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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: BACKGROUND, MATERIALS AND METHODS, RESULTS. Meshes: Clinical Decision-Making, Diagnostic Tests, Routine, Disease Management, Health Care Costs, Hospitals, University, Humans, Physicians, Practice Patterns, Physicians', Retrospective Studies, Seasons.
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Can physician laboratory-test requests be influenced by interventions? Context: Laboratory tests affect healthcare costs and unnecessary test requests can thus be a concern. We studied whether it was possible to influence physician laboratory-test requests using four structured interventions: introduction of clinical guidelines, education, feedback, and reminder letters. The interventions occurred at different times at Landspítali University Hospital, Reykjavik, Iceland. Akureyri Hospital, northern Iceland, was used as a control, since no formal interventions were introduced there. Six types of laboratory tests were analyzed. The relative risk of a laboratory test being conducted at Landspítali University Hospital compared to Akureyri Hospital was calculated for various points in time, as well as the associated 95% confidence intervals. The primary estimates compare the pre- and post-intervention periods (2007-2009 vs. 2010-2013), but also on a monthly basis in order to observe the trends in greater detail. Interventions at Landspítali University Hospital led to a significant reduction in the average number of laboratory tests (12-52%, p<0.001) compared with Akureyri Hospital. Relative risk coefficients of laboratory tests at Landspítali University Hospital (LUH) compared to Akureyri Hospital (AH) were calculated pre- and post-guidelines, the relative risk for ASAT, CRP and GGT fell markedly, while ALAT and ALP tests did not show a significant decrease. Relative risk for a blood culture test in the period after the guidelines was statistically significantly increased.
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It is possible to influence physician laboratory-test requests using multifaceted interventions that include continuous monitoring and follow-up.