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...

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Main Authors: 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
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2021-01-01
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.
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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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