Diagnostic error is extremely common in the US and most likely worldwide. A major reason for the diagnostic error is both the overutilization and the underutilization of laboratory tests. Experts were given the rare opportunity to review cases in real time and in clinical context and immediately provide a consensus answer on test utilization.
In September 2015, the National Academy of Medicine, formerly the Institute of Medicine, issued a report on diagnostic error in America. The principal conclusion is that every adult American experiences at least one diagnostic error in a lifetime. One of the major contributing factors to diagnostic error is the failure to order the correct diagnostic tests. There is often significant controversy, even among experts about which tests should be included and which ones excluded from a laboratory evaluation. Generalizations are often made about test use by individuals, not a group of experts.
Scientists from the University of Texas Medical Branch, USA completed a study , published in the journal Diagnosis, with the rare opportunity to have multiple experts in diagnostic coagulation, and hear the clinical presentation of patients who are being evaluated in real time for bleeding or thrombotic disorders. These experts were able to provide an opinion about overutilization or underutilization of coagulation laboratory tests on a case-by-case basis in real time.
The results of this study indicate that experts hearing cases in clinical context found that overutilization and underutilization of laboratory tests pertaining to coagulation testing were present in about 78% of the cases, with 44% due to underutilization, 16% due to overutilization, and about 18% due to both. This causes an immense financial burden to a healthcare facility, and can cause serious clinical consequences.
The use of patient specific, expert driven interpretive comments by a diagnostic management team accompanying laboratory results helps physicians to more accurately request the correct, and only the correct laboratory tests, reducing delayed or missed diagnosis.
Read the original article here:
Mayukh K. Sarkar, Chad M. Botz, Michael Laposata: An assessment of overutilization and underutilization of laboratory tests by expert physicians in the evaluation of patients for bleeding and thrombotic disorders in clinical context and in real time, 20.01.2017