DIAGNOSTIC YIELD OF BIOCHEMICAL INVESTIGATIONS: IMPLICATIONS

Ashima Badyal*

ABSTRACT

Laboratory tests are important elements of medical practice. Overuse of clinical chemistry investigations has implications for the patients, physicians and also to the laboratory. Effective use of clinicians and the clinical laboratory has great implications on the cost and operational efficiency of the hospital. This study aimed at determining the yield of simple clinical biochemistry investigation across different test-ordering categories.The study was conducted in the main lab of the Department of Biochemistry, Government Medical College and Hospital, Jammu. A total of more than one lakh investigations are performed in a single month, out of which, an average of thirty thousand investigations are performed in the Main Lab itself. Out of the 12 types of clinical chemistry investigations ordered, serum sodium, serum potassium, serum creatinine, serum bilirubin, total protein had low diagnostic yield, while serum uric acid, serum alp, serum alt, serum urea had intermediate diagnostic yield ranging from 36.1% to 44.7% . Serum AST with the diagnostic yield of 64.3% was the highest. Amongst all,serum uric acid with a total of 2370 investigations (3.9% of total investigations) had a relatively high diagnostic yield of 36.1 %. The overall/average diagnostic yield of all popular tests taken together came out to be 31.9%.This study has conclusively proven that the diagnostic yield of major investigations in a hospital lab are invariably low. There is a need to develop protocols for ordering specific clinical chemistry results.

Keywords: Clinical chemistry, diagnosis, yield, biochemical.