title: Patterns of Laboratory Testing Utilization Among Uveitis Specialists.
abstract: OBJECTIVE
  To examine the range of practice in laboratory testing utilization among a subset of uveitis specialists using a scenario-based survey.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  A web-based survey consisting of 13 patient scenarios was presented to the Executive Committee and Trustees of the American Uveitis Society. The participants were allowed to choose preferred testing in a free-form manner. The patterns of test utilization were studied and the cost of the testing was calculated based on Noridian Medicare reimbursal rates for Seattle, Washington.
  
  
  RESULTS
  Nearly all providers recommended some testing for all scenarios. Forty-five different tests, including laboratory investigations and imaging and diagnostic procedures, were ordered. The mean number of tests ordered per scenario per provider was 5.47 ± 2.71. There was limited consensus among providers in test selection, with most tests in each scenario ordered by fewer than half of the providers. Average cost of testing per scenario per provider was $282.80, with 4 imaging tests (fluorescein angiography, magnetic resonance imaging, chest radiograph, and chest computed tomography) together contributing 59.9% of the total testing costs.
  
  
  CONCLUSIONS
  Uveitis specialists have a high rate of laboratory testing utilization in their evaluation of new patients. There is substantial variability in the evaluations obtained between providers. Imaging tests account for the majority of evaluation cost. The low agreement on specific testing plans suggests need for evidence-based practice guidelines for the evaluation of uveitis patients.
authors: Department of Ophthalmology, University of Washington School of Medicine, Seattle, Washington.
authors: Cecilia S
authors: CS
authors: Lee
authors: Department of Ophthalmology, University of Washington School of Medicine, Seattle, Washington.
authors: Sandeep
authors: S
authors: Randhawa
authors: Department of Ophthalmology, University of Washington School of Medicine, Seattle, Washington; VA Puget Sound Healthcare System, Seattle, Washington.
authors: Aaron Y
authors: AY
authors: Lee
authors: Department of Ophthalmology, University of Washington School of Medicine, Seattle, Washington; VA Puget Sound Healthcare System, Seattle, Washington.
authors: Deborah L
authors: DL
authors: Lam
authors: Department of Ophthalmology, University of Washington School of Medicine, Seattle, Washington; Department of Biological Structure, University of Washington School of Medicine, Seattle, Washington; Department of Pathology, University of Washington School of Medicine, Seattle, Washington. Electronic address: russvg@uw.edu.
authors: Russell N
authors: RN
authors: Van Gelder
mesh_terms: D019411:Clinical Laboratory Techniques / Q000191:economics / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003941:Diagnostic Techniques, Ophthalmological / Q000191:economics / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013038:Specialization; D014605:Uveitis / Q000175:diagnosis*