Choosing Daily Labs Wisely in the Hospital: A Novel Tool for Assessing Laboratory Testing Appropriateness

Caleb J. Murphy, Alisa M. Duran, Susan J. Diem, Jill M. Bowman Peterson

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: The Minnesota Lab Appropriateness (MLAB) criteria were developed for assessing appropriateness of complete blood counts (CBCs) and serum electrolyte panels (SEPs) ordered for adult inpatients. Methods: Two independent raters used the MLAB criteria to rate appropriateness of labs ordered during 50 hospitalizations through retrospective medical record review. Results: Evaluation of 208 CBCs and 253 SEPs on a 2-category scale (appropriate/inappropriate) resulted in an inappropriate lab rate of 24% and 25% for CBCs and SEPs, respectively. Using a 3-category Likert scale that included an "equivocal" rating to allow for clinical uncertainty, 17% of CBCs and 20% of SEPs were considered inappropriate. Interrater reliability was "substantial" using the dichotomous scale for both CBCs and SEPs. Using the 3-category Likert scale, reliability was "substantial" for CBCs and "moderate" for SEPs. Conclusion: The MLAB criteria identified inappropriate labs at a rate consistent with published figures, with good interrater reliability.

Original languageEnglish (US)
Pages (from-to)169-172
Number of pages4
JournalQuality management in health care
Volume29
Issue number3
DOIs
StatePublished - Jul 1 2020

Bibliographical note

Publisher Copyright:
© 2020 Lippincott Williams and Wilkins. All rights reserved.

Keywords

  • clinical decision-making
  • high-value care
  • hospital medicine
  • measurement

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