Is That Lab Test Necessary?

For decades, there has been the perception that many lab-oratory tests are ordered inappropriately. Most often, this is seen as overutilization of tests—too many unnecessary lab tests ordered. Occasionally, there have been reports of under-utilization. There also are reports revealing overutilization and underutilization, best labeled inappropriate utilization. Clearly, this implies wasting resources and exposing patients to unnecessary risk. It also is thought that this problem is worse in academic and teaching institutions where new trainees are given the responsibility of ordering tests. Efforts to remedy this problem have been tried for decades as well. Yet the problem still seems to exist. Lab tests are used to help make diagnoses, to assist in estimating prognosis, and to monitor the effects of a disease and its treatment. Inappropriate utilization can occur with any