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Gastrointestinal (GI) diagnostic studies are pivotal in confirming, ruling out, diagnosing, or staging various diseases, including cancers. Following diagnosis, allocating time for discussions with the patient and providing informational resources is crucial. Diagnostic assessments of the GI tract often occur in outpatient settings like endoscopy suites or GI labs. Preparation for these tests may include dietary restrictions, fasting, liquid bowel preparations, laxatives, enemas, and the...
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Related Experiment Video

Updated: Jun 13, 2026

Three Laboratory Procedures for Assessing Different Manifestations of Impulsivity in Rats
09:12

Three Laboratory Procedures for Assessing Different Manifestations of Impulsivity in Rats

Published on: March 17, 2019

Reflex and reflective testing: efficiency and effectiveness of adding on laboratory tests.

Rajeev Srivastava1, William A Bartlett, Ian M Kennedy

  • 1Department of Biochemical Medicine, Ninewells Hospital & Medical School, Dundee, Scotland.

Annals of Clinical Biochemistry
|April 16, 2010
PubMed
Summary

Reflex and reflective testing improve diagnostic efficiency in laboratories. Optimizing reflex testing and diagnostic thresholds maximizes efficiency, while reflective testing offers complementary diagnostic value.

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Last Updated: Jun 13, 2026

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Published on: June 18, 2018

Area of Science:

  • Clinical Chemistry
  • Laboratory Medicine
  • Diagnostic Testing

Background:

  • Clinical utility of reflex and reflective testing remains underexplored.
  • Efficiency and effectiveness of these testing strategies require further investigation.

Purpose of the Study:

  • To evaluate the efficiency and effectiveness of reflex and reflective testing in specific biochemical scenarios.
  • To assess the impact of varying thyroid-stimulating hormone (TSH) thresholds on hyper- and hypothyroidism diagnosis.

Main Methods:

  • Prospective measurement of efficiency and effectiveness for hypovitaminosis D, hypomagnesaemia, hypothyroidism, hyperthyroidism, and haemochromatosis.
  • Analysis of TSH thresholds using a separate dataset to examine hyper- and hypothyroidism diagnosis outcomes.

Main Results:

  • Reflex testing generally yielded more diagnoses compared to reflective testing.
  • Predictive accuracy for 25-hydroxy-vitamin D deficiency was high (>90%) in older patients under specific conditions.
  • Diagnostic efficiency for hyper- and hypothyroidism plateaued outside the euthyroid TSH range, with declining effectiveness.

Conclusions:

  • Near-maximal efficiency in reflex testing is achievable through optimized reflex and diagnostic thresholds.
  • Reflex and reflective testing are complementary, with clinical utility dependent on the chosen initiators.