Effectiveness of Practices to Support Appropriate Laboratory Test Utilization: A Laboratory Medicine Best Practices Systematic Review and Meta-Analysis

To evaluate the effectiveness of practices used to support appropriate clinical laboratory test utilization. This review followed the Centers for Disease Control and Prevention (CDC) Laboratory Medicine Best Practices A6 cycle method. Eligible studies assessed one of the following practices for effe...

Full description

Saved in:
Bibliographic Details
Published in:American journal of clinical pathology 2018-02, Vol.149 (3), p.197-221
Main Authors: Rubinstein, Matthew, Hirsch, Robert, Bandyopadhyay, Kakali, Madison, Bereneice, Taylor, Thomas, Ranne, Anne, Linville, Millie, Donaldson, Keri, Lacbawan, Felicitas, Cornish, Nancy
Format: Article
Language:English
Subjects:
Clinical Laboratory Techniques - standards
Clinical Laboratory Techniques - statistics & numerical data
Decision Support Systems, Clinical - standards
Decision Support Systems, Clinical - statistics & numerical data
Editor's Choice
Feedback
Humans
Laboratories
Medical Order Entry Systems - standards
Medical Order Entry Systems - statistics & numerical data
Morbidity
Practice Guidelines as Topic
Quality Assurance, Health Care - methods
Quality Improvement
Review
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by
cites
container_end_page 221
container_issue 3
container_start_page 197
container_title American journal of clinical pathology
container_volume 149
creator Rubinstein, Matthew
Hirsch, Robert
Bandyopadhyay, Kakali
Madison, Bereneice
Taylor, Thomas
Ranne, Anne
Linville, Millie
Donaldson, Keri
Lacbawan, Felicitas
Cornish, Nancy
description To evaluate the effectiveness of practices used to support appropriate clinical laboratory test utilization. This review followed the Centers for Disease Control and Prevention (CDC) Laboratory Medicine Best Practices A6 cycle method. Eligible studies assessed one of the following practices for effect on outcomes relating to over- or underutilization: computerized provider order entry (CPOE), clinical decision support systems/tools (CDSS/CDST), education, feedback, test review, reflex testing, laboratory test utilization (LTU) teams, and any combination of these practices. Eligible outcomes included intermediate, systems outcomes (eg, number of tests ordered/performed and cost of tests), as well as patient-related outcomes (eg, length of hospital stay, readmission rates, morbidity, and mortality). Eighty-three studies met inclusion criteria. Fifty-one of these studies could be meta-analyzed. Strength of evidence ratings for each practice ranged from high to insufficient. Practice recommendations are made for CPOE (specifically, modifications to existing CPOE), reflex testing, and combined practices. No recommendation for or against could be made for CDSS/CDST, education, feedback, test review, and LTU. Findings from this review serve to inform guidance for future studies.
doi_str_mv 10.1093/ajcp/aqx147
format article
fullrecord <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6016712</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2007982503</sourcerecordid><originalsourceid>FETCH-LOGICAL-p224t-b9c87cc30894d6e56ec959d8c19601bcc7a45a9ca83eab86221cba076e54bcdb3</originalsourceid><addsrcrecordid>eNpdkctv1DAQh60K1C5tT9yRJS5cQv1KHPdQaanKQ9oK1Mc5mjiz4FU2Tm1nYflH-Hfrir7gNBrNN5_mpyHkNWfvOTPyCFZ2PIKbX1zpHTLjRslCayFekBljTBSGa7lHXsW4YoyLmqldsieM0lwKNSN_zpZLtMltcMAYqV_SbwFybzHS5OnlNI4-JDofx-DH4CAhXUDrAyQftvQKY6LXyfXuNyTnh2M6fz4-x85ZNyD9cMc9iS-3MeE6b1h6gRuHPykMXaYTFPMB-m108YC8XEIf8fC-7pPrj2dXp5-LxddPX07ni2IUQqWiNbbW1kpWG9VVWFZoTWm62nJTMd5aq0GVYCzUEqGtKyG4bYHpjKrWdq3cJyd_vePUrrGzOKQAfZOjriFsGw-u-XcyuB_Nd79psr7SXGTBu3tB8DdTztmsXbTY9zCgn2IjGNOmFiWTGX37H7ryU8iBM8WrspI5xB315vlFj6c8_EzeAuyWnVo</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2165638943</pqid></control><display><type>article</type><title>Effectiveness of Practices to Support Appropriate Laboratory Test Utilization: A Laboratory Medicine Best Practices Systematic Review and Meta-Analysis</title><source>Oxford Journals Online</source><creator>Rubinstein, Matthew ; Hirsch, Robert ; Bandyopadhyay, Kakali ; Madison, Bereneice ; Taylor, Thomas ; Ranne, Anne ; Linville, Millie ; Donaldson, Keri ; Lacbawan, Felicitas ; Cornish, Nancy</creator><creatorcontrib>Rubinstein, Matthew ; Hirsch, Robert ; Bandyopadhyay, Kakali ; Madison, Bereneice ; Taylor, Thomas ; Ranne, Anne ; Linville, Millie ; Donaldson, Keri ; Lacbawan, Felicitas ; Cornish, Nancy</creatorcontrib><description>To evaluate the effectiveness of practices used to support appropriate clinical laboratory test utilization. This review followed the Centers for Disease Control and Prevention (CDC) Laboratory Medicine Best Practices A6 cycle method. Eligible studies assessed one of the following practices for effect on outcomes relating to over- or underutilization: computerized provider order entry (CPOE), clinical decision support systems/tools (CDSS/CDST), education, feedback, test review, reflex testing, laboratory test utilization (LTU) teams, and any combination of these practices. Eligible outcomes included intermediate, systems outcomes (eg, number of tests ordered/performed and cost of tests), as well as patient-related outcomes (eg, length of hospital stay, readmission rates, morbidity, and mortality). Eighty-three studies met inclusion criteria. Fifty-one of these studies could be meta-analyzed. Strength of evidence ratings for each practice ranged from high to insufficient. Practice recommendations are made for CPOE (specifically, modifications to existing CPOE), reflex testing, and combined practices. No recommendation for or against could be made for CDSS/CDST, education, feedback, test review, and LTU. Findings from this review serve to inform guidance for future studies.</description><identifier>ISSN: 0002-9173</identifier><identifier>EISSN: 1943-7722</identifier><identifier>DOI: 10.1093/ajcp/aqx147</identifier><identifier>PMID: 29471324</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Clinical Laboratory Techniques - standards ; Clinical Laboratory Techniques - statistics &amp; numerical data ; Decision Support Systems, Clinical - standards ; Decision Support Systems, Clinical - statistics &amp; numerical data ; Editor's Choice ; Feedback ; Humans ; Laboratories ; Medical Order Entry Systems - standards ; Medical Order Entry Systems - statistics &amp; numerical data ; Morbidity ; Practice Guidelines as Topic ; Quality Assurance, Health Care - methods ; Quality Improvement ; Review</subject><ispartof>American journal of clinical pathology, 2018-02, Vol.149 (3), p.197-221</ispartof><rights>Copyright Oxford University Press Feb 2018</rights><rights>American Society for Clinical Pathology, 2018. 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29471324$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rubinstein, Matthew</creatorcontrib><creatorcontrib>Hirsch, Robert</creatorcontrib><creatorcontrib>Bandyopadhyay, Kakali</creatorcontrib><creatorcontrib>Madison, Bereneice</creatorcontrib><creatorcontrib>Taylor, Thomas</creatorcontrib><creatorcontrib>Ranne, Anne</creatorcontrib><creatorcontrib>Linville, Millie</creatorcontrib><creatorcontrib>Donaldson, Keri</creatorcontrib><creatorcontrib>Lacbawan, Felicitas</creatorcontrib><creatorcontrib>Cornish, Nancy</creatorcontrib><title>Effectiveness of Practices to Support Appropriate Laboratory Test Utilization: A Laboratory Medicine Best Practices Systematic Review and Meta-Analysis</title><title>American journal of clinical pathology</title><addtitle>Am J Clin Pathol</addtitle><description>To evaluate the effectiveness of practices used to support appropriate clinical laboratory test utilization. This review followed the Centers for Disease Control and Prevention (CDC) Laboratory Medicine Best Practices A6 cycle method. Eligible studies assessed one of the following practices for effect on outcomes relating to over- or underutilization: computerized provider order entry (CPOE), clinical decision support systems/tools (CDSS/CDST), education, feedback, test review, reflex testing, laboratory test utilization (LTU) teams, and any combination of these practices. Eligible outcomes included intermediate, systems outcomes (eg, number of tests ordered/performed and cost of tests), as well as patient-related outcomes (eg, length of hospital stay, readmission rates, morbidity, and mortality). Eighty-three studies met inclusion criteria. Fifty-one of these studies could be meta-analyzed. Strength of evidence ratings for each practice ranged from high to insufficient. Practice recommendations are made for CPOE (specifically, modifications to existing CPOE), reflex testing, and combined practices. No recommendation for or against could be made for CDSS/CDST, education, feedback, test review, and LTU. Findings from this review serve to inform guidance for future studies.