Clinical laboratory use in the evaluation of anemia
L. A. Wheeler, G. Brecher and L. B. Sheiner
Follow-up tests ordered on 258 consecutively examined inpatients with low
hemoglobin values on admission were analyzed. The appropriateness of the
follow-up tests was evaluated by chart review after preselection by an
algorithm. When the cause of the anemia was known or was irrelevant in view
of the patient's clinical status, the laboratory use was judged to be
adequate. Seventy-one percent of patients studied had an adequate
follow-up, though 11% had nonindicated tests performed, scored as
laboratory overuse. Twenty-four percent had no follow-up, scored as
laboratory underuse. Five percent did not have all indicated tests done and
had nonindicated tests done, scored as a mixture of underuse and overuse.
Potential remedies to correct misuse are discussed.
