Avoiding unnecessary tests

Before any investigations are requested, ask the questions:

• why order this test?
• what is being looked for in the result?
• will it affect the diagnosis?
• will it affect the management of the case?
• will it ultimately benefit the patient? and:
  • can the result be obtained more cheaply & less invasively by for example a fuller history or by letting time pass
  • are the risks and costs justified by the value of the information likely to be gained?

A definite and sustained reduction in inappropriate requests may be achieved by an policy of interventions such as:

• issuing guidelines and fact sheets
• holding seminars
• a positive attitude among senior staff

Reference:

• Bareford D, Hayling A . Inappropriate use of laboratory services. BMJ 1990;301(6764):1305-1307.