Journal of Clinical Chemistry and Laboratory Medicine
Open Access

Abstract

Unnecessary Repeated Total PSA Tests and Evaluation with Minimum Retest Interval and Reference Change Value

Nergiz Zorbozan and İlker Akarken

Background: Laboratory costs are one of the fastest growing areas of health care cost. Not only the developments in education and technology cause a natural increase in the test requests but also unnecessary tests are known to have an important role in the increase in laboratory use. Aim of the study: The aim of study was to determine unnecessary repeated total prostate specific antigen (tPSA) according to minimum retest interval and to evaluate the change between consecutive measurement results with RCV. Methods: According to report of Association for Clinical Biochemistry and Laboratory Medicine, when first result is raised, it is recommended to repeat tPSA once in 6 weeks to assess the trend. In March 2015-2017, tPSA of patients were evaluated. If tPSA was >2.5 ng/mL and this test was repeated in less than 6 weeks, it was determined as unnecessary repeated test. RCV was calculated. Results: The number of tPSA was 1794 and number of consecutive tPSA requested was 427 (12.5%). The first tPSA result was >2.5 ng/mL in 46.4% (198/427) of consecutive tPSA tests, 49% of these tests (97/198) were unnecessary. RCV was calculated as 51.45%. In 82.5% (80/97) of unnecessary repeated tPSA, the change between two results was smaller than RCV. Number of consecutive tests which changed below RCV was significantly lower in appropriately requested tPSA tests than unnecessary repeated tPSA. Conclusion: Absence of significant difference between two consecutive results in unnecessary repeated test suggests the importance of test requesting according to guidelines. We believe that our work will raise awareness about reducing unnecessary requests.