High-Volume Laboratory Tests as Baseline for Benchmarking Less-Common Tests

Abstract Introduction/Objective Benchmarking establishes baseline laboratory utilization patterns across health systems. Nicholas et al. (2021) recently evaluated the use of test volume ratios to identify intervention targets at VA hospitals. We aim investigate potential differences reported with those non-VA Methods/Case Report Using Vizient® Clinical Data Base permission from Vizient, Inc. (All rights reserved.), we obtained aggregated annual and patient volumes 2019-2021. To assess accuracy high-volume tests as a surrogate for volumes, compared mean sodium MCV number encounters 712 hospitals (7,685,149 volume). then calculated eight less common analytes (homocysteine, prolactin, vitamin D (25-OH), HCV viral load, HIV Lyme disease serology, CD4, HSV serology) greater than 10,000 (279 hospitals, 6,046,670 using 1) 2) denominator comparison ratios. All are included in Choosing Wisely™ guidelines. Results (if Case Study enter NA) There was strong positive correlation between (R = 0.92 R=0.96, respectively). Our analyte-to-sodium were smaller expected. However, analyte-to-patient median similar reported. A showed (R=0.90), but nearly 4x On average, two methods agreed 70% time institutions 90th percentile- threshold. In previously ratios, five serology significant difference published Conclusion found. For calculating an adequate may pose challenge inter- institution comparisons. Standardization quantifying would improve benchmarking.