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Licensed Unlicensed Requires Authentication Published by De Gruyter February 25, 2021

Clinical usefulness of drug-laboratory test interaction alerts: a multicentre survey

Jasmijn A. van Balveren, Wilhelmine P. H. G. Verboeket-van de Venne, Carine J. M. Doggen, Anne S. Cornelissen, Lale Erdem-Eraslan, Albert J. de Graaf, Johannes G. Krabbe, Ruben E. A. Musson, Wytze P. Oosterhuis, Yolanda B. de Rijke, Heleen van der Sijs, Andrei N. Tintu, Rolf J. Verheul, Rein M. J. Hoedemakers, Ron Kusters, Dutch Society for Clinical Chemistry and Laboratory Medicine and task group ‘SMILE’: Signaling Medication Interactions and Laboratory test Expert system



Knowledge of possible drug-laboratory test interactions (DLTIs) is important for the interpretation of laboratory test results. Failure to recognize these interactions may lead to misinterpretation, a delayed or erroneous diagnosis, or unnecessary extra diagnostic tests or therapy, which may harm patients. The aim of this multicentre survey was to evaluate the clinical value of DLTI alerts.


A survey was designed with six predefined clinical cases selected from the clinical laboratory practice with a potential DLTI. Physicians from several departments, including internal medicine, cardiology, intensive care, surgery and geriatrics in six participating hospitals were recruited to fill in the survey. The survey addressed their knowledge of DLTIs, motivation to receive an alert and opinion on the potential influence on medical decision making.


A total of 210 physicians completed the survey. Of these respondents 93% had a positive attitude towards receiving DLTI alerts; however, the reported value differed per case and per respondent’s background. In each clinical case, medical decision making was influenced as a consequence of the reported DLTI message (ranging from 3 to 45% of respondents per case).


In this multicentre survey, most physicians stated DLTI messages to be useful in laboratory test interpretation. Medical decision making was influenced by reporting DLTI alerts in each case. Alerts should be adjusted according to the needs and preferences of the receiving physicians.

Corresponding author: Jasmijn A. van Balveren, MSc, Laboratory for Clinical Chemistry and Haematology, Jeroen Bosch Hospital, Henri Dunantstraat 1, PO Box 90153, ’s-Hertogenbosch, Den Bosch, The Netherlands; and Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, The Netherlands, Phone: +31 (0)73-553 27 64, Fax: +31 (0)73-5532958, E-mail:

Funding source: Stichting Kwaliteitsgelden Medisch Specialisten (SKMS)

Award Identifier / Grant number: 42678870


We thank all the respondents for their time to complete the survey.

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.


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Supplementary Material

The online version of this article offers supplementary material (

Received: 2020-11-30
Accepted: 2021-02-15
Published Online: 2021-02-25
Published in Print: 2021-06-25

© 2021 Walter de Gruyter GmbH, Berlin/Boston

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