Antiquated tests within the clinical pathology laboratory.
OBJECTIVE
To provide evidence supporting the discontinuation of laboratory tests that do not have clinical utility today.


METHODS
We selected 10 representative tests considered antiquated by most experts in the clinical laboratory medicine field: creatine kinase-MB, myoglobin, serum folate and red blood cell folate, amylase, lecithin/sphingomyelin ratio, qualitative serum human chorionic gonadotropin, prostatic acid phosphatase, bleeding time, and erythrocyte sedimentation rate.


METHODS
Published literature was reviewed to provide evidence of the poor performance and/or limited clinical utility of these tests. When available, subscriptions to the Proficiency Testing Program of the College of American Pathologists were tracked from 1993 to 2008 as supporting evidence. Finally, when appropriate, alternative testing was suggested.


RESULTS
The data show clearly that there is a national trend toward reduction or elimination of these 10 tests.


CONCLUSIONS
Together with their clinical colleagues, clinical laboratorians should review their menu of tests and consider removing tests that do not provide clinical benefit. In most cases, alternative tests are already in clinical use.
Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA 94110, USA. wualan@labmed2.ucsf.edu
Alan H B
AH
Wu
Kent
K
Lewandrowski
Ann M
AM
Gronowski
David G
DG
Grenache
Lori J
LJ
Sokoll
Barbarajean
B
Magnani
D003955:Diagnostic Tests, Routine / Q000639:trends; D006801:Humans; D007753:Laboratories; D010338:Pathology, Clinical