Ahmet ESENDEMİR, Canan TOPÇUOĞLU, Turan TURHAN, Tuba BATUR, Selamet ELARSLAN
Turkish Journal of Health and Sport - 2025;6(3):106-114
Objectives: Minimum test repeat intervals have been determined in various national guidelines under the name of Rational Laboratory Use to reduce unnecessary test requests within evidence-based medical practices. The aim of this study is to investigate how much of the popular and costly Vitamin D [25(OH)D Cholecalciferol] test requests are unnecessary according to three retrospective research appropriate criteria in the guideline, and to evaluate their impact in terms of cost. Materials and methods: A retrospective study was conducted on 25(OH)D test requests from Ankara Numune Training and Research Hospital between January 2013 and December 2017. Evidence-based guidelines were used to determine minimum test repeat intervals (MRI) and categorize the tests as appropriate or unnecessary according to three recommendations. The number of patients, test requests, repeated tests, and their associated costs were evaluated. Results: The analysis of 233,077 Vitamin D [25(OH)D] tests conducted over five years revealed a significant increase in test requests, highlighting the need for rational laboratory practices. From 2013 to 2017, the proportion of unnecessary repeat tests, based on established guidelines, reached approximately 10%, leading to considerable resource and cost implications. Key findings include: In 2013, the number of test requests was 18,193. Despite no significant change in the prevalence of vitamin D deficiency, this number increased steadily to 64,245 in 2017. Approximately 28.6% of total tests consisted of repeat requests, and 34.6%, 25.1%, and 9.7% of these were considered unnecessary according to three different guideline or study recommendations. The estimated financial impact of inappropriate tests was calculated to approximately 10% of the total expenditure on Vitamin D tests, reaching a level of around 3.5 million TL. Conclusion: The significant increase in 25(OH)D test requests over the study period highlights the need for rational laboratory use. A large proportion of repeated tests were found to be unnecessary, contributing to increased costs and potential patient risks. The implementation of evidence-based minimum test repeat intervals may help reduce unnecessary testing and associated costs.
