Tuesday, July 16, 2024

Laboratory Tests in Canada: Expert Panel Sets Minimum Retesting Intervals

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New guidance from Canada’s Drug Agency (CDA-AMC) offers recommendations on minimum retesting intervals for five laboratory tests commonly repeated in hospitals, health authorities, and community laboratories across Canada. This guidance aims to support the appropriate use of laboratory tests and address inefficient healthcare resource utilization. Improving lab test usage is a priority.

The recommendations cover specific laboratory tests used in predetermined populations or clinical scenarios. Antinuclear antibody tests monitor individuals with suspected or confirmed systemic autoimmune disease. Hemoglobin A1C tests are used for people with diabetes on lifestyle modification, glucose-lowering agents, or insulin. Lipase tests monitor those with acute or chronic pancreatitis. Serum protein electrophoresis tests are for people with confirmed plasma cell dyscrasias.

Thyroid-stimulating hormone tests monitor individuals treated for hypothyroidism or hyperthyroidism. These minimum retesting interval recommendations are intended to inform decisions about repeat testing. However, clinicians should exercise clinical judgment as exceptions may arise where recommendations do not apply. Labs must consider their local context and capabilities when implementing these intervals, as they are not absolute recommendations for repeat testing or clinical indications.

Expert Panel Provides Implementation Tips for Minimum Retesting Intervals of Laboratory Tests

To support the adoption of these recommendations, the panel has developed specific implementation advice for several laboratory tests. This includes practical tips for labs, such as suggested timing for hard stops. Additionally, specially designed Quick Guides have been created for each test, providing key information in a concise format to facilitate knowledge translation. The minimum retesting intervals aim to improve decision-making regarding repeat testing. This will help reduce unnecessary tests, save resources, and ensure patients receive timely and appropriate care. It is essential for labs to incorporate these recommendations into their workflow while considering their operational context.

The Advisory Panel on Minimum Retesting Intervals for Lab Tests, convened by Choosing Wisely Canada and Canada’s Drug Agency, is an independent, time-limited panel. It consists of seven core members with expertise in laboratory medicine, family practice, and patient lived experience, along with seven specialist members from various disciplines including endocrinology, cardiology, rheumatology, hematology, oncology, and general internal medicine.

In developing the guidance, panelists considered evidence from focused literature reviews, input from patient groups, equity considerations, and their own clinical experience. The draft recommendations were publicly posted for feedback in April 2024, which helped refine and improve the guidance. Lab tests are a critical component of effective patient care, providing vital information for diagnosis, treatment, and disease management. Provinces and territories in Canada spend billions annually on laboratory tests. Efficient use of these resources is crucial to the sustainability of the healthcare system.

Laboratory Test

Choosing Wisely Canada and CDA Issue New Guidance to Optimize Laboratory Test Use

Choosing Wisely Canada addresses the importance of lab resource stewardship through its Using Labs Wisely consortium, which includes over 150 hospitals committed to the appropriate use of lab testing. These hospitals have identified a need for support and guidance on minimum retesting intervals, which the new recommendations aim to fulfill. Choosing Wisely Canada is the national voice for reducing unnecessary laboratory tests and treatments. It collaborates with national clinician societies to develop recommendations on frequently overused tests and treatments that do not add value to patient care. By mobilizing healthcare providers and organizations, Choosing Wisely Canada integrates these recommendations into routine practice to improve care quality.

Canada’s Drug Agency is a pan-Canadian health organization created and funded by federal, provincial, and territorial governments. Its mission is to drive better coordination, alignment, and public value within Canada’s drug and health technology landscape. The agency provides independent evidence and advice to health system leaders to inform their decisions on drugs, health technologies, and health systems. Collaborating with national and international partners, CDA-AMC enhances collective impact on health outcomes.

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The new expert guidance on minimum retesting intervals for laboratory tests is a significant step toward optimizing laboratory resource use in Canada. By implementing these recommendations, healthcare providers can ensure more efficient and effective use of lab tests, ultimately improving patient care and resource stewardship across the country. This initiative represents a collaborative effort to enhance healthcare delivery and maximize the value of laboratory resources, ensuring that patients receive the best possible care with the resources available.

 

Resource: Canada’s Drug Agency, June 11, 2024

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