Perception of usefulness of laboratory tests ordering by internal medicine residents in ambulatory setting: A single-center prospective cohort study.
The demand for high value health care uncovered a steady trend in laboratory tests ordering and inappropriate testing practices. Residents' training in laboratory ordering practice provides an opportunity for quality improvement. We collected information on demographics, the main reason for the...
Main Authors: | , , , , , , , , , , , , , |
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Format: | Article |
Language: | English |
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Public Library of Science (PLoS)
2021-01-01
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Series: | PLoS ONE |
Online Access: | https://doi.org/10.1371/journal.pone.0250769 |
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author | Dimitria Doi Romulo Ribeiro do Vale Jean Michell Correia Monteiro Glauco Cabral Marinho Plens Mario Ferreira Junior Luiz Augusto Marcondes Fonseca Sandro Félix Perazzio Bruno Adler Maccagnan Pinheiro Besen Arnaldo Lichtenstein Leandro Utino Taniguchi Nairo Massakazu Sumita Aline Pivetta Corá Adriana Pasmanik Eisencraft Alberto José da Silva Duarte |
author_facet | Dimitria Doi Romulo Ribeiro do Vale Jean Michell Correia Monteiro Glauco Cabral Marinho Plens Mario Ferreira Junior Luiz Augusto Marcondes Fonseca Sandro Félix Perazzio Bruno Adler Maccagnan Pinheiro Besen Arnaldo Lichtenstein Leandro Utino Taniguchi Nairo Massakazu Sumita Aline Pivetta Corá Adriana Pasmanik Eisencraft Alberto José da Silva Duarte |
author_sort | Dimitria Doi |
collection | DOAJ |
description | The demand for high value health care uncovered a steady trend in laboratory tests ordering and inappropriate testing practices. Residents' training in laboratory ordering practice provides an opportunity for quality improvement. We collected information on demographics, the main reason for the appointment, preexisting medical conditions and presence of co-morbidities from first-visit patients to the internal medicine outpatient service of our university general hospital. We also collected information on all laboratory tests ordered by the attending medical residents. At a follow-up visit, we recorded residents' subjective perception on the usefulness of each ordered laboratory test for the purposes of diagnosis, prognosis, treatment or screening. We observed that 17.3% of all ordered tests had no perceived utility by the attending resident. Tests were usually ordered to exclude differential diagnoses (26.7%) and to help prognosis estimation (19.1%). Age and co-morbidity influenced the chosen category to legitimate usefulness of tests ordering. This study suggests that clinical objectives (diagnosis, prognosis, treatment or prevention) as well as personalization to age and previous health conditions should be considered before test ordering to allow a more appropriate laboratory tests ordering, but further studies are necessary to examine this framework beyond this medical training scenario. |
first_indexed | 2024-12-20T14:23:27Z |
format | Article |
id | doaj.art-98be46bc03c546669cb5ea3a3f586ff1 |
institution | Directory Open Access Journal |
issn | 1932-6203 |
language | English |
last_indexed | 2024-12-20T14:23:27Z |
publishDate | 2021-01-01 |
publisher | Public Library of Science (PLoS) |
record_format | Article |
series | PLoS ONE |
spelling | doaj.art-98be46bc03c546669cb5ea3a3f586ff12022-12-21T19:37:52ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01165e025076910.1371/journal.pone.0250769Perception of usefulness of laboratory tests ordering by internal medicine residents in ambulatory setting: A single-center prospective cohort study.Dimitria DoiRomulo Ribeiro do ValeJean Michell Correia MonteiroGlauco Cabral Marinho PlensMario Ferreira JuniorLuiz Augusto Marcondes FonsecaSandro Félix PerazzioBruno Adler Maccagnan Pinheiro BesenArnaldo LichtensteinLeandro Utino TaniguchiNairo Massakazu SumitaAline Pivetta CoráAdriana Pasmanik EisencraftAlberto José da Silva DuarteThe demand for high value health care uncovered a steady trend in laboratory tests ordering and inappropriate testing practices. Residents' training in laboratory ordering practice provides an opportunity for quality improvement. We collected information on demographics, the main reason for the appointment, preexisting medical conditions and presence of co-morbidities from first-visit patients to the internal medicine outpatient service of our university general hospital. We also collected information on all laboratory tests ordered by the attending medical residents. At a follow-up visit, we recorded residents' subjective perception on the usefulness of each ordered laboratory test for the purposes of diagnosis, prognosis, treatment or screening. We observed that 17.3% of all ordered tests had no perceived utility by the attending resident. Tests were usually ordered to exclude differential diagnoses (26.7%) and to help prognosis estimation (19.1%). Age and co-morbidity influenced the chosen category to legitimate usefulness of tests ordering. This study suggests that clinical objectives (diagnosis, prognosis, treatment or prevention) as well as personalization to age and previous health conditions should be considered before test ordering to allow a more appropriate laboratory tests ordering, but further studies are necessary to examine this framework beyond this medical training scenario.https://doi.org/10.1371/journal.pone.0250769 |
spellingShingle | Dimitria Doi Romulo Ribeiro do Vale Jean Michell Correia Monteiro Glauco Cabral Marinho Plens Mario Ferreira Junior Luiz Augusto Marcondes Fonseca Sandro Félix Perazzio Bruno Adler Maccagnan Pinheiro Besen Arnaldo Lichtenstein Leandro Utino Taniguchi Nairo Massakazu Sumita Aline Pivetta Corá Adriana Pasmanik Eisencraft Alberto José da Silva Duarte Perception of usefulness of laboratory tests ordering by internal medicine residents in ambulatory setting: A single-center prospective cohort study. PLoS ONE |
title | Perception of usefulness of laboratory tests ordering by internal medicine residents in ambulatory setting: A single-center prospective cohort study. |
title_full | Perception of usefulness of laboratory tests ordering by internal medicine residents in ambulatory setting: A single-center prospective cohort study. |
title_fullStr | Perception of usefulness of laboratory tests ordering by internal medicine residents in ambulatory setting: A single-center prospective cohort study. |
title_full_unstemmed | Perception of usefulness of laboratory tests ordering by internal medicine residents in ambulatory setting: A single-center prospective cohort study. |
title_short | Perception of usefulness of laboratory tests ordering by internal medicine residents in ambulatory setting: A single-center prospective cohort study. |
title_sort | perception of usefulness of laboratory tests ordering by internal medicine residents in ambulatory setting a single center prospective cohort study |
url | https://doi.org/10.1371/journal.pone.0250769 |
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