Skip to main content
Top
Published in: Journal of General Internal Medicine 3/2013

01-03-2013 | Perspectives

Decoding Laboratory Test Names: A Major Challenge to Appropriate Patient Care

Authors: Elissa Passiment, EdM, James L. Meisel, MD, John Fontanesi, PhD, George Fritsma, MS, Samir Aleryani, PhD, Marisa Marques, MD

Published in: Journal of General Internal Medicine | Issue 3/2013

Login to get access

Abstract

Clinical laboratory tests have no value if clinicians cannot quickly order and obtain the results they need. We found that efforts to obtain even the most commonly ordered tests are often derailed by excessively complex nomenclature. Ordering the right laboratory tests is critical to diagnosis and treatment, but existing mechanisms for entering lab orders actively interfere with physicians’ efforts to provide good clinical care. Rather than simplifying lab orders, the advent of computerized physician order entry (CPOE) systems—generally programmed by non-clinicians—has introduced new and vexing practical problems. Medical laboratories have filled their test menus, whether paper or electronic, with bewildering nomenclature and abbreviations, and have failed to appreciate the dangers of assigning perilously similar names to different tests. The efficient and efficacious patient care demanded by the quality care initiative requires progress beyond traditional solutions, such as convening naming conventions, to the development of innovative software with intelligent, real-time, clinically driven search functions that will allow these programs to help rather than hinder physicians.
Literature
1.
go back to reference Surks MI, Chopra IJ, Mariash CN, Nicoloff JT, Solomon DH. American thyroid association guidelines for use of laboratory tests in thyroid disorders. JAMA. 1990;263:1529–1532.PubMedCrossRef Surks MI, Chopra IJ, Mariash CN, Nicoloff JT, Solomon DH. American thyroid association guidelines for use of laboratory tests in thyroid disorders. JAMA. 1990;263:1529–1532.PubMedCrossRef
3.
go back to reference Emons MF. Integrated patient data for optimal patient management: the value of laboratory data in quality improvement. Clin Chem. 2001;47(8):1516–20.PubMed Emons MF. Integrated patient data for optimal patient management: the value of laboratory data in quality improvement. Clin Chem. 2001;47(8):1516–20.PubMed
4.
go back to reference Sucov A, Bazarian JJ, deLahunta EA, Sillane L. Test ordering guidelines can alter ordering patterns in an academic emergency department. Sucov A, Bazarian JJ, deLahunta EA, Sillane L. Test ordering guidelines can alter ordering patterns in an academic emergency department.
5.
go back to reference Shalev V, Chodick G, Heymann AD. Format change of a laboratory test order form affects physician behavior. Int J Med Inform. 2009;78(10):639–44.PubMedCrossRef Shalev V, Chodick G, Heymann AD. Format change of a laboratory test order form affects physician behavior. Int J Med Inform. 2009;78(10):639–44.PubMedCrossRef
6.
go back to reference Miyakis S, Karamanof G, Liontos M, Mountokalakis TD. Factors contributing to inappropriate ordering of tests in an academic medical department and the effect of an educational feedback strategy. Postgrad Med J. 2006;82(974):823–9.PubMedCrossRef Miyakis S, Karamanof G, Liontos M, Mountokalakis TD. Factors contributing to inappropriate ordering of tests in an academic medical department and the effect of an educational feedback strategy. Postgrad Med J. 2006;82(974):823–9.PubMedCrossRef
7.
go back to reference Valenstein PN, Walsh MK, Stankovic AK. Accuracy of send-out test ordering: a College of American Pathologists Q-Probes study of ordering accuracy in 97 clinical laboratories. Arch Pathol Lab Med. 2008;132(2):206–10.PubMed Valenstein PN, Walsh MK, Stankovic AK. Accuracy of send-out test ordering: a College of American Pathologists Q-Probes study of ordering accuracy in 97 clinical laboratories. Arch Pathol Lab Med. 2008;132(2):206–10.PubMed
8.
go back to reference Perraro F, Rossi P, Liva C, Bulfoni A, et al. Inappropriate emergency test ordering in a general hospital: preliminary reports. Qual Assur Health Care. 1992;4(1):77–81.PubMed Perraro F, Rossi P, Liva C, Bulfoni A, et al. Inappropriate emergency test ordering in a general hospital: preliminary reports. Qual Assur Health Care. 1992;4(1):77–81.PubMed
9.
go back to reference Laposata M, Dighe A. “Pre-pre” and “post-post” analytical error: high incidence patient safety hazards involving the clinical laboratory. Clin Chem Lab Med. 2007;45(6):712–9.PubMedCrossRef Laposata M, Dighe A. “Pre-pre” and “post-post” analytical error: high incidence patient safety hazards involving the clinical laboratory. Clin Chem Lab Med. 2007;45(6):712–9.PubMedCrossRef
10.
go back to reference Shmerling RH, Delbanco TL. How useful is the rheumatoid factor? An analysis of sensitivity, specificity, and predictive value. Arch Intern Med. 1992;152(12):2417–20.PubMedCrossRef Shmerling RH, Delbanco TL. How useful is the rheumatoid factor? An analysis of sensitivity, specificity, and predictive value. Arch Intern Med. 1992;152(12):2417–20.PubMedCrossRef
11.
