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Diagnosis (Berl). 2019 Mar 26;6(1):69-71. doi: 10.1515/dx-2018-0098.

Diagnostic error as a result of drug-laboratory test interactions.

Author information

Laboratory for Clinical Chemistry and Haematology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.
Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, The Netherlands.
Department of Clinical Chemistry, Zuyderland Medical Centre, Heerlen, The Netherlands.
Department of Clinical Chemistry, Erasmus University Medical Centre, Rotterdam, The Netherlands.
Department of Clinical Chemistry, Medical Spectrum Twente, Enschede, The Netherlands.
Department of Clinical Chemistry, Certe, Groningen, The Netherlands.
Laboratory for Clinical Chemistry and Haematology, University Medical Centre Utrecht, Utrecht, The Netherlands.
Department of Clinical Chemistry, Slingeland Hospital, Doetinchem, The Netherlands.
Department of Hospital Pharmacy, Erasmus Medical Centre, University Medical Centre Rotterdam, Rotterdam, The Netherlands.
Department of Clinical Chemistry, LabWest/HMC Westeinde, The Hague, The Netherlands.
Department of Clinical Chemistry, Rivierenland Hospital, Tiel, The Netherlands.


Background Knowledge of possible drug-laboratory test interactions (DLTIs) is important for the interpretation of laboratory test results. Test results may be affected by physiological or analytical drug effects. Failure to recognize these interactions may lead to misinterpretation of test results, a delayed or erroneous diagnosis or unnecessary extra tests or therapy, which may harm patients. Content Thousands of interactions have been reported in the literature, but are often fragmentarily described and some papers even reported contradictory findings. How can healthcare professionals become aware of all these possible interactions in their individual patients? DLTI decision support applications could be a good solution. In a literature search, only four relevant studies have been found on DLTI decision support applications in clinical practice. These studies show a potential benefit of automated DLTI messages to physicians for the interpretation of laboratory test results. All physicians reported that part of the DLTI messages were useful. In one study, 74% of physicians even sometimes refrained from further additional examination. Summary and outlook Unrecognized DLTIs potentially cause diagnostic errors in a large number of patients. Therefore, efforts to avoid these errors, for example with a DLTI decision support application, could tremendously improve patient outcome.


(computerized) clinical decision support; clinical laboratory test; diagnostic error; drug-laboratory test interaction; patient safety


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