OpenLabs services for ordering laboratory investigations
An automated system is described that screens requests for laboratory investigations from GPs and delivers feedback with respect to the adequacy of the requests. The system has to replace and extend the current system in which feedback is provided on a manual basis each half year, based on the tests...
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| Published in: | Computer methods and programs in biomedicine Vol. 50; no. 2; pp. 135 - 141 |
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| Main Authors: | , , , |
| Format: | Journal Article |
| Language: | English |
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Ireland
Elsevier Ireland Ltd
01-07-1996
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| Abstract | An automated system is described that screens requests for laboratory investigations from GPs and delivers feedback with respect to the adequacy of the requests. The system has to replace and extend the current system in which feedback is provided on a manual basis each half year, based on the tests requested during a period of one month, randomly selected from the previous half year. It has been reported elsewhere that the manual system reduced the number of tests requested considerably. The criteria used by the automated system and the manual system are based on guidelines and work agreements that GPs have agreed to follow when requesting investigations. It is concluded that the automated system is very user-friendly and that in the order of 4–17% of the requested tests could be identified as unnecessary, with a false negative rate in between 4% (for hyperthyroidism) and 23% (for hypothyroidism). The achieved reduction in the number of tests is in addition to the reduction obtained in the manual system. |
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| AbstractList | An automated system is described that screens requests for laboratory investigations from GPs and delivers feedback with respect to the adequacy of the requests. The system has to replace and extend the current system in which feedback is provided on a manual basis each half year, based on the tests requested during a period of one month, randomly selected from the previous half year. It has been reported elsewhere that the manual system reduced the number of tests requested considerably. The criteria used by the automated system and the manual system are based on guidelines and work agreements that GPs have agreed to follow when requesting investigations. It is concluded that the automated system is very user-friendly and that in the order of 4-17% of the requested tests could be identified as unnecessary, with a false negative rate in between 4% (for hyperthyroidism) and 23% (for hypothyroidism). The achieved reduction in the number of tests is in addition to the reduction obtained in the manual system. |
| Author | Pop, P. Hasman, A. de Wilde, E.J.L. Blom, J.A. |
| Author_xml | – sequence: 1 givenname: E.J.L. surname: de Wilde fullname: de Wilde, E.J.L. organization: Department of Medical Informatics, University of Limburg, P.O. Box 616, 6200 MD Maastricht, Netherlands – sequence: 2 givenname: P. surname: Pop fullname: Pop, P. organization: Diagnostic Coordinating Centre, Academic Hospital Maastricht, P.O. Box 5800, 6202 AZ Maastricht, Netherlands – sequence: 3 givenname: A. surname: Hasman fullname: Hasman, A. email: hasman@mi.rulimburg.nl organization: Department of Medical Informatics, University of Limburg, P.O. Box 616, 6200 MD Maastricht, Netherlands – sequence: 4 givenname: J.A. surname: Blom fullname: Blom, J.A. organization: Department of Medical Informatics, University of Limburg, P.O. Box 616, 6200 MD Maastricht, Netherlands |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/8875020$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1111/j.1365-2923.1985.tb01154.x 10.7326/0003-4819-107-4-569 10.1136/bmj.1.5166.78 10.1097/00005650-198701000-00009 10.1016/0020-7101(94)90031-0 10.1136/bmj.304.6834.1093 10.1001/jama.1988.03720080028023 10.1001/jama.1986.03370110072024 10.1056/NEJM199005243222105 10.1016/0009-8981(93)90091-H |
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| Keywords | Screening Reduction of tests requested Feedback Laboratory investigations Expert system |
