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Frequency of Laboratory Test Utilization in the Intensive Care Unit and Its Implications for Large-Scale Data Collection Efforts

Affiliation of the author: Division of Pediatric Critical Care, Departments of Pediatrics and Anesthesiology, University of Massachusetts Medical School, Worcester, MA.

Correspondence and reprints: Joseph J. Frassica, MD, Division of Pediatric Critical Care, Room H5-524, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655; e-mail: <frassicj{at}ummhc.org>.

Received for publication: 04/23/04; accepted for publication: 11/10/04.

Objective: Mapping local use names to standardized nomenclatures such as LOINC (Logical Observation Identifiers Names and Codes) is a time-consuming task when done retrospectively or during the configuration of new information systems. The author sought to identify a subset of intensive care unit (ICU) laboratory tests, which, because of their frequency of use, should be the focus of efforts to standardize test names in ICU information systems.

Design: The author reviewed the ordering practices in medical, surgical, and pediatric ICUs within a large university teaching hospital to identify the subset of laboratory tests that represented the majority of tests performed in these settings. The author compared the results of his findings with the laboratory tests required to complete several of the most frequently used ICU acuity scoring systems.

Results: It was found that between 104 and 202 tests and profiles represented 99% of all testing in the three ICUs. All the laboratory studies needed for six commonly used ICU scoring systems fell into the top 21 laboratory studies and profiles performed in each ICU.

Conclusion: The author identified a small subset of the LOINC database that should be the focus of efforts to standardize test names in ICU information systems. Mapping this subset of laboratory tests and profiles to LOINC vocabulary will simplify the process of collecting data for large-scale databases such as ICU scoring systems and the configuration of new ICU information systems.