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Clinical Chemistry 45: 1168-1175, 1999;
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(Clinical Chemistry. 1999;45:1168-1175.)
© 1999 American Association for Clinical Chemistry, Inc.

Articles

The Influence of an Expert System for Test Ordering and Interpretation on Laboratory Investigations

Beverly J. Smith1,a and Michael D.D. McNeely2

1 Acquired Intelligence Inc., No. 205-1095 McKenzie Ave., Victoria BC V8P 2L5, Canada.

2 MDS Metro Laboratory Services, 4489 Viewmont Ave., Victoria BC V8Z 5K8, Canada.
a Author for correspondence. Fax 250-479-0764; e-mail bsmith{at}aiinc.ca

Background: The Laboratory Advisory System (LAS) is an expert system interface that works interactively with clinicians to assist them with test selection and result interpretation throughout the laboratory investigation of a patient.

Methods: To study the influence of the LAS on laboratory investigations, a repeated-measures experiment using clinical vignettes was conducted. To collect baseline data on how laboratory investigations are currently conducted, clinicians investigated one-half of the vignettes using a conventional (noncomputer) approach. To determine the influence of the LAS on clinicians' behavior, the other half of the vignettes were investigated using the LAS.

Results: Clinicians using the LAS (compared with conventional practice) ordered fewer laboratory tests during the diagnostic process (mean, 17.8 vs 32.7), completed the diagnostic workup with fewer sample collections (mean, 5.8 vs 7.5), generated lower laboratory costs (mean, $194 vs $232), shortened the time required to reach a diagnosis (mean, 1 day vs 3.2 days), showed closer adherence to established clinical practice guidelines, and exhibited a more uniform and diagnostically successful investigation.

Conclusion: The LAS enhances the outcome of the investigation and improves laboratory utilization.© 1999 American Association for Clinical Chemistry




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eLetters:

Read all eLetters

Test utilisation and outcomes
John Place
Clinical Chemistry Online, 14 Jan 2000 [Full text]
The Laboratory Advisory System is a Tool to Optimize Utilization.
B Smith, et al.
Clinical Chemistry Online, 14 Jan 2000 [Full text]

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Copyright © 1999 by the American Association for Clinical Chemistry.