Clinical value of microbiological investigations in general practice

The clinical value of many laboratory tests has frequently been queried. A short questionnaire was attached to individual microbiology reports issued to general practitioners in Bradford for an eight week period. Of the 2386 questionnaires sent out 1847 (77%) were returned. The general practitioners indicated that 34% of reports gave unexpected findings, 28% resulted in a change of therapy and most of the investigations (83%) were seen as beneficial to the patients. The majority of the specimens (56%) were mid-stream urine samples of which 77% gave negative findings. This study indicates that conventional microbiology test results are more valuable in general practice than previous hospital based surveys might suggest. Alternative strategies for investigation to reduce the number of tests of low value are discussed.