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PubMed · 7101911

Common and correctable errors in diagnostic test ordering.

A R Martin
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Abstract

Diagnostic tests represent a significant percentage of medical costs. Knowledge of test ordering principles and a few testing strategies can significantly reduce unnecessary testing and costs. Awareness of the limitations of screening, less frequent monitoring of known abnormalities, reduced utilization of stat. tests and test panels and better use of existing information will improve the efficiency and accuracy of diagnostic testing.

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Diagnostic ServicesDiagnostic Tests, RoutineHealth Services MisuseUnited StatesJournal Article

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A R Martin. 1982. Common and correctable errors in diagnostic test ordering.. https://pubmed.ncbi.nlm.nih.gov/7101911/

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PubMed1995

Randomised controlled trial of routine individual feedback to improve rationality and reduce numbers of test requests.

Feedback can be described as a way to provide information on doctors' performance to enable changes in future behaviour. Feedback is used with the aim of changing test-ordering behaviour. It can lead to reductions in test usage and cost savings. It is not sufficiently clear, however, whether feedback leads to more appropriate test use. Since 1985, the Diagnostic Coordinating Center Maastricht has been giving feedback on diagnostic tests as a routine health care activity to all family doctors in its region. Both quantity and quality of requests are discussed. In a randomised, controlled trial over 2.5 years, discussion of tests not included previously was added to the existing routine feedback. One group of family doctors (n = 39) received feedback on test-group A (electrocardiography, endoscopy, cervical smears, and allergy tests), the other (n = 40) on test-group B (radiographic and ultrasonographic tests). Thus, each group of doctors acted as a control group for the other. Changes in volume and rationality of requests were analysed. The number of requests decreased during the trial (p = 0.036). Request numbers decreased particularly for test-group A (p = 0.04). The proportion of requests that were non-rational decreased more in the intervention than in the control groups (p = 0.009). Rationality improved predominantly for test-group B (p = 0.043). Thus, routine feedback can change the quantity and quality of requests.

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