TY - JOUR
T1 - Reflective testing - A randomized controlled trial in primary care patients
AU - Oosterhuis, Wytze P
AU - Venne, Wilhelmine Phg Verboeket-van de
AU - Deursen, Cees Tbm van
AU - Stoffers, Henri Ejh
AU - Acker, Bernadette Ac van
AU - Bossuyt, Patrick Mm
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was partly supported by a grant of Stichting Kwaliteitsgelden Medisch Specialisten (SKMS), the Netherlands.
Publisher Copyright:
© The Author(s) 2020.
PY - 2021/3
Y1 - 2021/3
N2 - BACKGROUND: Reflective testing, i.e. interpreting, commenting on and, if necessary, adding tests in order to aid the diagnostic process in a meaningful and efficient manner, is an extra service provided by laboratory medicine. However, there have been no prospective randomized controlled trials investigating the value of reflective testing in patient management.METHODS: In this trial, primary care patients were randomly allocated to an intervention group, where general practitioners received laboratory tests results as requested as well as add-on test results with interpretative comments where considered appropriate by the laboratory specialist, or to a control group, where general practitioners only received the laboratory test results requested. Patients' medical records were evaluated with a follow-up period of six months. For both groups, the primary outcome measures, i.e. both intended action and actual management action, were blindly assessed by an independent expert panel as adequate, neutral or inadequate.RESULTS: In 226 of the 270 cases (84%), reflective testing was considered to be useful for the patient. In the intervention group (n = 148), actual management by the general practitioner was scored as adequate (n = 104; 70%), neutral (n = 29; 20%) or not adequate (n = 15; 10%). In the control group (n = 122), these numbers were 57 (47%), 37 (30%) and 28 (23%). This difference was statistically significant (P < 0.001).CONCLUSION: This randomized controlled trial showed a positive effect of reflective testing in primary care patients on the adequacy of their management, as documented in medical records.
AB - BACKGROUND: Reflective testing, i.e. interpreting, commenting on and, if necessary, adding tests in order to aid the diagnostic process in a meaningful and efficient manner, is an extra service provided by laboratory medicine. However, there have been no prospective randomized controlled trials investigating the value of reflective testing in patient management.METHODS: In this trial, primary care patients were randomly allocated to an intervention group, where general practitioners received laboratory tests results as requested as well as add-on test results with interpretative comments where considered appropriate by the laboratory specialist, or to a control group, where general practitioners only received the laboratory test results requested. Patients' medical records were evaluated with a follow-up period of six months. For both groups, the primary outcome measures, i.e. both intended action and actual management action, were blindly assessed by an independent expert panel as adequate, neutral or inadequate.RESULTS: In 226 of the 270 cases (84%), reflective testing was considered to be useful for the patient. In the intervention group (n = 148), actual management by the general practitioner was scored as adequate (n = 104; 70%), neutral (n = 29; 20%) or not adequate (n = 15; 10%). In the control group (n = 122), these numbers were 57 (47%), 37 (30%) and 28 (23%). This difference was statistically significant (P < 0.001).CONCLUSION: This randomized controlled trial showed a positive effect of reflective testing in primary care patients on the adequacy of their management, as documented in medical records.
KW - Reflective testing
KW - consultation
KW - interpretative comment
KW - laboratory test results
KW - primary care
KW - GENERAL-PRACTITIONER
U2 - 10.1177/0004563220968373
DO - 10.1177/0004563220968373
M3 - Article
C2 - 33040573
SN - 0004-5632
VL - 58
SP - 78
EP - 85
JO - Annals of Clinical Biochemistry
JF - Annals of Clinical Biochemistry
IS - 2
ER -