Do not perform repetitive laboratory tests when patients show clinical and laboratory stability.

Do not perform repetitive laboratory tests when patients show clinical and laboratory stability.

Type of practice

Laboratory tests

Age

Adult, Geriatric, Pediatric

Topic Area

Hospital Internal Medicine

During hospitalization, internal medicine patients often undergo a high number of blood samples for lab tests, usually redundant and repetitive, resulting in further diagnostic procedures. Frequent blood sampling is responsible for iatrogenic anemia with consequent worsening health conditions in patients suffering from cardiovascular diseases. In order to reduce useless lab tests training, audit and feedback programs are indicated along with costs visualization, policy changes and laboratory information systems. It is up to the medical prescriber to strictly consider which lab test is useful and what is needlessly repetitive, even with close interactions with the doctor/laboratory director. There is no association between reduction in laboratory tests and increase in mortality.

Sources

1. Attali M, Barel Y, Somin M et al. A cost-effective method for reducing the volume of laboratory tests in a university-associated teaching hospital. Mt Sinai J Med. 2006;73:787-94. PMID: 17008940.
2. Salisbury AC, Reid KJ, Alexander KP et al. Diagnostic blood loss from phlebotomy and hospital-acquired anemia during acute myocardial infarction. Arch Intern Med. 2011;171:1646-53. doi: 10.1001/archinternmed.2011.361.
3. Yeshoua B, Bowman C, Dullea J, et al. Interventions to reduce repetitive ordering of low-value inpatient laboratory tests: a systematic review. BMJ Open Quality 2023;12:e002128. doi: 10.1136/bmjoq-2022-002128
4. Thurm M, Craggs H, Watts M, Brooks A. Reducing the number of unnecessary laboratory tests within hospital through the use of educational interventions. Ann Clin Biochem 2021;58:632-637. doi: 10.1177/00045632211040670.
5. Fondazione GIMBE. Strategie per ridurre la ripetizione dei test di laboratorio nei pazienti ospedalizzati. Evidence 2018;10: e1000185. https://www.evidence.it/articoli/pdf/e1000185.pdf. (last accessed March 2024).

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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.