[Proffered opinion forum medical decision making, impact on laboratory tests]

Raising medical expenditure is a universal problem. The Japanese government started taking measures not to increase medical expenses in the recent years. Laboratory tests are no exception. Therefore we as clinical pathologists have reevaluated laboratory tests from the primary care situations to more advanced stages of clinical medicine. As the first step, we formed a subcommittee to effective by utilize laboratory tests and agreed to establish the "essential lab tests". Essential lab tests are made of qualitative bed side tests (type I) and slightly advanced tests (type II) and these tests are to be done on every patient at their first clinic visit. These tests are also to be performed parallel to physical examination and history-taking. The results revealed 50% and 90% positivities on the type I and type II tests, which indicate rather effective means for making an initial impression.