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  1. Do we know what inappropriate laboratory utilization is ? A systematic review of laboratory clinical audits.

    Article - En anglais

    Objective

    - Laboratory utilization has steadily increased, and some studies suggest inappropriate utilization.

    Therefore, we wished to assess studies that measure inappropriate laboratory use in light of methodological criteria.

    Design

    - Systematic review of published studies.

    Data Sources

    - MEDLINE, HEALTHSTAR, and EMBASE databases were searched from 1966 to September 1997 using a broad and inclusive strategy with no language restriction.

    In addition, the references of all retrieved studies and 3 textbooks on diagnostic testing were hand-searched.

    Study Selection

    - All studies that provided and applied criteria for inappropriate laboratory use.

    Data Extraction

    - Studies were categorized based on whether the criteria were implicit (objective criteria for inappropriate utilization not provided or very broad) or explicit.

    Guidelines for evaluation were applied to each study by a single reviewer.

    Data Synthesis

    - Forty-four eligible studies were identified.

    Eleven studies used implicit criteria for inappropriate laboratory utilization and contained small numbers of patients or physicians.

    Most did not adequately assess the reliability of the implicit criteria.

    Thirty-three studies used explicit criteria based on the appropriateness of test choice, frequency, and timing, as well as the probability of a positive result.

    There were large variations in the estimates of inappropriate laboratory use (4.5% - 95%). (...)

    Mots-clés Pascal : Examen laboratoire, Utilisation, Pratique professionnelle, Personnel sanitaire, Revue bibliographique, Evaluation, Evolution, Homme, Economie santé

    Mots-clés Pascal anglais : Laboratory investigations, Use, Professional practice, Health staff, Bibliographic review, Evaluation, Evolution, Human, Health economy

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0395693

    Code Inist : 002B30A11. Création : 25/01/1999.