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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Greaves, Ronda / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter

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Volume 53, Issue 9


Laboratory utilization improvement through a computer-aided algorithm developed with general practitioners

Maria Salinas
  • Corresponding author
  • Clinical Laboratory, Hospital Universitario de San Juan, San Juan de Alicante, Alicante, Spain
  • Department of Biochemistry and Molecular Pathology, Universidad Miguel Hernandez, Elche, Spain
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Maite López-Garrigós
  • Clinical Laboratory, Hospital Universitario de San Juan, San Juan de Alicante, Alicante, Spain
  • Department of Biochemistry and Molecular Pathology, Universidad Miguel Hernandez, Elche, Spain
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Alberto Asencio / Maria Leiva-Salinas
  • Department of Biochemistry and Molecular Pathology, Universidad Miguel Hernandez, Elche, Spain
  • Department of Dermatology, Hospital General Universitario de Alicante, Alicante, Spain
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Javier Lugo
  • Clinical Laboratory, Hospital Universitario de San Juan, San Juan de Alicante, Alicante, Spain
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Carlos Leiva-Salinas
Published Online: 2014-12-02 | DOI: https://doi.org/10.1515/cclm-2014-0762


Background: One of the main duties of healthcare workers is to get an appropriate use of diagnostic and therapeutic tools. The aim of this study was to show how strategies can be designed and established in consensus with general practitioners (GPs) to reach an optimal laboratory test request.

Methods: The laboratory serves a population of approximately 235,000 inhabitants, including nine primary care centers. GPs could request every test in profiles and individually. In meetings between the laboratory and GPs our request patterns were compared to other geographic regions, and we investigated the appropriateness of test requesting. The group devised strategies that consisted of removing tests from profiles [aspartate aminotransferase (AST), γ-glutamyltranspeptidase (GGT) and phosphate], removing tests from GPs requests (iron and transferrin), substituting tests (IgA antigliadin antibody), and measuring total bilirubin (tBil) only when the icteric index value was above 34.2 mmol/L (2 mg/dL). We analyzed every test request in the post- (years 2012–2013) and pre-intervention period (years 2010–2011), and the tBil measured in the post-intervention period. We studied if AST/alanine aminotransferase (ALT) and GGT/ALT achieved indicators targets and calculated the economic savings in the post-intervention period.

Results: There was a significant drop in every test request in the post-intervention period. AST/ALT achieved the indicator target. GGT/ALT, never achieved the indicator goal. The strategies resulted in a savings of more than €34,000.

Conclusions: The strategies designed between the laboratory and the requesting clinicians and automatically established by using our laboratory information system were successful.

Keywords: costs; laboratory tests utilization; outcome results; patient safety; primary care; test request appropriateness


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About the article

Corresponding author: Dra. Maria Salinas, Clinical Laboratory, Hospital Universitario de San Juan, Carretera Alicante-Valencia, s/n, 03550 San Juan de Alicante, Alicante, Spain, Phone: +34 965938877, Fax: +34 965938383, E-mail: ; and Department of Biochemistry and Molecular Pathology, Universidad Miguel Hernandez, Elche, Spain

Received: 2014-07-24

Accepted: 2014-10-22

Published Online: 2014-12-02

Published in Print: 2015-08-01

Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), Volume 53, Issue 9, Pages 1391–1397, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/cclm-2014-0762.

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