Iberoamerican Journal of Medicine
https://app.periodikos.com.br/journal/iberoamericanjm/article/doi/10.5281/zenodo.5040646
Iberoamerican Journal of Medicine
Original article

Inappropriate laboratory testing requests: perspectives of clinical laboratory professionals

Solicitudes de pruebas de laboratorio inapropiadas: perspectivas de los profesionales del laboratorio clínico

Sultan Alasmari

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Abstract

Introduction: Laboratory examinations constitute a major factor in achieving the correct clinical diagnosis for patients. However, the ordering of unnecessary or inappropriate laboratory testing remains common, with consequent consumption of laboratory resources whether human or material. The present work evaluated the level of satisfaction of laboratory practitioners toward the appropriateness of laboratory tests ordered by physicians.
Methods: This cross-sectional study involved a total of 256 medical laboratory practitioners representing different qualifications and health care sectors, who answered several questions concerning their knowledge and attitudes toward inappropriate laboratory testing ordered by physicians.
Results: More than 85% of respondents agreed with the definition provided in the survey, which is substantially consistent with prior studies. More than 90% affirmed the associated drain on time and resources. However, discrepant responses were received concerning physician awareness of test availability, and participants reported laboratory staff arguments with physicians due to orders for unnecessary tests. Data showed that unnecessary orders were mainly requested by physicians of less experience.
Conclusions: Ultimately, dissatisfaction was manifest among clinical laboratory professionals, and educational interventions are required to moderate request behaviors.

Keywords

Inappropriate laboratory testing; Clinical laboratory professionals; Physicians

Resumen

Introducción: Los exámenes de laboratorio constituyen un factor importante para lograr el diagnóstico clínico correcto de los pacientes. Sin embargo, el pedido de pruebas de laboratorio innecesarias o inapropiadas sigue siendo común, con el consiguiente consumo de recursos de laboratorio, ya sean humanos o materiales. El presente trabajo evaluó el nivel de satisfacción de los profesionales de laboratorio con respecto a la idoneidad de las pruebas de laboratorio ordenadas por los médicos.
Métodos: Este estudio transversal involucró a un total de 256 médicos de laboratorio de diferentes calificaciones y sectores de atención de la salud, quienes respondieron varias preguntas sobre sus conocimientos y actitudes hacia las pruebas de laboratorio inapropiadas ordenadas por los médicos.
Resultados: Más del 85% de los encuestados estuvo de acuerdo con la definición proporcionada en la encuesta, que es sustancialmente consistente con estudios anteriores. Más del 90% afirmó la pérdida asociada de tiempo y recursos. Sin embargo, se recibieron respuestas discrepantes con respecto al conocimiento de los médicos sobre la disponibilidad de las pruebas, y los participantes informaron sobre las discusiones del personal del laboratorio con los médicos debido a las órdenes de pruebas innecesarias. Los datos mostraron que los pedidos innecesarios fueron solicitados principalmente por médicos con menos experiencia.
Conclusiones: En última instancia, la insatisfacción se manifestó entre los profesionales del laboratorio clínico y se requieren intervenciones educativas para moderar las conductas de solicitud.

Palabras clave

Test de laboratorio inapropiados; Profesionales clínicos de laboratorio; Médicos

References

1. Regan M, Forsman R. The impact of the laboratory on disease management. Dis Manag. 2006;9(2):122-30. doi: 10.1089/dis.2006.9.122.
2. Wians FH. Clinical Laboratory Tests: Which, Why, and What Do The Results Mean? Lab Med. 2009;40(2):105-13. doi: 10.1309/LM4O4L0HHUTWWUDD.
3. Lippi G, Bovo C, Ciaccio M. Inappropriateness in laboratory medicine: an elephant in the room? Ann Transl Med. 2017;5(4):82. doi: 10.21037/atm.2017.02.04.
4. Lippi G, Mattiuzzi C. The biomarker paradigm: between diagnostic efficiency and clinical efficacy. Pol Arch Med Wewn. 2015;125(4):282-8. doi: 10.20452/pamw.2788.
5. Beriault DR, Gilmour JA, Hicks LK. Overutilization in laboratory medicine: tackling the problem with quality improvement science. Crit Rev Clin Lab Sci. 2021:1-24. doi: 10.1080/10408363.2021.1893642.
6. Zhi M, Ding EL, Theisen-Toupal J, Whelan J, Arnaout R. The landscape of inappropriate laboratory testing: a 15-year meta-analysis. PLoS One. 2013;8(11):e78962. doi: 10.1371/journal.pone.0078962.
7. Vrijsen BEL, Naaktgeboren CA, Vos LM, van Solinge WW, Kaasjager HAH, Ten Berg MJ. Inappropriate laboratory testing in internal medicine inpatients: Prevalence, causes and interventions. Ann Med Surg (Lond). 2020;51:48-53. doi: 10.1016/j.amsu.2020.02.002.
8. Bindraban RS, Ten Berg MJ, Naaktgeboren CA, Kramer MHH, Van Solinge WW, Nanayakkara PWB. Reducing Test Utilization in Hospital Settings: A Narrative Review. Ann Lab Med. 2018;38(5):402-12. doi: 10.3343/alm.2018.38.5.402.
9. Levinson W, Kallewaard M, Bhatia RS, Wolfson D, Shortt S, Kerr EA, et al. 'Choosing Wisely': a growing international campaign. BMJ Qual Saf. 2015;24(2):167-74. doi: 10.1136/bmjqs-2014-003821.
10. Jalbert R, Gob A, Chin-Yee I. Decreasing daily blood work in hospitals: What works and what doesn't. Int J Lab Hematol. 2019;41 Suppl 1:151-61. doi: 10.1111/ijlh.13015.
11. Sedrak MS, Patel MS, Ziemba JB, Murray D, Kim EJ, Dine CJ, et al. Residents' self-report on why they order perceived unnecessary inpatient laboratory tests. J Hosp Med. 2016;11(12):869-72. doi: 10.1002/jhm.2645.
12. 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(974):823-9. doi: 10.1136/pgmj.2006.049551.
13. Morris TF, Ellison TL, Mutabagani M, Althawadi SI, Heppenheimer M. Demand management and optimization of clinical laboratory services in a tertiary referral center in Saudi Arabia. Ann Saudi Med. 2018;38(4):299-304. doi: 10.5144/0256-4947.2018.299.
14. Callender C ,Grasman SE. Barriers and Best Practices for Material Management in the Healthcare Sector. Eng Manag J. 2010;22(4):11-9. doi: 10.1080/10429247.2010.11431875.
15. Cadamuro J, Ibarz M, Cornes M, Nybo M, Haschke-Becher E, von Meyer A, et al. Managing inappropriate utilization of laboratory resources. Diagnosis (Berl). 2019;6(1):5-13. doi: 10.1515/dx-2018-0029.
16. Vrijsen B,Berg Mt,Naaktgeboren C,Vos L,Solinge Wv and Kaasjager K. 25 Physicians’ perceptions of inappropriate laboratory testing in clinically admitted patients. BMJ Evid-Based Med. 2018;23(Suppl 2):A11-A11. doi: 10.1136/bmjebm-2018-111070.25.


Submitted date:
05/18/2021

Reviewed date:
06/20/2021

Accepted date:
06/29/2021

Publication date:
06/29/2021

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