What methods are being used to create an evidence base on the use of laboratory tests to monitor long-term conditions in primary care? A scoping review

摘要: Background Studies have shown unwarranted variation in test ordering among GP practices and regions, which may lead to patient harm increased health care costs. There is currently no robust evidence base inform guidelines on monitoring long-term conditions. Objectives To map the extent nature of research that provides use laboratory tests monitor conditions primary care, identify gaps existing research. Methods We performed a scoping review-a relatively new approach for mapping across broad topics-using data abstraction forms charting according framework. searched CINAHL, EMBASE MEDLINE April 2019. included studies aimed optimize determine costs, or related testing population with Results Ninety-four were included. Forty percent describe 36% investigate performance. Renal function (35%), HbA1c (23%) lipids (17%) most studied tests. Most applied cohort design using routinely collected (49%). found strategies improve outcomes, optimal intervals harms caused by over-testing. Conclusions Future needs address these evidence. High-level missing, i.e. randomized controlled trials comparing one strategy another quasi-experimental designs such as interrupted time series analysis if are not feasible.