"More than 90% of the time that providers access
an electronic medical record it is for the purpose of obtaining laboratory
data"
Joe Miles (ARUP
Laboratories)
Gareth
Gareth Llewelyn ap Huw
Jones
Principal Clinical Scientist
Clinical Biochemistry UCLH
3rd
Floor, 60 Whitfield Street
London W1T 4EU
Hi all
I know this has come up before, but I have recently
been looking for evidence underpinning the widespread claim that lab tests
underpin 70% of [whatever]. I thought I would summarise my (limited)
understanding of this, and see if the collective brain has anything to add.
Happy to post a summary of whatever I receive.
I have seen the assertion in three main
forms:
"60-70% of NHS patients' diagnoses depend on
laboratory tests"
(stated - unreferenced -
in DH Modernising Pathology Services document, 2004)
I can find no evidence for this, and common sense suggests
that if you consider all NHS diagnoses (including primary care, mental
health etc) it must be wrong. I have previously offered the trainees £100 for
anyone who can provide the evidence to support this statement, and am happy to
repeat the offer here!
"60-70% of all critical medical decisions depend on
laboratory data"
This much more circumspect
claim is made in a 1996 paper from the Mayo Clinic (Forsman RW, Clin Chem 1996:
42: 813-816, p813). The paper actually says
"We know that, although the laboratory represents a
small percentage of medical center costs, it leverages 60-70% of all critical
decisions, e.g. admission, discharge and therapy". - although it does not
say how we know that! - presumably internal Mayo studies. But it is at least
believable and referenced! (I think the first quote above derives from
misquotation of this statement)
A variant occurs in Carter 1: "It is estimated that
70-80% of all health care decisions affecting diagnosis or treatment involve a
pathology investigation" (para 1) - but NB the loss of the word 'critical' and
the increased percentage!
"70-80% of the
EMR consists of laboratory data"
This also
sounds feasible, but I cannot trace a reference to it.
Can anyone add to this with published references or
primary sources? The statement has become a very familiar one, quoted and
requoted in its various guises. I am fully convinced of the importance of lab
medicine, but just think that as scientists we should be able to support the
statements we make! Or is it just a lab 'urban myth'?
Many thanks
Mike
