Trends and Between-Physician Variation in Laboratory Testing: A Retrospective Longitudinal Study in General Practice

Journal of Clinical Medicine
Lisa D SchumacherStefan Markun

Abstract

Laboratory tests are frequently ordered by general practitioners (GPs), but little is known about time trends and between-GP variation of their use. In this retrospective longitudinal study, we analyzed over six million consultations by Swiss GPs during the decade 2009-2018. For 15 commonly used test types, we defined specific laboratory testing rates (sLTR) as the percentage of consultations involving corresponding laboratory testing requests. Patient age- and sex-adjusted time trends of sLTR were modeled with mixed-effect logistic regression accounting for clustering of patients within GPs. We quantified between-GP variation by means of intraclass correlation coefficients (ICC). Nine out of the 15 laboratory test types considered showed significant temporal increases, most eminently vitamin D (ten-year odds ratio (OR) 1.88, 95% confidence interval (CI) 1.71-2.06) and glycated hemoglobin (ten-year OR 1.87, 95% CI 1.82-1.92). Test types both subject to substantial increase and high between-GP variation of sLTR were vitamin D (ICC 0.075), glycated hemoglobin (ICC 0.101), C-reactive protein (ICC 0.202), and vitamin B12 (ICC 0.166). Increasing testing frequencies and large between-GP variation of specific test type use pointed at ...Continue Reading

References

Mar 1, 1992·Family Practice·I S Kristiansen, P Hjortdahl
Nov 1, 1988·Journal of General Internal Medicine·P S Heckerling
Mar 1, 1981·Medical Care·J M Eisenberg, D Nicklin
Feb 10, 1998·Medical Decision Making : an International Journal of the Society for Medical Decision Making·M L DeKay, D A Asch
Oct 16, 2004·Journal of Clinical Epidemiology·Geoffrey AdamsMichael J Campbell
Jun 9, 2009·Diabetes Care·UNKNOWN International Expert Committee
Jan 26, 2011·Clinical Orthopaedics and Related Research·Peggy M Cawthon
Mar 19, 2011·BMJ : British Medical Journal·John E Wennberg
Sep 7, 2011·British Medical Bulletin·Mark P J Vanderpump
Aug 29, 2012·JAMA : the Journal of the American Medical Association·Etienne PuymiratUNKNOWN FAST MI Investigators
Oct 3, 2013·Clinica Chimica Acta; International Journal of Clinical Chemistry·Christopher Naugler
Mar 13, 2014·Journal of the American Board of Family Medicine : JABFM·John HicknerJulie R Taylor
Jul 29, 2015·London Journal of Primary Care·Sizheng ZhaoNicola Goodson
Aug 25, 2015·International Journal of Medical Informatics·Sima DjalaliRyan Tandjung
Oct 16, 2015·Clinical Chemistry and Laboratory Medicine : CCLM·Fernando Granado-LorencioBelén Pérez-Sacristán
Jun 3, 2018·Clinical Medicine : Journal of the Royal College of Physicians of London·Henry J WoodfordStewart Pattman
Jul 22, 2018·Clinical Biochemistry·Celia RoddEric Bohm
Nov 30, 2018·BMJ : British Medical Journal·Jack W O'SullivanCarl Heneghan
Jun 23, 2019·Clinica Chimica Acta; International Journal of Clinical Chemistry·Leonard T NguyenChristopher Naugler
Oct 17, 2019·JAMA Network Open·Ishani GanguliThomas D Sequist

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Citations

Dec 10, 2020·International Journal of General Medicine·Carola A HuberStefan Markun
Jun 3, 2021·Diagnostics·Md Mohaimenul IslamYu-Chuan Jack Li

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Software Mentioned

lme4
R
oLTR

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