Evaluation of unnecessary test requests based on free prostate- specific antigen testing

Authors : Eda Şahin, Havva Yasemin Çinpolat

Pages : 70-74

Doi:10.55665/troiamedj.1718719

View : 45 | Download : 41

Publication Date : 2025-09-30

Article Type : Research Paper

Abstract :Objective: As the demand for healthcare services increases, so does the frequency of laboratory test requests, leading to a rise in unnecessary testing. In this study, we aimed to evaluate the extent of unnecessary free prostate- specific antigen (fPSA) testing by analyzing prostate-specific antigen (PSA) and fPSA test requests at our hospital. Methods: We retrospectively reviewed PSA and fPSA test requests recorded in the hospital information system at Çanakkale Onsekiz Mart University Hospital between January 1, 2021, and December 31, 2023. Requests for fPSA were classified as unnecessary when PSA levels were either 10 ng/mL, when fPSA was ordered alone without a PSA test, or when fPSA was ordered together with PSA at the initial request when PSA levels were between 4 and 10 ng/mL. Additionally, according to the Rational Laboratory Use Test Request Procedure, PSA tests ordered at intervals shorter than 28 days were also considered unnecessary. The distribution of test requests was analyzed by clinical department. Results: Of the 2,728 fPSA tests, 2,522 (92.4%) were deemed unnecessary. Specifically, 2,306 (92%) of 2,507 requests from outpatient clinics and 216 (97.3%) of 221 requests from inpatient services were unnecessary. According to the Rational Test Request Procedure, 11.3% of PSA test requests were considered unnecessary. Conclusion: Unnecessary laboratory test orders contribute to increased healthcare costs and may lead to more invasive procedures due to false-positive results. Collaboration with clinicians and the elimination of unit-specific test request forms may help reduce unnecessary test utilization.
Keywords : tanısal testler, prostat-spesifik antijen, sağlık hizmeti maliyetleri

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