Discrepancies between knowledge and use of diagnostic studies in asymptomatic patients

The value of educational programs designed to promote optimal use of laboratory tests by physicians remains unsolved. To assess the effects of level of training and knowledge of test characteristics in determining laboratory ordering habits, physicians' use of laboratory tests as applied to asymptomatic patients was surveyed and their knowledge of four specific procedures was tested. The survey included 148 physicians both in training and in practice in Rochester, New York. Increased selectivity in the use of tests occurred during residency training, but selectivity correlated poorly with knowledge of test characteristics. These data underline the need for additional studies to determine the role of factors other than knowledge which contribute to the use of laboratory tests. Planners of cost containment programs and educational strategies will need to direct attention to these factors.