What proportion of common diagnostic tests appear redundant ?
To identify ancillary tests for which there are criteria defining the earliest interval at which a repeat test might be indicated, to determine how often each test is repeated earlier than these intervals and, if repeated, provides useful information.
SUBJECTS AND METHODS
We performed a retrospective cohort study of 6,007 adults discharged from a large teaching hospital during a 3-month period in 1991.
We measured the proportion of commonly performed diagnostic tests that were redundant, and their associated charges.
Of the 6,007 patients discharged, 5,289 (88%) had at least one of 12 target tests performed.
Overall, 78,798 of the target tests were performed during the study period, of which 22,237 (28%) were repeated earlier than test-specific predefined intervals.
This percentage varied substantially by test (range, 2% to 62%). To assess how many early repeats were justified, we performed chart reviews in a random sample stratified by test.
For two tests, nearly all the initial results in the sample were abnormal, and all repeats were considered justified.
Of early repeats following a normal initial result for the remaining to tests, chart review found no clinical indication for 92%, and a weighted mean of 40% appeared redundant.
Overall, 8.6% of these 10 tests appeared redundant ; if these were not performed, the annual charge reductions would be $930,000 at our hospital, although the impact on costs would be much smaller. (...)
Mots-clés Pascal : Test clinique, Diagnostic, Redondance, Centre hospitalier universitaire, Maladie, Intervalle temps, Etude cohorte, Rétrospective, Homme, Répétition, Surveillance
Mots-clés Pascal anglais : Clinical test, Diagnosis, Redundancy, Teaching hospital, Disease, Time interval, Cohort study, Retrospective, Human, Repetition, Surveillance
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0244901
Code Inist : 002B30A01C. Création : 11/09/1998.