When Laboratory Tests Do More Harm Than Good
Did you know laboratory (lab) tests influence two-thirds of clinical decisions?1 While the right tests enable better diagnoses and treatment, the wrong ones can often do more harm than good. They can lead to a cascade of unnecessary additional tests and referrals that are time-consuming and costly and, most concerning, don’t provide the information needed to help patients get better. That’s why it’s critical for providers to connect patients to the right lab tests throughout their care journey. Unfortunately, it’s often harder than it sounds.
The world of lab testing is vast and complex.
The sheer explosion of lab tests is a major contributing factor to why patients sometimes get the wrong tests for their needs. There are more than 160,000 genetic tests available,2 with one or two new tests launching every day.
This pace alone makes it challenging for any provider to keep up with new developments. In fact, more than two-thirds of physicians report being overwhelmed by the amount of new information they have to absorb.3 More challenging is that most tests come to market before clinical studies have demonstrated how they impact patient care.
Even potentially helpful tests may not align with the current science. For example, about 30% of all genetic tests ordered do not meet current evidence-based medical guidelines, meaning they’re unlikely to benefit the patient.4
Targeted genetic testing can help guide treatment decisions. However, labs are promoting a wide range of more extensive (and expensive) genetic panel testing to providers. Rather than focusing on the gene relevant to the patient, these panels needlessly test several additional genes at once. Often, the results will include “variants of unknown significance” within genes that are of no interest to the patient’s doctor. This unhelpful result may lead to patient anxiety and further testing that doesn’t positively impact the patient’s health outcome. The out-of-pocket costs for such testing also add up fast.
“A test may not be inherently ‘low value,’” Dr. Lon Castle, Associate Chief Medical Officer of Precision Medicine at EviCore. “In most cases, it’s more likely that we don’t see value in that particular test for that particular patient when other tests would provide more answers in less time.”
The EviCore Laboratory Management solution helps ensure the right tests at the right time.
The EviCore Laboratory Management team conducts rigorous technology assessments to ensure that lab tests demonstrate value for patients in three key areas:
1. Analytic validity: In the lab, can the test repeatedly and accurately find what it’s looking for?
2. Clinical validity: Does the test actually work consistently in patients in the real world?
3. Clinical utility: Does the information provided by the test inform and influence provider decision-making in a way that positively impacts patient outcomes?
“Lab tests are often launched into the market before clinical utility is established,” said Dr. Castle. “That makes the job of a physician trying to pick tests incredibly difficult because the value for patients hasn’t necessarily been established.”
When providers request such tests for their patients, the Laboratory Management team, made up of board-certified physicians in medical genetics, oncology or pathology, review them. Their decisions are based on the technology assessment and policy development work created in concert with EviCore research scientists and genetic counselors, who use all available evidence about a lab test to ensure it will provide value for patients. These guidelines help confirm the test is being used in clinical scenarios where it can deliver the greatest benefit.
Through these efforts, EviCore is able to help providers protect their patients from unnecessary and unhelpful testing while connecting them with tests that are proven to improve outcomes.
Want to learn more about the EviCore Laboratory Management solution? Check out the solution page on our website.