go back to reference Ratnoff OD, Margolius A Jr. Hageman trait: an asymptomatic disorder of blood coagulation. Trans Assoc Am Physicians. 1955;68:149–54.PubMed Ratnoff OD, Margolius A Jr. Hageman trait: an asymptomatic disorder of blood coagulation. Trans Assoc Am Physicians. 1955;68:149–54.PubMed
12.
go back to reference Inoue Y, Nakamura J. Codes and names for clinical laboratory tests and shared interlaboratory databases. Rinsho Byon. 1997;45(6):577–80. Inoue Y, Nakamura J. Codes and names for clinical laboratory tests and shared interlaboratory databases. Rinsho Byon. 1997;45(6):577–80.
13.
go back to reference Pontet F, Magdal PU, Fuentes-Arderiu X. Petersen U, X, et al. Clinical laboratory sciences data transmission: the NPU coding system. Joint Committee on Nomenclature, Properties and Units (C-SC-NPU) of the IFCC and IUPAC. Stud Health Technol Inform. 2009;150:265–9.PubMed Pontet F, Magdal PU, Fuentes-Arderiu X. Petersen U, X, et al. Clinical laboratory sciences data transmission: the NPU coding system. Joint Committee on Nomenclature, Properties and Units (C-SC-NPU) of the IFCC and IUPAC. Stud Health Technol Inform. 2009;150:265–9.PubMed
14.
go back to reference Nomenclature announcement: Redefined Nomenclature for Members of the Carcinoembryonic Antigen Family1. Experimental Cell Research. 1999; 252: 243–249 Nomenclature announcement: Redefined Nomenclature for Members of the Carcinoembryonic Antigen Family1. Experimental Cell Research. 1999; 252: 243–249
15.
go back to reference Larsen P, Alexander N, et al. Revised nomenclature for tests of thyroid hormones and thyroid-related proteins in serum. Arch Pathol Lab Med. 1988;112:132. Larsen P, Alexander N, et al. Revised nomenclature for tests of thyroid hormones and thyroid-related proteins in serum. Arch Pathol Lab Med. 1988;112:132.
16.
go back to reference Wright IS. Special report: the nomenclature of blood clotting factors. Can Med Assoc J. 1962;86:373–374.PubMed Wright IS. Special report: the nomenclature of blood clotting factors. Can Med Assoc J. 1962;86:373–374.PubMed
17.
go back to reference Huff SM, Rocha RA, McDonald CJ, et al. Development of the Logical Observation Identifier Names and Codes (LOINC) vocabulary. J Am Med Inform Assoc. 1998;5(3):276–92.PubMedCrossRef Huff SM, Rocha RA, McDonald CJ, et al. Development of the Logical Observation Identifier Names and Codes (LOINC) vocabulary. J Am Med Inform Assoc. 1998;5(3):276–92.PubMedCrossRef
18.
go back to reference McDonald CJ, Huff SM, Suico JG, et al. LOINC, a universal standard for identifying laboratory observations: a 5-year update. Clin Chem. 2003;49(4):624–33.PubMedCrossRef McDonald CJ, Huff SM, Suico JG, et al. LOINC, a universal standard for identifying laboratory observations: a 5-year update. Clin Chem. 2003;49(4):624–33.PubMedCrossRef
19.
go back to reference McDonald CJ, Huff SM, Suico JG, Hill G, Leavelle D, Aller R, Forrey A, Mercer K, DeMoor G, Hook J, Williams W, Case J, Maloney P. LOINC, a universal standard for identifying laboratory observations: a 5-year update. Clin Chem. 2003;49(4):624–33.PubMedCrossRef McDonald CJ, Huff SM, Suico JG, Hill G, Leavelle D, Aller R, Forrey A, Mercer K, DeMoor G, Hook J, Williams W, Case J, Maloney P. LOINC, a universal standard for identifying laboratory observations: a 5-year update. Clin Chem. 2003;49(4):624–33.PubMedCrossRef
22.
go back to reference Wang AY, Barrett JW, Bentley T, et al. Mapping between SNOMED RT and clinical terms version 3: A Key Component of the SNOMED CT development process. Proc AMIA Symp. 2001; 741–745. Wang AY, Barrett JW, Bentley T, et al. Mapping between SNOMED RT and clinical terms version 3: A Key Component of the SNOMED CT development process. Proc AMIA Symp. 2001; 741–745.
24.
go back to reference Baorto DM, Cimino JJ, Parvin CA, Kahn MG. Using Logical Observation Identifier Names and Codes (LOINC) to exchange laboratory data among three academic hospitals. Proc AMIA Annu Fall Symp. 1997;96–100. Baorto DM, Cimino JJ, Parvin CA, Kahn MG. Using Logical Observation Identifier Names and Codes (LOINC) to exchange laboratory data among three academic hospitals. Proc AMIA Annu Fall Symp. 1997;96–100.
25.
go back to reference NISTIR 7432: Common Industry Specifications for Usability Requirements, Information Access Division, Information Technology Laboratory, National Institute of Standards and Technology, June 2007. NISTIR 7432: Common Industry Specifications for Usability Requirements, Information Access Division, Information Technology Laboratory, National Institute of Standards and Technology, June 2007.
Metadata
Title
Decoding Laboratory Test Names: A Major Challenge to Appropriate Patient Care
Authors
Elissa Passiment, EdM
James L. Meisel, MD
John Fontanesi, PhD
George Fritsma, MS
Samir Aleryani, PhD
Marisa Marques, MD
Publication date
01-03-2013
Publisher
Springer-Verlag
Published in
Journal of General Internal Medicine / Issue 3/2013
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-012-2253-8

Other articles of this Issue 3/2013

Journal of General Internal Medicine 3/2013 Go to the issue

Healing Arts: Materia Medica

This Wound is Consistent with Harm

Healing Arts: Materia Medica

Medicine Man

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.