Laboratory Results That Should Be Ignored

Dirk M. Elston, MD


October 11, 2006


Laboratory results that should have been ignored commonly trigger a cascade of unnecessary testing. At the worst, they result in unnecessary surgery or the inappropriate use of a medication. Improvements in quality can be gained by addressing the entire testing cycle, both in clinical and anatomic pathology. Unambiguous communication with the clinician and common standards of language are essential in order to avoid bad outcomes. During training, clinicians are often admonished not to ignore laboratory results, and clinicians are naturally cautious when dealing with conditions that are potentially serious. A commonly cited motive for ordering additional laboratory tests is the perceived need to reassure the patient through further testing.[66] Interpretative reports and clinical decision support pathways can reduce unnecessary testing without adversely affecting patient outcomes.[43,67,68,69,70,71,72,73,74]

The College of American Pathologists continues to address questions of sensitivity, specificity, and predictive value of laboratory tests.[73] Clinical specialties have begun to address the undesirable consequences of incidental test results.[74] The time is ripe for joint efforts to improve quality. The establishment of standards will require significant investment by all stakeholders, but represents an opportunity to improve patient outcomes and reduce healthcare costs.


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