</description><subject>Clinical Laboratory Techniques - standards</subject><subject>Clinical Laboratory Techniques - statistics &amp; numerical data</subject><subject>Decision Support Systems, Clinical - standards</subject><subject>Decision Support Systems, Clinical - statistics &amp; numerical data</subject><subject>Editor's Choice</subject><subject>Feedback</subject><subject>Humans</subject><subject>Laboratories</subject><subject>Medical Order Entry Systems - standards</subject><subject>Medical Order Entry Systems - statistics &amp; numerical data</subject><subject>Morbidity</subject><subject>Practice Guidelines as Topic</subject><subject>Quality Assurance, Health Care - methods</subject><subject>Quality Improvement</subject><subject>Review</subject><issn>0002-9173</issn><issn>1943-7722</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNpdkctv1DAQh60K1C5tT9yRJS5cQv1KHPdQaanKQ9oK1Mc5mjiz4FU2Tm1nYflH-Hfrir7gNBrNN5_mpyHkNWfvOTPyCFZ2PIKbX1zpHTLjRslCayFekBljTBSGa7lHXsW4YoyLmqldsieM0lwKNSN_zpZLtMltcMAYqV_SbwFybzHS5OnlNI4-JDofx-DH4CAhXUDrAyQftvQKY6LXyfXuNyTnh2M6fz4-x85ZNyD9cMc9iS-3MeE6b1h6gRuHPykMXaYTFPMB-m108YC8XEIf8fC-7pPrj2dXp5-LxddPX07ni2IUQqWiNbbW1kpWG9VVWFZoTWm62nJTMd5aq0GVYCzUEqGtKyG4bYHpjKrWdq3cJyd_vePUrrGzOKQAfZOjriFsGw-u-XcyuB_Nd79psr7SXGTBu3tB8DdTztmsXbTY9zCgn2IjGNOmFiWTGX37H7ryU8iBM8WrspI5xB315vlFj6c8_EzeAuyWnVo</recordid><startdate>20180217</startdate><enddate>20180217</enddate><creator>Rubinstein, Matthew</creator><creator>Hirsch, Robert</creator><creator>Bandyopadhyay, Kakali</creator><creator>Madison, Bereneice</creator><creator>Taylor, Thomas</creator><creator>Ranne, Anne</creator><creator>Linville, Millie</creator><creator>Donaldson, Keri</creator><creator>Lacbawan, Felicitas</creator><creator>Cornish, Nancy</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20180217</creationdate><title>Effectiveness of Practices to Support Appropriate Laboratory Test Utilization: A Laboratory Medicine Best Practices Systematic Review and Meta-Analysis</title><author>Rubinstein, Matthew ; Hirsch, Robert ; Bandyopadhyay, Kakali ; Madison, Bereneice ; Taylor, Thomas ; Ranne, Anne ; Linville, Millie ; Donaldson, Keri ; Lacbawan, Felicitas ; Cornish, Nancy</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p224t-b9c87cc30894d6e56ec959d8c19601bcc7a45a9ca83eab86221cba076e54bcdb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Clinical Laboratory Techniques - standards</topic><topic>Clinical Laboratory Techniques - statistics &amp; numerical data</topic><topic>Decision Support Systems, Clinical - standards</topic><topic>Decision Support Systems, Clinical - statistics &amp; numerical data</topic><topic>Editor's Choice</topic><topic>Feedback</topic><topic>Humans</topic><topic>Laboratories</topic><topic>Medical Order Entry Systems - standards</topic><topic>Medical Order Entry Systems - statistics &amp; numerical data</topic><topic>Morbidity</topic><topic>Practice Guidelines as Topic</topic><topic>Quality Assurance, Health Care - methods</topic><topic>Quality Improvement</topic><topic>Review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rubinstein, Matthew</creatorcontrib><creatorcontrib>Hirsch, Robert</creatorcontrib><creatorcontrib>Bandyopadhyay, Kakali</creatorcontrib><creatorcontrib>Madison, Bereneice</creatorcontrib><creatorcontrib>Taylor, Thomas</creatorcontrib><creatorcontrib>Ranne, Anne</creatorcontrib><creatorcontrib>Linville, Millie</creatorcontrib><creatorcontrib>Donaldson, Keri</creatorcontrib><creatorcontrib>Lacbawan, Felicitas</creatorcontrib><creatorcontrib>Cornish, Nancy</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Source</collection><collection>ProQuest - Health &amp; Medical Complete保健、医学与药学数据库</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Biological Science Database</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>American journal of clinical pathology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rubinstein, Matthew</au><au>Hirsch, Robert</au><au>Bandyopadhyay, Kakali</au><au>Madison, Bereneice</au><au>Taylor, Thomas</au><au>Ranne, Anne</au><au>Linville, Millie</au><au>Donaldson, Keri</au><au>Lacbawan, Felicitas</au><au>Cornish, Nancy</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effectiveness of Practices to Support Appropriate Laboratory Test Utilization: A Laboratory Medicine Best Practices Systematic Review and Meta-Analysis</atitle><jtitle>American journal of clinical pathology</jtitle><addtitle>Am J Clin Pathol</addtitle><date>2018-02-17</date><risdate>2018</risdate><volume>149</volume><issue>3</issue><spage>197</spage><epage>221</epage><pages>197-221</pages><issn>0002-9173</issn><eissn>1943-7722</eissn><abstract>To evaluate the effectiveness of practices used to support appropriate clinical laboratory test utilization. This review followed the Centers for Disease Control and Prevention (CDC) Laboratory Medicine Best Practices A6 cycle method. Eligible studies assessed one of the following practices for effect on outcomes relating to over- or underutilization: computerized provider order entry (CPOE), clinical decision support systems/tools (CDSS/CDST), education, feedback, test review, reflex testing, laboratory test utilization (LTU) teams, and any combination of these practices. Eligible outcomes included intermediate, systems outcomes (eg, number of tests ordered/performed and cost of tests), as well as patient-related outcomes (eg, length of hospital stay, readmission rates, morbidity, and mortality). Eighty-three studies met inclusion criteria. Fifty-one of these studies could be meta-analyzed. Strength of evidence ratings for each practice ranged from high to insufficient. Practice recommendations are made for CPOE (specifically, modifications to existing CPOE), reflex testing, and combined practices. No recommendation for or against could be made for CDSS/CDST, education, feedback, test review, and LTU. Findings from this review serve to inform guidance for future studies.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>29471324</pmid><doi>10.1093/ajcp/aqx147</doi><tpages>25</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0002-9173
ispartof American journal of clinical pathology, 2018-02, Vol.149 (3), p.197-221
issn 0002-9173
1943-7722
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6016712
source Oxford Journals Online
subjects Clinical Laboratory Techniques - standards
Clinical Laboratory Techniques - statistics & numerical data
Decision Support Systems, Clinical - standards
Decision Support Systems, Clinical - statistics & numerical data
Editor's Choice
Feedback
Humans
Laboratories
Medical Order Entry Systems - standards
Medical Order Entry Systems - statistics & numerical data
Morbidity
Practice Guidelines as Topic
Quality Assurance, Health Care - methods
Quality Improvement
Review
title Effectiveness of Practices to Support Appropriate Laboratory Test Utilization: A Laboratory Medicine Best Practices Systematic Review and Meta-Analysis
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-10T10%3A32%3A32IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Effectiveness%20of%20Practices%20to%20Support%20Appropriate%20Laboratory%20Test%20Utilization:%20A%20Laboratory%20Medicine%20Best%20Practices%20Systematic%20Review%20and%20Meta-Analysis&rft.jtitle=American%20journal%20of%20clinical%20pathology&rft.au=Rubinstein,%20Matthew&rft.date=2018-02-17&rft.volume=149&rft.issue=3&rft.spage=197&rft.epage=221&rft.pages=197-221&rft.issn=0002-9173&rft.eissn=1943-7722&rft_id=info:doi/10.1093/ajcp/aqx147&rft_dat=%3Cproquest_pubme%3E2007982503%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-p224t-b9c87cc30894d6e56ec959d8c19601bcc7a45a9ca83eab86221cba076e54bcdb3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2165638943&rft_id=info:pmid/29471324&rfr_iscdi=true