Cited by 395Healthcare cost, quality, practicesClinical Reasoning and Diagnostic SkillsClinical Laboratory Practices and Quality Control

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Principles for high-quality, high-value testing

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Power, Michael, Fell, Greg, Wright, Michael·2013·Evidence Based Medicine

DOI 10.1136/eb-2012-100645PMC PMC3585491

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Abstract

A survey of doctors working in two large NHS hospitals identified over 120 laboratory tests, imaging investigations and investigational procedures that they considered not to be overused. A common suggestion in this survey was that more training was required. And, this prompted the development of a list of core principles for high-quality, high-value testing. The list can be used as a framework for training and as a reference source. The core principles are: (1) Base testing practices on the best available evidence. (2) Apply the evidence on test performance with careful judgement. (3) Test efficiently. (4) Consider the value (and affordability) of a test before requesting it. (5) Be aware of the downsides and drivers of overdiagnosis. (6) Confront uncertainties. (7) Be patient-centred in your approach. (8) Consider ethical issues. (9) Be aware of normal cognitive limitations and biases when testing. (10) Follow the ‘knowledge journey’ when teaching and learning these core principles.

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Authors: Power, M., Fell, G., & Wright, M.
Affiliations: Newcastle upon Tyne Hospitals NHS Foundation Trust (GB)
Airedale NHS Foundation Trust (GB)
Corresponding author: Power, Michael
ORCID: Power, Michael
Wright, Michael
Venue: Evidence Based Medicine
Publisher: BMJ
Published: 2012-06-27
Volume: 18
Issue: 1
Pages: 5-10
ISSN: 1356-5524 (ISSN-L)
1473-6810
DOI: 10.1136/eb-2012-100645
PMC: PMC3585491
OpenAlex: W2051681038
Cited by: 394
References: 24
Citations by year: 2026: 40 · 2025: 84 · 2024: 82 · 2023: 83 · 2022: 58 · 2021: 33 · 2020: 4 · 2019: 2 · 2018: 4 · 2014: 2 · 2013: 2
FWCI: 2.27
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by-nc
Locations: BMJ Evidence-Based Medicine (publishedVersion, cc-by-nc)
Europe PMC (PubMed Central) (publishedVersion, other-oa)
PubMed Central (publishedVersion, cc-by-nc)
PubMed (publishedVersion)
Topics: Health Sciences › Health Professions › General Health Professions › Healthcare cost, quality, practices
Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
Health Sciences › Health Professions › Medical Laboratory Technology › Clinical Laboratory Practices and Quality Control
Keywords: overuse of diagnostic testing, high-value care, evidence-based practice, test performance, overdiagnosis, patient-centered care, cognitive biases, medical training, NHS doctors, diagnostic imaging
MeSH terms: Cost-Benefit Analysis, Diagnostic Tests, Routine, Humans, Predictive Value of Tests, Quality of Health Care, Sensitivity and Specificity, Evidence-Based Medicine, Uncertainty

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