J 2016;353:i2139.
20. World Health Organisation. WHO - Global Health Expenditure Database. Available at: http://apps.who.int/nha/database. Accessed: 20 Apr 2018.
21. European Diagnostic Manufacturers Association. European IVD Market Statistics Report 2011-2015. Available at: http://www. medtecheurope.org/EU-IVD-market-stats-rep-2016. Accessed: 20 Apr 2018.
22. Studdert DM, Mello MM, Sage WM, Des Roches CM, Peugh J, Zapert K, et al. Defensive medicine among high-risk specialist physicians in a volatile malpractice environment. J Am Med Assoc 2005;293:2609-17.
23. Ortashi O, Virdee J, Hassan R, Mutrynowski T, Abu-Zidan F. The practice of defensive medicine among hospital doctors in the United Kingdom. BMC Med Ethics 2013;14:1-6.
24. van der Horst A, van de Wijngaart DJ, Scherrenburg J, van Dijk N, Janssens PM. Practical motives are prominent in test-ordering in the Emergency Department. Clin Chem Lab Med 2017;55:1523-9.
25. Laposata M. Putting the patient first - using the expertise of laboratory professionals to produce rapid and accurate diagnoses. Lab Med 2014;45:4-5.
26. Janssens PM. Managing the demand for laboratory testing: options and opportunities. Clin Chim Acta 2010;411:1596-602.
27. Han SJ, Saigal R, Rolston JD, Cheng JS, Lau CY, Mistry RI, et al. Targeted reduction in neurosurgical laboratory utilization: resident-led effort at a single academic institution. J Neurosurg 2014;120:173-7.
28. Plebani M. Towards a new paradigm in laboratory medicine: the five rights. Clin Chem Lab Med 2016;54:1881-91.
29. Plebani M. Quality and future of clinical laboratories: the Vico's whole cyclical theory of the recurring cycles. Clin Chem Lab Med 2018;56:901-8.
30. Jackson BR. Managing laboratory test use: principles and tools. Clin Lab Med 2007;27:733-48.
31. Fryer AA, Smellie WS. Managing demand for laboratory tests: a laboratory toolkit. J Clin Pathol 2013;66:62-72.
32. Hoffmann GE, Aufenanger J, Fodinger M, Cadamuro J, von Eckardstein A, Kaeslin-Meyer M, et al. Benefits and limitations of laboratory diagnostic pathways. Diagnosis 2014;1:269-76.
33. Roshanov PS, You JJ, Dhaliwal J, Koff D, Mackay JA, Weise-Kelly L, et al. Can computerized clinical decision support systems improve practitioners' diagnostic test ordering behavior? A decision-maker-researcher partnership systematic review. Implement Sci 2011;6:88.
34. Luo Y, Szolovits P, Dighe AS, Baron JM. Using machine learning to predict laboratory test results. Am J Clin Pathol 2016;145:778-88.
35. Thakkar RN, Kim D, Knight AM, Riedel S, Vaidya D, Wright SM. Impact of an educational intervention on the frequency of daily blood test orders for hospitalized patients. Am J Clin Pathol 2015;143:393-7.
36. Wertheim BM, Aguirre AJ, Bhattacharyya RP, Chorba J, Jadhav AP, Kerry VB, et al. An educational and administrative intervention to promote rational laboratory test ordering on an academic general medicine service. Am J Med 2017;130:47-53.
37. Fang DZ, Sran G, Gessner D, Loftus PD, Folkins A, Christopher JY, 3rd, et al. Cost and turn-around time display decreases inpatient ordering of reference laboratory tests: a time series. BMJ Qual Saf 2014;23:994-1000.
38. Miyakis S, Karamanof G, Liontos M, Mountokalakis TD. Factors contributing to inappropriate ordering of tests in an academic medical department and the effect of an educational feedback strategy. Postgrad Med J 2006;82:823-9.
39. Choosing wisely project (USA). Available at: http://www.choosingwisely. org/. Accessed: 7 May 2018.
40. Lab Tests Online. Available at: https://labtestsonline.org/. Accessed: 7 May 2018.
41. Quality Use of Pathology Program (Australia). Available at: http://www.health.gov.au/qupp. Accessed: 7 May 2018.
42. van Walraven C, Raymond M. Population-based study of repeat laboratory testing. Clin Chem 2003;49:1997-2005.
43. Driskell OJ, Holland D, Hanna FW, Jones PW, Pemberton RJ, Tran M, et al. Inappropriate requesting of glycated hemoglobin (Hb A1c) is widespread: assessment of prevalence, impact of national guidance, and practice-to-practice variability. Clin Chem 2012;58:906-15.
44. Lang T, Croal B. National minimum retesting intervals in pathology. London: The Royal College of Pathologists, 2015. Contract No.: G147.
