[Unnecessary laboratory tests]

Abstract

During the last 40 year medical laboratory tests per hospital stay have increased 12-fold. This is due to an increase of traditional test as well as by newly introduced analyses. Traditional markers of liver, heart and kidney diseases as well as tumor markers, markers of endocrine and metabolic disorders are critically analysed for regarding their medical needs. Assays which are no longer needed (aspartate aminotransferase, lactate dehydrogenase in heart infarction, acid phosphatase) are assessed differently from those ordered at the wrong time and too often (tumor markers, lipids, HbA (1c), thyroid hormones) and those whose indication has to be continuously renewed because of rapidly changing conditions (autoantibodies, marker of iron status, natriuretic peptides and gene analysis). The rapidly proceeding scientific and technical development allows to conclude, that even under strong and critical control of the medical needs the reduction of tests will contribute little to the further development of total costs of the medical laboratory.