MANDATORY LABORATORY CONSULTATION - HOW ONE HOSPITALS PROGRAM REDUCEDOVERUSE OF CARDIAC TESTS

We retrospectively analyzed test use patterns during a 4-year period b efore and after institution of a mandatory laboratory approval program for lactate dehydrogenase isoenzyme analysis. In the first month afte r institution of the program, requests for lactate dehydrogenase isoen zymes declined from about 2,000 per month to 7 per month (greater than 99% decrease) and remained stable for 2 years. The decrease in lactat e dehydrogenase isoenzyme requests did not result in any significant c hange in requests for creatine kinase or creatine kinase MB isoenzyme, and total lactase dehydrogenase requests (relative to creatine kinase requests) were reduced. Of the remaining lactate dehydrogenase isoenz yme tests that were performed, most were normal or nondiagnostic.