The Landscape of Inappropriate Laboratory Testing: A 15-Year Meta-Analysis

Ming Zhi, Eric L Ding, Jesse Theisen-Toupal, Julia Whelan and Ramy Arnaout

PLOS ONE, 2013, vol. 8, issue 11, 1-8

Abstract: Background: Laboratory testing is the single highest-volume medical activity and drives clinical decision-making across medicine. However, the overall landscape of inappropriate testing, which is thought to be dominated by repeat testing, is unclear. Systematic differences in initial vs. repeat testing, measurement criteria, and other factors would suggest new priorities for improving laboratory testing. Methods: A multi-database systematic review was performed on published studies from 1997–2012 using strict inclusion and exclusion criteria. Over- vs. underutilization, initial vs. repeat testing, low- vs. high-volume testing, subjective vs. objective appropriateness criteria, and restrictive vs. permissive appropriateness criteria, among other factors, were assessed. Results: Overall mean rates of over- and underutilization were 20.6% (95% CI 16.2–24.9%) and 44.8% (95% CI 33.8–55.8%). Overutilization during initial testing (43.9%; 95% CI 35.4–52.5%) was six times higher than during repeat testing (7.4%; 95% CI 2.5–12.3%; P for stratum difference

Date: 2013
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0078962

DOI: 10.1371/journal.pone.0078962

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