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Related Experiment Video

Updated: Nov 16, 2025

Evaluation of a Point-of-Care Testing Analyzer for Measuring Peripheral Blood Leukocytes
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Frequency that Laboratory Tests Influence Medical Decisions.

Andy Ngo1, Paras Gandhi1, W Greg Miller1

  • 1Virginia Commonwealth University, Department of Pathology, Richmond, VA.

The Journal of Applied Laboratory Medicine
|February 27, 2021
PubMed
Summary

This study looked at how often laboratory tests are ordered during patient visits. It used electronic medical records from a large academic hospital to track test use across inpatient, emergency, and outpatient settings. The results showed that inpatient visits almost always included tests, while emergency and outpatient visits had lower but still significant rates. The study concluded that test use varies by care type and cannot be captured by a single percentage. These findings highlight the need for context-specific data when assessing diagnostic testing frequency in healthcare.

Keywords:
diagnostic testing patternsclinical decision supporthealthcare data analysismedical record review

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Area of Science:

  • Clinical decision-making in internal medicine
  • Healthcare utilization analysis in hospital settings
  • Diagnostic testing frequency in medical practice

Background:

Estimating how often laboratory tests impact medical decisions has remained a challenge. Prior research has shown that diagnostic testing is a key factor in clinical workflows. However, precise data on how frequently tests are ordered across different medical settings is limited. No prior work had resolved the variation in test use across inpatient, emergency, and outpatient care. This gap motivated the need for a study using real-world electronic medical records. Existing studies often rely on self-reported data or small samples, which may not reflect full healthcare systems. The researchers aimed to address this uncertainty by analyzing a large dataset of patient encounters. Their approach allowed them to track test ordering patterns across various clinical services.

Purpose Of The Study:

The goal was to estimate how often laboratory tests are ordered during patient encounters. The researchers focused on a comprehensive academic medical center's electronic medical records. They examined 72,196 encounters over four 1-week intervals in a year. The study aimed to determine the proportion of encounters with at least one laboratory test ordered. The researchers also wanted to compare test use across inpatient, emergency, and outpatient settings. This approach allowed them to assess variability in diagnostic testing frequency. Their objective was to provide data that could inform clinical practice and resource allocation. By analyzing a large and diverse patient population, they sought to capture real-world patterns of test utilization.

Main Methods:

The study used electronic medical records from a single academic medical center. Researchers extracted data from 72,196 patient encounters across four quarterly intervals. They categorized encounters into inpatient, emergency, and outpatient groups. For each encounter, they recorded whether laboratory tests were ordered. The dataset included a wide range of clinical conditions and services. No additional diagnostic tools or surveys were used in the analysis. The researchers focused on the presence or absence of laboratory orders. They calculated percentages of encounters with at least one test ordered per care type.

Main Results:

Overall, 35% of all patient encounters included at least one laboratory test. Inpatient encounters had the highest rate at 98%. Emergency department encounters followed with 56% of patients receiving tests. Outpatient visits had the lowest rate at 29%. These findings show significant variation across care settings. No single percentage could summarize test use across all services. The researchers observed that inpatient care almost always involved laboratory testing. Emergency and outpatient settings showed moderate and low test use, respectively.

Conclusions:

The study found that laboratory test use varies significantly by care setting. Inpatient encounters had nearly universal test ordering. Emergency and outpatient settings showed lower but still notable test use. The researchers concluded that a single frequency estimate is insufficient. Instead, test use depends on the type of medical service. These findings support the need for context-specific data in clinical decision-making. No prior work had resolved this variability in diagnostic testing patterns. The authors suggest that future research should explore factors driving these differences.

The study found that 98% of inpatient encounters included laboratory tests, compared to 56% in emergency departments and 29% in outpatient settings.

The researchers used electronic medical records from a single academic medical center over four quarterly intervals.

Test use varies significantly across inpatient, emergency, and outpatient care, so a single frequency estimate is not sufficient.

Approximately 29% of outpatient encounters had at least one laboratory test ordered.

Emergency departments had 56% test use, while inpatient care had 98%—a nearly twofold difference.

The authors suggest that test use depends on the type of medical service and cannot be summarized by a single number.