INTRODUCTION The appropriate use of laboratory diagnostics is increasingly at stake. The aim of this study was to depict some paradigmatic examples of under- and overutilization, as well as possible solutions across Europe. METHODS We collected six examples from five European countries where a rise or decline of orders for specific laboratory parameters was observed after organizational changes but without evidence of changes in patient collective characteristics as source of this variation. RESULTS The collected examples were the following: 1-Germany) Switch from a Brain-Natriuretic-Peptide assay to NT-pro Brain-Natriuretic-Peptide assay, resulting in a 374% increase in these analytics; 2-Spain) Implementation of a gatekeeping strategy in tumor marker diagnostics, resulting in a 15-61% reduction of these diagnostics; 3-Croatia) Stepwise elimination of creatine-kinase-MB assay from the laboratory portfolio; 4-UK) Removal of γ-glutamyl transferase from a "liver function" profile, resulting in 82% reduction of orders; 5-Austria) Implementation of a new device for rapid Influenza-RNA detection, resulting in a 450% increase of Influenza testing; 6-Spain) Insourcing of 1,25-(OH)2-Vitamin D measurements, leading to a 378% increase of these analyses. CONCLUSION The six paradigmatic examples described in this manuscript show that availability of laboratory resources may considerably catalyze the demand, thus underscoring that inappropriate use of laboratory resources may be commonplace in routine laboratories all across Europe and most probably beyond. They also demonstrate that the application of simple strategies may assist in overcoming this issue. We believe that laboratory specialists need to refocus on the extra-analytical parts of the testing process and engage more in interdisciplinary patient-care.

中文翻译：

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实验室测试的不当使用：可用性如何触发需求 - 欧洲的示例。

引言 实验室诊断的适当使用越来越受到威胁。本研究的目的是描述一些使用不足和过度使用的典型例子，以及整个欧洲的可能解决方案。方法 我们从五个欧洲国家收集了六个例子，其中在组织变化后观察到特定实验室参数订单的上升或下降，但没有证据表明患者集体特征的变化是这种变化的来源。结果 收集的示例如下： 1-德国）从脑利钠肽测定转换为 NT-pro 脑利钠肽测定，导致这些分析增加 374%；2-西班牙）在肿瘤标志物诊断中实施把关策略，导致这些诊断减少 15-61%；3-克罗地亚）从实验室产品组合中逐步消除肌酸激酶MB检测；4-UK) 从“肝功能”谱中去除 γ-谷氨酰转移酶，导致订单减少 82%；5-奥地利) 实施一种用于快速检测流感 RNA 的新设备，导致流感检测增加 450%；6-西班牙) 1,25-(OH)2-维生素 D 测量的内购，导致这些分析增加了 378%。结论 本手稿中描述的六个典型示例表明，实验室资源的可用性可能会极大地促进需求，从而强调实验室资源的不当使用可能在整个欧洲乃至其他地区的常规实验室中很常见。他们还表明，应用简单的策略可能有助于克服这个问题。