Do not perform routine laboratory tests or screenings without a clear clinical question and within an inappropriate retesting interval.

Oct 15, 2025

Do not perform routine laboratory tests or screenings without a clear clinical question and within an inappropriate retesting interval.

Type of practice

Laboratory tests

Age

Adult, Geriatric, Pediatric

Topic Area

Laboratory Medicine

The issue of appropriateness in laboratory testing is central from the standpoint of environmental sustainability. Inappropriateness entails negative consequences, including interpretative errors and incidental findings leading to unnecessary interventions, increased workload, and both direct and indirect costs, with a consequent rise in greenhouse gas emissions, waste production, and water and air pollution. The “clear clinical question” constitutes the first step in the diagnostic process and the foundation for implementing robust Laboratory Medicine stewardship, both in diagnostic settings and in screening stricto sensu, as recommended by the WHO. There is no evidence that routine health checks or general screening programmes are effective in reducing morbidity and mortality from disease. Within a green laboratory framework, it is also essential to respect the minimum retesting interval for each examination, proper for the specific clinical context.

Sources

1. McAlister S, Barratt AL, Bell KJ, et al. The carbon footprint of pathology testing. Med J Aust 2020;212:377-82. doi: 10.5694/mja2.50583.
2. World Health Organization (WHO). Screening programmes: a short guide. Increase effectiveness, maximize benefits and minimize harm. https://iris.who.int/bitstream/handle/10665/330829/9789289054782-eng.pdf. (ultimo accesso: maggio 2025).
3. Krogsbøll LT, Jørgensen KJ, Gøtzsche PC. General health checks in adults for reducing morbidity and mortality from disease. Cochrane Database of Systematic Reviews 2019, Issue 1. Art. No.: CD009009. doi: 10.1002/14651858.CD009009.pub3.
4. Royal College of Pathologists. National Minimum Re-testing Interval Project. 2 version 2021. https://www.rcpath.org/static/253e8950-3721-4aa2-8ddd4bd94f73040e/g147_national-minimum_retesting_intervals_in_pathology.pdf. (ultimo accesso: maggio 2025).
5. CADTH and CW Canada. Advisory Panel Guidance on Minimum Retesting Intervals for Lab Tests. 2024. https://www.cda-amc.ca/sites/default/files/hta-he/HC0078_Guidance_Report_final.pdf (ultimo accesso: maggio 2025).

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Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.