Population-based Study of Repeat Laboratory Testing
Why this work is in the frame
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Bibliographic record
Abstract
BACKGROUND: Test repetition could be a readily modifiable component of laboratory utilization. Laboratory test repetition has not been rigorously studied at a population-based level. Our objective was to determine the prevalence of, and charges associated with, repetition of eight common laboratory tests. METHODS: We performed a cross-sectional study using high-quality, population-based clinical databases that included adults in Eastern Ontario, Canada, between September 1999 and September 2000 for incidence of repeating eight common laboratory tests (hemoglobin, sodium, creatinine, thyrotropin, total cholesterol, HDL-cholesterol, ferritin, and hemoglobin A(1C)). Tests were classified as potentially redundant if repeated within the test's baseline testing interval. For creatinine, sodium, and hemoglobin, only tests repeated in the community were considered. For a sensitivity analysis, we varied the repeat interval by 25%, excluded tests repeated by different physicians, and excluded repeats of normal tests. RESULTS: Almost 4 million tests were conducted during the study year. Most tests (76%) were conducted on patients in the community. More than one-half of all people in the population had at least one laboratory test, with an overall testing rate of 367 tests per 100 people per year. Repeat testing within 1 month accounted for 30% of all utilization (109 repeat tests per 100 people per year). Repetition was more common in hospitalized patients, varied extensively among tests, and was concentrated in a limited number of people. For the eight tests included in the study, charges of potentially redundant repetition in adults totaled between 13.9 and 35.9 million dollars (Canadian) annually. CONCLUSIONS: Laboratory test repetition is very common, makes up a significant component of overall test utilization, and is costly.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.052 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it