Department of Pathology, New York University Langone Health, 560 1st Avenue, New York, NY 10016, USA.
Department of Pathology, New York University Langone Health, 560 1st Avenue, New York, NY 10016, USA.
Clin Lab Med. 2024 Mar;44(1):23-32. doi: 10.1016/j.cll.2023.10.010. Epub 2023 Nov 15.
Inappropriate ordering practices, either under or over ordering of diagnostic tests, are recognized problems with possible negative downstream consequences. As the menu of clinical tests, especially molecular tests grows, it is becoming increasingly important to provide guidance to providers on the appropriate utilization. Diagnostic stewardship programs have been established at many institutions to help direct the appropriate utilization of laboratory testing to ultimately guide patient management and treatment decisions. Many molecular tests have now received Clinical Laboratory Improvement Amendments (CLIA)-waived status for use in a point-of-care (POC) setting; however, parallel diagnostic stewardship programs have not been established to help guide providers on how best to use these tests. In this article, we will discuss the available molecular POC tests and opportunities and challenges for establishing diagnostic stewardship programs for molecular testing performed in the POC setting.
不适当的医嘱实践，无论是过度还是不足的诊断性检测，都被认为是可能带来负面下游后果的问题。随着临床检测项目，尤其是分子检测项目的不断增加，为临床医生提供关于适当利用这些检测的指导变得越来越重要。许多机构已经建立了诊断管理项目，以帮助指导实验室检测的适当利用，最终指导患者管理和治疗决策。许多分子检测现在已经获得了临床实验室改进修正案（CLIA）豁免，可在即时检测（POC）环境中使用；然而，尚未建立平行的诊断管理项目来帮助指导临床医生如何最好地使用这些检测。在本文中，我们将讨论现有的分子即时检测检测，并探讨在即时检测环境中建立分子检测诊断管理项目的机会和挑战。