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| References | Crooks, Murray, Wayne (BIB15) 1959 Winkens, Pop, Grol, Kester, Knottnerus (BIB7) 1992; 304 Tierney, Miller, McDonald (BIB10) 1990; 322 Wones (BIB2) 1987; 27 Zaat (BIB5) 1991 Broughton (BIB1) 1990 Pop, Winkens (BIB6) 1989; 39 Tierney, McDonald, Hui, Martin (BIB8) 1988; 259 De Moor, Segers, Schilders (BIB12) 1994; 34 Hasman, Pop, Winkens, Blom (BIB14) 1993; 222 Tierney, McDonald, Martin, Siu, Rogers (BIB9) 1987; 107 (BIB11) 1987 Berwick, Coltin (BIB3) 1986 Everett (BIB4) 1985; 19 Blom (BIB13) 1990 Wayne (BIB16) 1960 Berwick (10.1016/0169-2607(96)01742-N_BIB3) 1986 Wones (10.1016/0169-2607(96)01742-N_BIB2) 1987; 27 (10.1016/0169-2607(96)01742-N_BIB11) 1987 Winkens (10.1016/0169-2607(96)01742-N_BIB7) 1992; 304 Pop (10.1016/0169-2607(96)01742-N_BIB6) 1989; 39 Zaat (10.1016/0169-2607(96)01742-N_BIB5) 1991 De Moor (10.1016/0169-2607(96)01742-N_BIB12) 1994; 34 Hasman (10.1016/0169-2607(96)01742-N_BIB14) 1993; 222 Tierney (10.1016/0169-2607(96)01742-N_BIB10) 1990; 322 Wayne (10.1016/0169-2607(96)01742-N_BIB16) 1960 Broughton (10.1016/0169-2607(96)01742-N_BIB1) 1990 Everett (10.1016/0169-2607(96)01742-N_BIB4) 1985; 19 Blom (10.1016/0169-2607(96)01742-N_BIB13) 1990 Tierney (10.1016/0169-2607(96)01742-N_BIB8) 1988; 259 Tierney (10.1016/0169-2607(96)01742-N_BIB9) 1987; 107 Crooks (10.1016/0169-2607(96)01742-N_BIB15) 1959 |
| References_xml | – volume: 222 start-page: 49 year: 1993 end-page: 56 ident: BIB14 article-title: To test or not to test, that is the question publication-title: Clinica Chimica Acta contributor: fullname: Blom – start-page: 211 year: 1959 end-page: 234 ident: BIB15 article-title: Statistical methods applied to the clinical diagnosis of thyrotoxicosis publication-title: Quart. J. Med. contributor: fullname: Wayne – year: 1987 ident: BIB11 publication-title: ICPC international classification of primary care – volume: 259 start-page: 1194 year: 1988 end-page: 1198 ident: BIB8 article-title: Computer predictions of abnormal test results. Effect on outpatient testing publication-title: JAMA contributor: fullname: Martin – start-page: 2 year: 1990 end-page: 3 ident: BIB1 article-title: Laboratory medicine in primary health care publication-title: Br. J. Gen. Practice contributor: fullname: Broughton – start-page: 1450 year: 1986 end-page: 1454 ident: BIB3 article-title: Feedback reduces test use in a health maintenance organization publication-title: J. Am. Med. Assoc. contributor: fullname: Coltin – year: 1991 ident: BIB5 article-title: De macht der gewoonte, over de huisarts en zijn laboratoriumonderzoek publication-title: Thesis in Dutch with English summary contributor: fullname: Zaat – start-page: 78 year: 1960 end-page: 90 ident: BIB16 article-title: Clinical and metabolic studies in thyroid disease (the second of two Lumleian Lectures delivered before the Royal College of Physicians of London on April 14 and 16, 1959 publication-title: Br. Med. J. contributor: fullname: Wayne – volume: 27 start-page: 78 year: 1987 end-page: 82 ident: BIB2 article-title: Failure of low cost audits with feedback to reduce laboratory test utilization publication-title: Med. Care contributor: fullname: Wones – volume: 34 start-page: 319 year: 1994 end-page: 330 ident: BIB12 article-title: Towards a meta-syntax for medical EDI publication-title: Int. J. Biomed. Comput. contributor: fullname: Schilders – volume: 322 start-page: 1499 year: 1990 end-page: 1504 ident: BIB10 article-title: The effect on test ordering of informing physicians of the charges for outpatient diagnostic tests publication-title: N. Engl. J. Med. contributor: fullname: McDonald – volume: 39 start-page: 507 year: 1989 end-page: 508 ident: BIB6 article-title: A diagnostic center for general practitioners: results of individual feedback on diagnostic actions publication-title: J. Roy. Coll. Gen. Prac. contributor: fullname: Winkens – volume: 19 start-page: 138 year: 1985 end-page: 142 ident: BIB4 article-title: Impact of supervision by medical teachers and in patient test control programmes on the out-patient test utilization of residents publication-title: Med. Educ. contributor: fullname: Everett – volume: 304 start-page: 1093 year: 1992 end-page: 1096 ident: BIB7 article-title: Effect of feedback on test ordering behaviour of general practitioners publication-title: Br. Med. J. contributor: fullname: Knottnerus – year: 1990 ident: BIB13 article-title: The SIMPLEXYS experiment; real time expert systems in patient monitoring publication-title: PhD thesis contributor: fullname: Blom – volume: 107 start-page: 569 year: 1987 end-page: 574 ident: BIB9 article-title: Computerized