Researchers from Beth Israel Deaconess Medical Center recently published a meta-analysis of 42 articles published between 1997 and 2012 years that specifically addressed appropriateness of laboratory tests [Zhia etal. PLOS ONE 2013;8(11)e78962, 1-8]. They determined the appropriateness of 1.6 million results of the 46 most commonly ordered tests. Using either permissive or restrictive review criteria, they determined that the rate of inappropriate laboratory test utilization ranged from 21% to 45%. Inappropriate testing occurred six times more often during initial orders than during repeat testing (44% vs 7%). Inappropriate testing was three times higher for low volume than high volume tests (32% vs 10%). In addition to overutilization, the authors also found a 45% rate of inappropriate underutilization. They did not detect a change in the appropriateness rate over the course of the 15 year study.
This recent study corroborates the findings of all of the previous studies that were discussed in a previous blog posted on September 20, 2013. Together, all of these studies have convincingly documented that the rate of appropriate test utiliization by physicians remains dismally low.