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BMJ. 2018 Nov 28;363:k4666. doi: 10.1136/bmj.k4666.

Temporal trends in use of tests in UK primary care, 2000-15: retrospective analysis of 250 million tests.

Author information

1
Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK jack.osullivan@phc.ox.ac.uk.
2
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
3
Center for Inherited Cardiovascular Disease, Stanford University, Stanford, CA, USA.
4
Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA.
5
Centre for Academic Primary Care, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
6
Primary Care and Population Sciences, University of Southampton, Southampton, UK.
7
Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK.

Abstract

OBJECTIVES:

To assess the temporal change in test use in UK primary care and to identify tests with the greatest increase in use.

DESIGN:

Retrospective cohort study.

SETTING:

UK primary care.

PARTICIPANTS:

All patients registered to UK General Practices in the Clinical Practice Research Datalink, 2000/1 to 2015/16.

MAIN OUTCOME MEASURES:

Temporal trends in test use, and crude and age and sex standardised rates of total test use and of 44 specific tests.

RESULTS:

262 974 099 tests were analysed over 71 436 331 person years. Age and sex adjusted use increased by 8.5% annually (95% confidence interval 7.6% to 9.4%); from 14 869 tests per 10 000 person years in 2000/1 to 49 267 in 2015/16, a 3.3-fold increase. Patients in 2015/16 had on average five tests per year, compared with 1.5 in 2000/1. Test use also increased statistically significantly across all age groups, in both sexes, across all test types (laboratory, imaging, and miscellaneous), and 40 of the 44 tests that were studied specifically.

CONCLUSION:

Total test use has increased markedly over time, in both sexes, and across all age groups, test types (laboratory, imaging, and miscellaneous) and for 40 of 44 tests specifically studied. Of the patients who underwent at least one test annually, the proportion who had more than one test increased significantly over time.

PMID:
30487169
PMCID:
PMC6260131

Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

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