Læknablaðið - 15.09.1992, Blaðsíða 25

LÆKNABLAÐIÐ
285
Verkfræðistofunni Streng, fyrir margvíslega
aðstoð.
SUMMARY
The optimal use of clinical laboratory tests by
doctors is not known. Reasons behind requests
for laboratory tests are often complicated and are
changing fast due to rapid progress in technology.
A retrospective study was performed on a computer
accumulated database of patients referred to an
outpatient laboratory in Reykjavík during the
period from 1. Aprii 1987 to 31. December
1990. Two groups of doctors were selected for
the study, general practitioners and cardiologists.
The material consisted of about 21000 referrals of
14500 patients, 97% of which were referred by 26
general practitioners and 11 cardiologists. The well
equipped and highly automated laboratory offers
all the most common laboratory tests in clinical
haematology and biochemistry together with some
not so common, over ninety different tests in
all. General practitioners referred 1.7 times more
women than men and the largest number was in the
age group 20-30 years, numbers declining slowly
with age. The cardiologists referred 1.3 times more
men than women and the 50-59 and 60-69 age
groups were the most numerous. The distribution
of age and sex was in fair agreement with the
known prevalence of cardiovascular diseases in
the Icelandic population. Blood status and ESR
were the tests most frequently asked for by both
groups of doctors but otherwise requests were
different. Cardiologists requested tests for lipids,
glucose, kidney tests and electrolytes most often,
whereas general practitioners requested a greater
variety of tests, large groups being liver tests
and enzymes, serum proteins and haematopoiesis
related tests such as iron, and folate. A
significant increase in the number of tests per
patient with increasing age was found, ranging
from 3.3 to 7.7 for the ages 0-9 to 60-69 years,
respectively. During the observation period 70% of
the patients of both groups were referred only once
and 10% were referred more than twice, with iittle
difference between the two groups of doctors. It
is concluded that, in spite of increased intensity
and sophistication of primary care in Iceland,
both groups of doctors in the area specialize in
their field, use the laboratory modestly and, by
requesting tests associated with the search for risk
factors of diseases, do a substantia! screening and
preventive work as well.
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