What proportion of common diagnostic tests appear redundant? Export

@article{citeulike:531890, abstract = {PURPOSE: To identify ancillary tests for which there are criteria defining the earliest interval at which a repeat test might be indicated, to determine how often each test is repeated earlier than these intervals and, if repeated, provides useful information. SUBJECTS AND METHODS: We performed a retrospective cohort study of 6,007 adults discharged from a large teaching hospital during a 3-month period in 1991. We measured the proportion of commonly performed diagnostic tests that were redundant, and their associated charges. RESULTS: Of the 6,007 patients discharged, 5,289 (88\%) had at least one of 12 target tests performed. Overall, 78,798 of the target tests were performed during the study period, of which 22,237 (28\%) were repeated earlier than test-specific predefined intervals. This percentage varied substantially by test (range, 2\% to 62\%). To assess how many early repeats were justified, we performed chart reviews in a random sample stratified by test. For two tests, nearly all the initial results in the sample were abnormal, and all repeats were considered justified. Of early repeats following a normal initial result for the remaining 10 tests, chart review found no clinical indication for 92\%, and a weighted mean of 40\% appeared redundant. Overall, 8.6\% of these 10 tests appeared redundant; if these were not performed, the annual charge reductions would be \$930,000 at our hospital, although the impact on costs would be much smaller. CONCLUSIONS: For some tests, an important proportion are repeated too early to provide useful clinical information. Most such tests might be eliminated using computerized reminder systems.}, address = {Center for Applied Medical Information Systems, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.}, author = {Bates, D. W. and Boyle, D. L. and Rittenberg, E. and Kuperman, G. J. and Ma'Luf, N. and Menkin, V. and Winkelman, J. W. and Tanasijevic, M. J.}, citeulike-article-id = {531890}, citeulike-linkout-0 = {http://view.ncbi.nlm.nih.gov/pubmed/9576410}, citeulike-linkout-1 = {http://www.hubmed.org/display.cgi?uids=9576410}, issn = {0002-9343}, journal = {Am J Med}, keywords = {cpoe, labs, notification, redundancy}, month = {April}, number = {4}, pages = {361--368}, posted-at = {2006-03-06 20:13:44}, priority = {2}, title = {What proportion of common diagnostic tests appear redundant?}, url = {http://view.ncbi.nlm.nih.gov/pubmed/9576410}, volume = {104}, year = {1998} }

TY - JOUR ID - citeulike:531890 L3 - citeulike-article-id:531890 N2 - PURPOSE: To identify ancillary tests for which there are criteria defining the earliest interval at which a repeat test might be indicated, to determine how often each test is repeated earlier than these intervals and, if repeated, provides useful information. SUBJECTS AND METHODS: We performed a retrospective cohort study of 6,007 adults discharged from a large teaching hospital during a 3-month period in 1991. We measured the proportion of commonly performed diagnostic tests that were redundant, and their associated charges. RESULTS: Of the 6,007 patients discharged, 5,289 (88%) had at least one of 12 target tests performed. Overall, 78,798 of the target tests were performed during the study period, of which 22,237 (28%) were repeated earlier than test-specific predefined intervals. This percentage varied substantially by test (range, 2% to 62%). To assess how many early repeats were justified, we performed chart reviews in a random sample stratified by test. For two tests, nearly all the initial results in the sample were abnormal, and all repeats were considered justified. Of early repeats following a normal initial result for the remaining 10 tests, chart review found no clinical indication for 92%, and a weighted mean of 40% appeared redundant. Overall, 8.6% of these 10 tests appeared redundant; if these were not performed, the annual charge reductions would be $930,000 at our hospital, although the impact on costs would be much smaller. CONCLUSIONS: For some tests, an important proportion are repeated too early to provide useful clinical information. Most such tests might be eliminated using computerized reminder systems. IS - 4 JF - Am J Med SN - 0002-9343 AD - Center for Applied Medical Information Systems, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. EP - 368 TI - What proportion of common diagnostic tests appear redundant? VL - 104 SP - 361 KW - cpoe KW - labs KW - notification KW - redundancy AU - Bates, DW AU - Boyle, DL AU - Rittenberg, E AU - Kuperman, GJ AU - Ma'Luf, N AU - Menkin, V AU - Winkelman, JW AU - Tanasijevic, MJ PY - 1998/04// UR - http://view.ncbi.nlm.nih.gov/pubmed/9576410 ER -