Related Experiment Video
Updated: Jan 11, 2026

Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
Published on: August 9, 2024
Driving value in college health by transforming clinical decision-making with evidence-based laboratory standards:
Rachel G Kasdin1,2, Pasquale Frisina2, Gayathri Ganesan2
1Ichan School of Medicine at Mount Sinai, New York, New York, USA.
Objective:
Assess the impact of interventions on laboratory testing practices, focusing on alignment with evidence-based medicine (EBM), clinical decision-making, and value of care.
Participants:
Seventeen providers and 263 patients at a university health center.
Methods:
A retrospective chart review compared pre-intervention (1/1/20-2/28/20 and 7/1/21-11/29/21) and post-intervention (12/12/22-1/26/23) data. Signal detection theory (SDT) analysis evaluated changes in clinical decision-making. Cost analyses were based on Student Health Plan enrollees.
Results:
Non-EBM orders initially accounted for 39% of Chem-HDLs and 32% of CBCs, reducing to 4.5% and 16% outside EBM and lowering costs by 23% and 68%, respectively. SDT analysis revealed improvements in Chem-HDL discrimination, increasing from 0.40 to 0.99 (p < .05), with reduced miss rates (40.2% to 17.2%, p < .01).
Conclusions:
Standardizing laboratory testing aligns care with EBM, improves provider discrimination, and reduces costs. These findings highlight a model for enhancing clinical decision-making and optimizing preventive care in university health settings.
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