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January 1972

Biochemical Screening Tests: Effect of Panel Size on Medical Care

Author Affiliations

Oakland, Calif; San Francisco; Oakland, Calif

From Department of Medical Methods Research, Permanente Medical Group, Oakland, Calif (Drs. Friedman, Goldberg, Ahwja, Siegelaub, and Callen); and Kaiser Foundation Hospi-; tal, San Francisco (Dr. Bassis). Dr. Goldberg is now District Health Officer, Vancouver City Health Department, Vancouver, BC, Canada.

Arch Intern Med. 1972;129(1):91-97. doi:10.1001/archinte.1972.00320010095012

During a period of evaluation of an automated clinical analyzer (AutoChemist), a panel of 20 biochemical tests was performed for patients undergoing a multiphasic health checkup. For a representative sample of the patients, the results of only eight previously used tests were reported to their physicians. Within three to four months of follow-up, new diagnoses, evidence for existing diagnoses, additional tests, additional follow-up visits, phone calls, referrals, therapeutic advice, and prescriptions occurred about 1½ to 2 times more frequently following abnormalities on the 20-test report than on the 8-test report. Normal results on related tests did not generally reduce the follow-up of abnormalities of the original tests. The value of the increase in diagnoses and therapy generated by the additional tests as compared to the associated costs has yet to be determined.