title: The role of laboratory in ensuring appropriate test requests.
abstract: This review highlights the role of laboratory professionals and the strategies to be promoted in strict cooperation with clinicians for auditing, monitoring and improving the appropriateness of test request. The introduction of local pathways and care maps in agreement with international and national guidelines as well as the implementation of reflex testing and algorithms have a central role in guiding test request and in correcting the overuse/misuse of tests. Furthermore, removing obsolete tests from laboratory menu and vetting of restricted tests is recommended to increase cost-effectiveness. This saves costs and permits to introduce new biomarkers with increased diagnostic accuracy with a better impact on patient outcome. An additional issue is concerning the periodicity of (re)testing, accounting that only a minority of tests may be ordered as often as necessary. In the majority of cases, a minimum retesting interval should be introduced. The availability of effective computerised order entry systems is relevant in ensuring appropriate test requests and in providing an aid by automated rules that may stop inappropriate requests before they reach the laboratory.
authors.affiliation: Clinical Pathology Unit, 'Luigi Sacco' University Hospital, University of Milan, Milan, Italy. Electronic address: simona.ferraro@asst-fbf-sacco.it.
authors.forename: Simona
authors.initials: S
authors.lastname: Ferraro
authors.affiliation: Clinical Pathology Unit, 'Luigi Sacco' University Hospital, University of Milan, Milan, Italy; Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Panteghini
mesh_terms: D000465:Algorithms; D019411:Clinical Laboratory Techniques / Q000191:economics / Q000592:standards; D003365:Costs and Cost Analysis; D006801:Humans; D016347:Medical Records Systems, Computerized / Q000191:economics / Q000458:organization & administration / Q000592:standards; D017410:Practice Guidelines as Topic