45. Pelloso M, Basso D, Padoan A, Fogar P, Plebani M. Computerbased- limited and personalised education management maximise appropriateness of vitamin D, vitamin B12 and folate retesting. J Clin Pathol 2016;69:777-83.
46. Waldron JL, Ford C, Dobie D, Danks G, Humphrey R, Rolli A, et al. An automated minimum retest interval rejection rule reduces repeat CRP workload and expenditure, and influences clinicianrequesting behaviour. J Clin Pathol 2014;67:731-3.
47. Lippi G, Brambilla M, Bonelli P, Aloe R, Balestrino A, Nardelli A, et al. Effectiveness of a computerized alert system based on retesting intervals for limiting the inappropriateness of laboratory test requests. Clin Biochem 2015;48:1174-6.
48. Kyrle PA, Eichinger S. Deep vein thrombosis. Lancet 2005;365:1163-74.
49. Kristoffersen AH, Ajzner E, Rogic D, Sozmen EY, Carraro P, Faria AP, et al. Is D-dimer used according to clinical algorithms in the diagnostic work-up of patients with suspicion of venous thromboembolism? A study in six European countries. Thromb Res 2016;142:1-7.
50. Greinacher A. Clinical practice. Heparin-induced thrombocytopenia. N Engl J Med 2015;373:252-61.
51. Cadamuro J, Mrazek C, Wiedemann H, Felder TK, Oberkofler H, Haschke-Becher E, et al. Effectiveness of a laboratory gate-keeping strategy to overcome inappropriate test utilization for the diagnosis of heparin-induced thrombocytopenia. Semin Thromb Hemost 2017;43:645-8.
52. Salinas M, Lopez-Garrigos M, Asencio A, Leiva-Salinas M, Lugo J, Leiva-Salinas C. Laboratory utilization improvement through a computer-aided algorithm developed with general practitioners. Clin Chem Lab Med 2015;53:1391-7.
53. Salinas M, Lopez-Garrigos M, Asencio A, Batlle E, Minguez M, Lugo J, et al. Strategy to improve the request of uric acid in primary care: preliminary results and evaluation through process and outcome appropriateness indicators. Clin Biochem 2014;47:467-70.
54. Elnenaei MO, Campbell SG, Thoni AJ, Lou A, Crocker BD, Nassar BA. An effective utilization management strategy by dual approach of influencing physician ordering and gate keeping. Clin Biochem 2016;49:208-12.
55. Smellie WS. Time to harmonise common laboratory test profiles. Br Med J 2012;344:e1169.
56. Collinson PO, van Dieijen-Visser MP, Pulkki K, Hammerer-Lercher A, Suvisaari J, Ravkilde J, et al. Evidence-based laboratory medicine: how well do laboratories follow recommendations and guidelines? The Cardiac Marker Guideline Uptake in Europe (CARMAGUE) study. Clin Chem 2012;58:305-6.
57. Jardine R, Dalby A, Klug E, Vermaak W. Consensus statement on the use of high sensitivity cardiac troponins. ASA Heart Journal 2012;9:210-5.
58. Harvey HB, Sotardi ST. The pareto principle. J Am Coll Radiol 2018;15:931.
59. Penaloza A, Verschuren F, Meyer G, Quentin-Georget S, Soulie C, Thys F, et al. Comparison of the unstructured clinician gestalt, the wells score, and the revised Geneva score to estimate pretest probability for suspected pulmonary embolism. Ann Emerg Med 2013;62:117-24.
60. Cervellin G, Borghi L, Lippi G. Do clinicians decide relying primarily on Bayesians principles or on Gestalt perception? Some pearls and pitfalls of Gestalt perception in medicine. Intern Emerg Med 2014;9:513-9.
61. Cadamuro J, Gaksch M, Mrazek C, Haschke-Becher E, Plebani M. How do we use the data from pre-analytical quality indicators and how should we? J Lab Precis Med 2018;3:1-9.
62. Salinas M, Lopez-Garrigos M, Flores E, Leiva-Salinas M, Asencio A, Lugo J, et al. Managing inappropriate requests of laboratory tests: from detection to monitoring. Am J Manag Care 2016;22:e311-6.
63. Sciacovelli L, Panteghini M, Lippi G, Sumarac Z, Cadamuro J, Galoro CA, et al. Defining a roadmap for harmonizing quality indicators in Laboratory Medicine: a consensus statement on behalf of the IFCC Working Group "Laboratory Error and Patient Safety" and EFLM Task and Finish Group "Performance specifications for the extra-analytical phases". Clin Chem Lab Med 2017;55:1478-88.
64. Plebani M, Astion ML, Barth JH, Chen W, de Oliveira Galoro CA, Escuer MI, et al. Harmonization of quality indicators in laboratory medicine. A preliminary consensus. Clin Chem Lab Med 2014;52:951-8.
65. Lippi G, Bovo C, Ciaccio M. Inappropriateness in laboratory medicine: an elephant in the room? Ann Transl Med 2017;5:82.