Effectiveness of Practices to Support Appropriate Laboratory Test Utilization

Rubinstein, Matthew; Hirsch, Robert; Bandyopadhyay, Kakali; Madison, Bereneice; Taylor, Thomas; Ranne, Anne; Linville, Millie; Donaldson, Keri; Lacbawan, Felicitas; Cornish, Nancy E.

doi:10.1093/ajcp/aqx147

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Effectiveness of Practices to Support Appropriate Laboratory Test Utilization

Published Date:

Feb 17 2018

Publisher's site:

http://dx.doi.org/10.1093/ajcp/aqx147 New Site Icon

Source:

Am J Clin Pathol. 2018; 149(3):197-221.

Language:

English

[PDF-978.64 KB]

Details:

Personal Authors:

Rubinstein, Matthew ; Hirsch, Robert ; Bandyopadhyay, Kakali ; Madison, Bereneice ; Taylor, Thomas ; ... More ▼

Keywords:

[+]

Pubmed ID:

29471324

Pubmed Central ID:

PMC6016712

Description:

Objectives

To evaluate the effectiveness of practices used to support appropriate clinical laboratory test utilization.

Methods

This review followed the Centers for Disease Control and Prevention (CDC) Laboratory Medicine Best Practices A6 cycle method. Eligible studies assessed one of the following practices for effect on outcomes relating to over- or underutilization: computerized provider order entry (CPOE), clinical decision support systems/tools (CDSS/CDST), education, feedback, test review, reflex testing, laboratory test utilization (LTU) teams, and any combination of these practices. Eligible outcomes included intermediate, systems outcomes (eg, number of tests ordered/performed and cost of tests), as well as patient-related outcomes (eg, length of hospital stay, readmission rates, morbidity, and mortality).

Results

Eighty-three studies met inclusion criteria. Fifty-one of these studies could be meta-analyzed. Strength of evidence ratings for each practice ranged from high to insufficient.

Conclusion

Practice recommendations are made for CPOE (specifically, modifications to existing CPOE), reflex testing, and combined practices. No recommendation for or against could be made for CDSS/CDST, education, feedback, test review, and LTU. Findings from this review serve to inform guidance for future studies.

Document Type:

Journal Article

Collection(s):

CDC Public Access

Main Document Checksum:

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