A controlled trial to decrease the unnecessary use of diagnostic tests

J Gen Intern Med. 1986 Jan-Feb;1(1):8-13. doi: 10.1007/BF02596318.


A controlled trial evaluated a program to decrease the unnecessary use of inpatient testing by medical residents in a university medical center. The program included education, concurrent feedback, and resident participation in program planning. Using specific criteria for 7,891 chart audits of patients who had repeat tests within seven days, the authors measured change in testing among 44 residents in the first year and 43 in the second year. There were no significant differences related to the program. They conclude that substantial overuse of diagnostic tests did occur, that it varied from hospital to hospital, and that the program could not overcome powerful counteracting influences. Future studies, using control groups and chart audits, should evaluate interventions other than education.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Clinical Laboratory Techniques / statistics & numerical data*
  • Clinical Trials as Topic
  • Health Services Misuse*
  • Health Services*
  • Hospitals, University
  • Humans
  • Internship and Residency*
  • Medical Audit
  • Practice Patterns, Physicians'
  • United States