Don’t Let You Doctor Order These 10 Useless Lab Test Docs Won’t Stop Getting

New Study in the current issue of the American Journal of Managed Care, found that many doctors continue to order antiquated tests of minimal to no usefulness.

The 10 tests (dating back to the 1960′s) are:

  1. creatine kinase-MB
  2. myoglobin
  3. serum folate
  4. blood cell folate
  5. amylase
  6. lecithin/sphingomyelin ratio testing
  7. qualitative serum human chorionic gonadotropin
  8. prostatic acid phosphatase
  9. bleeding time
  10. ESR

I must say this is an example where the old taboo idea of “economic migration” would end it overnight.  That is — have managed care simply make these tests not reimbursable (ie if you order the test the lab won’t be paid for it) and the use of these tests will end overnight.  HOWEVER– just the opposite happens. Newly introduced tests of clear benefit languish for months or years (ie MIF/AMH in fertility) being refused by managed care and patients forced to pay out of pocked for them.   Interestingly the old bad tests are relatively cheap and the new ones routinely more expensive.

According to the study, “given the current economic climate for medical practices, it is the responsibility of clinical laboratory directors … to review their test menu and … remove tests that do not provide clinical value to a particular medical practice, whether such testing is conducted in-house or sent to a reference laboratory.”

Think that’s bad– how about an old test that frequently gives incorrect false positive genital herpes results?

In fact, a recent paper in the American Journal of Obstetrics & Gynecology found that many US labs are using outdated genital herpes tests that often yield false-positive results.

“Commercially available herpes simplex virus antibody assays that were not glycoprotein-G based demonstrated high false-positive rates (14 percent-88 percent) for herpes simplex virus type-2 antibodies in sera that were positive for herpes simplex virus type-1 antibodies but negative for herpes simplex virus type-2 antibodies,” according to the paper. “Herpes simplex virus serologic testing should be performed with only glycoprotein-G–based tests.”

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