Currently Viewing:
Newsroom
Currently Reading
Should There Be a Worldwide Standard List of Essential Diagnostic Tests?
July 22, 2016 – Jackie Syrop
New Multiple Myeloma Drug Interferes With Routine Testing Prior to a Transfusion
July 22, 2016 – Surabhi Dangi-Garimella, PhD
ctDNA Could Predict Relapse in Ovarian Cancer Earlier
July 21, 2016 – Surabhi Dangi-Garimella, PhD
FDA Rejects Novartis' Biosimilar Application for Pegfilgrastim, Seeks Additional Information
July 20, 2016 – Surabhi Dangi-Garimella, PhD
Evidence Lacking on Relation Between IVF and Long-Term Risk of Breast Cancer
July 19, 2016 – Surabhi Dangi-Garimella, PhD
Mismatch Repair Deficiency an Ideal Marker to Initiate Precision Care in CRC
July 19, 2016 – Surabhi Dangi-Garimella, PhD
Medical Home Program in Pennsylvania Cuts Healthcare Costs for Complex Medicaid Patients
July 19, 2016 – Jackie Syrop
Study Says Therapeutic Substitution, While Controversial, May Help Decrease Drug Costs
July 18, 2016 – Jackie Syrop
UIC Study Supports Use of Adjuvant Chemotherapy in Stage II Colon Cancer
July 18, 2016 – Surabhi Dangi-Garimella, PhD

Should There Be a Worldwide Standard List of Essential Diagnostic Tests?

Jackie Syrop
Like the influential Model List of Essential Medicines maintained by the World Health Organization, there should be a list of key tests every country should have available, with high quality standards, write a group of experts.
Like the influential Model List of Essential Medicines (EML) maintained by the World Health Organization, there should be a list of key tests every country should have available, with high quality standards, according to a group of experts writing in the June issue of The New England Journal of Medicine.

EML, the authors note, has guided billions of dollars in spending by government agencies, healthcare organizations, and charities worldwide on more than 300 critical pharmaceuticals. A parallel Model List of Essential Diagnostics could help make healthcare more efficient by improving capacity and quality of testing in developing nations. “You can’t treat what you can’t test,” notes Lee F. Schroeder, MD, PhD, an assistant professor of pathology at the University of Michigan Medical School and lead author of the paper. “The list includes the most critical tests for diagnosing conditions, monitoring drug effects and toxicity, reducing overprescription of antibiotics, and enabling surveillance of infectious threats.”

Diagnostic tests are required to fulfill the healthcare needs of populations and are critical to the management of both communicable and noncommunicable diseases, surveillance of emerging infectious diseases, and the safe and rational use of EML medicines. For example, better access to diagnostic tests has been shown to quadruple the number of cases of HIV detected, to double the rate of adequate blood sugar control, and reduce overtreatment of malaria by 73%.

The paper proposes a list of 147 essential lab tests in 57 categories. Some of the tests could have an important impact on outbreaks that can spread throughout the world quickly, such as Ebola and Zika. As with medicines, some diagnostic tests have utility in more than 1 condition. For example, an elevated white cell count can suggest infection, and it can also indicate leukemia. The list syncs with the EML in that a single diagnostic test can guide the use of many different EML-listed medications. The paper lists 19 test categories that can guide the use of 10 or more medications or medication combinations that appear in the EML. The top test, complete blood count, corresponds with 136 medications on the EML; the second test, liver enzymes, corresponds with 104 medications. The last test listed, calcium, corresponds with 10 EML medications.

The EML is probably the single most important tool in global health, says Schroeder. A similar list of essential diagnostics is long overdue and could amplify the impact of current global health investment, he says, and would be cost-effective in the long run. “We believe the world can no longer wait to have laboratory testing available to all clinicians,” the authors say. “An EDL would clarify priorities for policymakers and encourage setting common goals regarding laboratory testing, paving the way toward improved health care delivery and ultimately better patient outcomes.”

Reference

Schroeder LF, Guarner J, Elbireer A, Castle PE, Amukele TK. Time for a model list of essential diagnostics. N Engl J Med. 2016;374:2511-2514. doi:10.1056/NEJMp1602825.

 
Copyright AJMC 2006-2020 Clinical Care Targeted Communications Group, LLC. All Rights Reserved.
x
Welcome the the new and improved AJMC.com, the premier managed market network. Tell us about yourself so that we can serve you better.
Sign Up