display of past test results. Effect on outpatient testing publication-title: Ann. Intern. Med. contributor: fullname: Rogers – volume: 19 start-page: 138 year: 1985 ident: 10.1016/0169-2607(96)01742-N_BIB4 article-title: Impact of supervision by medical teachers and in patient test control programmes on the out-patient test utilization of residents publication-title: Med. Educ. doi: 10.1111/j.1365-2923.1985.tb01154.x contributor: fullname: Everett – volume: 107 start-page: 569 year: 1987 ident: 10.1016/0169-2607(96)01742-N_BIB9 article-title: Computerized display of past test results. Effect on outpatient testing publication-title: Ann. Intern. Med. doi: 10.7326/0003-4819-107-4-569 contributor: fullname: Tierney – start-page: 78 year: 1960 ident: 10.1016/0169-2607(96)01742-N_BIB16 article-title: Clinical and metabolic studies in thyroid disease (the second of two Lumleian Lectures delivered before the Royal College of Physicians of London on April 14 and 16, 1959 publication-title: Br. Med. J. doi: 10.1136/bmj.1.5166.78 contributor: fullname: Wayne – year: 1987 ident: 10.1016/0169-2607(96)01742-N_BIB11 – volume: 27 start-page: 78 year: 1987 ident: 10.1016/0169-2607(96)01742-N_BIB2 article-title: Failure of low cost audits with feedback to reduce laboratory test utilization publication-title: Med. Care doi: 10.1097/00005650-198701000-00009 contributor: fullname: Wones – volume: 34 start-page: 319 year: 1994 ident: 10.1016/0169-2607(96)01742-N_BIB12 article-title: Towards a meta-syntax for medical EDI publication-title: Int. J. Biomed. Comput. doi: 10.1016/0020-7101(94)90031-0 contributor: fullname: De Moor – start-page: 211 year: 1959 ident: 10.1016/0169-2607(96)01742-N_BIB15 article-title: Statistical methods applied to the clinical diagnosis of thyrotoxicosis publication-title: Quart. J. Med. contributor: fullname: Crooks – volume: 39 start-page: 507 year: 1989 ident: 10.1016/0169-2607(96)01742-N_BIB6 article-title: A diagnostic center for general practitioners: results of individual feedback on diagnostic actions publication-title: J. Roy. Coll. Gen. Prac. contributor: fullname: Pop – volume: 304 start-page: 1093 year: 1992 ident: 10.1016/0169-2607(96)01742-N_BIB7 article-title: Effect of feedback on test ordering behaviour of general practitioners publication-title: Br. Med. J. doi: 10.1136/bmj.304.6834.1093 contributor: fullname: Winkens – year: 1991 ident: 10.1016/0169-2607(96)01742-N_BIB5 article-title: De macht der gewoonte, over de huisarts en zijn laboratoriumonderzoek contributor: fullname: Zaat – volume: 259 start-page: 1194 year: 1988 ident: 10.1016/0169-2607(96)01742-N_BIB8 article-title: Computer predictions of abnormal test results. Effect on outpatient testing publication-title: JAMA doi: 10.1001/jama.1988.03720080028023 contributor: fullname: Tierney – start-page: 1450 year: 1986 ident: 10.1016/0169-2607(96)01742-N_BIB3 article-title: Feedback reduces test use in a health maintenance organization publication-title: J. Am. Med. Assoc. doi: 10.1001/jama.1986.03370110072024 contributor: fullname: Berwick – volume: 322 start-page: 1499 year: 1990 ident: 10.1016/0169-2607(96)01742-N_BIB10 article-title: The effect on test ordering of informing physicians of the charges for outpatient diagnostic tests publication-title: N. Engl. J. Med. doi: 10.1056/NEJM199005243222105 contributor: fullname: Tierney – volume: 222 start-page: 49 year: 1993 ident: 10.1016/0169-2607(96)01742-N_BIB14 article-title: To test or not to test, that is the question publication-title: Clinica Chimica Acta doi: 10.1016/0009-8981(93)90091-H contributor: fullname: Hasman – start-page: 2 year: 1990 ident: 10.1016/0169-2607(96)01742-N_BIB1 article-title: Laboratory medicine in primary health care publication-title: Br. J. Gen. Practice contributor: fullname: Broughton – year: 1990 ident: 10.1016/0169-2607(96)01742-N_BIB13 article-title: The SIMPLEXYS experiment; real time expert systems in patient monitoring contributor: fullname: Blom |
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| SubjectTerms | Clinical Laboratory Information Systems Clinical Laboratory Techniques - statistics & numerical data Computer Communication Networks Databases, Factual Decision Support Systems, Management Expert system Expert Systems Family Practice Feedback Humans Laboratory investigations Reduction of tests requested Screening |
| Title | OpenLabs services for ordering laboratory investigations |
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