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Effective Test Utilization 
Recommendations

The right test to the right patient at the right time











Do not routinely order Thyroid Hormone Binding Ratio (THBR, e.g., T3 Resin Uptake or T-Uptake) assays to determine the free T4 index. Use free T4 assays instead.
Chemistry
Do not perform a hypercoagulable workup in patients taking direct factor Xa or direct thrombin inhibitors
Hematology
Don’t order tissue transglutaminase IgG antibody or Deamidated Gliadin Peptide (DGP) antibodies (IgG or IgA) in the initial screening for Celiac Disease
Immunology
Do not routinely order broad respiratory pathogen panels unless the result will affect patient management
Microbiology
Do not order red blood cell folate levels at all. In adults, consider folate supplementation instead of serum folate testing in patients with macrocytic anemia
Hematology
Do not order a frozen section on a pathology specimen if the result will not affect immediate (i.e., intraoperative or perioperative) patient management
Surgical Pathology
Do not prescribe immune suppressive agents for suspected autoimmune hepatitis (AIH) without first excluding hepatotropic virus infections (e.g., viral hepatitis A, B, and C)
Immunology
Don’t transfuse plasma to correct a laboratory value; treat the clinical status of the patient
Transfusion Medicine
Do not perform peripheral blood flow cytometry to screen for hematological malignancy in the settings of mature neutrophilia, basophilia, erythrocytosis, thrombocytosis, isolated anemia, or isolated thrombocytopenia
Hematology
Don’t test vitamin K levels unless the patient has an abnormal international normalized ratio (INR) and does not respond to vitamin K therapy
Hematology