Preoperative laboratory testing: Implications of "Choosing Wisely" guidelines.

Area of Science:

• Anesthesiology
• Laboratory Medicine
• Healthcare Economics

Background:

• Preoperative laboratory testing is essential for diagnosis and treatment in many cases.
• However, routine testing in healthy individuals offers limited benefits and incurs significant costs, estimated at $18 billion annually in the U.S.
• Identifying wasteful practices in preoperative testing is crucial for healthcare efficiency.

Purpose of the Study:

• To review evidence and guidelines regarding preoperative laboratory testing.
• To identify potential wasteful practices and associated harms.
• To emphasize cost-consciousness among healthcare providers, particularly anesthesiologists.

Main Methods:

• Review of existing literature and Choosing Wisely guidelines.
• Analysis of clinical findings related to preoperative laboratory testing.
• Assessment of potential harms and wasteful practices.

Main Results:

• A targeted patient history and physical examination should primarily determine the need for preoperative laboratory studies.
• Routine testing in healthy patients is generally not beneficial and contributes to significant healthcare expenditure.
• Evidence suggests potential for reducing wasteful spending through judicious test ordering.

Conclusions:

• Healthcare providers should adopt a cost-conscious approach to ordering preoperative laboratory tests.
• Relying on comprehensive patient assessment can minimize unnecessary testing.
• Optimizing preoperative testing strategies can improve healthcare value and patient outcomes.