An Example for Investigation of Unnecessary Laboratory Testing: Free PSA Test

Abstract

Laboratory tests are important in terms of confirmation of diagnosis given by clinics and implementation of appropriate treatment protocols for patients. Laboratory tests used by the clinics have been increased in parallel with time.There are many reasons for increased use of the test such as increase of elderly population, increase in standard of care, lack of information and shortening of turn around time. Unnecessary laboratory testing also constitute one of the reasons for increased use of laboratory tests. In our study we aimed to investigate the unnecessary laboratory testing for fPSA test. fPSA tests which are ordered with total psa tests that values of less than 4 ng/ml or greater than 10 ng/ml were accepted as inappropriate initial testing. 9759 fPSA tests were evaluated as unnecessary laboratory testing. The clinic which ordered the maximum unnecessary laboratory testing with 3315 was urology within all the clinics. Although to the restrictions about the ordering of total PSA and fPSA tests there were no decrease in the number of unnecessary laboratory testing. Unnecessary usage of laboratory testing may cause increase of false positive results, increase in the use of invasive testing, unnecessary drug consumption and increase of healtcare costs. Some precautions may be effective in reducing unnecessary tests such as to inform clinicians about the cost of laboratory tests, to increase the clinician education programs and to develop usage of disease specific diagnostic algorithms about test ordering.