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What proportion of common diagnostic tests appear redundant?
D W Bates1, D L Boyle, E Rittenberg
1Center for Applied Medical Information Systems, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
The American Journal of Medicine
|May 12, 1998
Summary
Many diagnostic tests are repeated too soon, providing little clinical value. Implementing computerized reminders could help reduce unnecessary repeat testing and associated costs.
Area of Science:
- Medical Diagnostics
- Health Services Research
- Clinical Laboratory Science
Background:
- Diagnostic testing is a cornerstone of modern medicine.
- The frequency and timing of repeat testing are critical for effective patient management and resource allocation.
- Understanding patterns of test repetition is essential for optimizing healthcare efficiency.
Purpose of the Study:
- To identify diagnostic tests with established criteria for repeat intervals.
- To quantify the frequency of early repeat testing.
- To assess the clinical utility and redundancy of early repeat tests.
Main Methods:
- Retrospective cohort study of 6,007 adult patients.
- Analysis of 12 commonly performed diagnostic tests.
- Chart reviews to determine the justification of early repeat tests.
Main Results:
- 28% of 78,798 target tests were repeated earlier than recommended intervals.
- Early repeats varied significantly by test type (2% to 62%).
- For 10 tests with normal initial results, 92% of early repeats lacked clinical indication, with 40% deemed redundant, potentially saving $930,000 annually.
Conclusions:
- A significant proportion of diagnostic tests are repeated prematurely, offering limited clinical benefit.
- Computerized reminder systems show promise in reducing unnecessary early repeat testing.
- Optimizing repeat testing protocols can lead to substantial cost savings.
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