“70% of clinical decisions depend on diagnostics.” You’ve seen this statistic, but it hides an important detail: timing.
The acuity gradient: Lab testing occurs in 98% of inpatient encounters, 56% in emergency departments, but only 29% in outpatient settings (Ngo et al., 2017): diagnostics concentrate where disease is most advanced.
Prevention is neglected: Evidence-based guidelines discourage comprehensive annual testing in asymptomatic patients, citing limited benefit and potential harm (Lazar & Gupta, 2013). Healthcare systems even nudge physicians to order fewer tests by displaying cost information (Feldman et al., 2013).
An efficiency trap: While symptom-driven testing is more cost-effective than mass screening, this optimizes for healthcare economics, not healthspan. What’s the cost of waiting years while preventable diseases progress silently? What is the cost for the individual?
An opportunity: I believe we need Precision Diagnostics that anticipate health trajectories cost-effectively, tests that are cheaper, simpler to deploy, with lower logistic costs, making maintenance of healthy status accessible and early detection possible, not just accurate.
If we priced added years of healthy life, wouldn’t our testing strategy look fundamentally different?
A reflection arising from thinking about Precision Diagnostics for my forthcoming book: https://lnkd.in/dN9xPFXx
hashtag#PrecisionDiagnostics hashtag#PredictiveMedicine hashtag#EarlyDetection hashtag#HealthcareInnovation
References: Feldman, L. S., Shihab, H. M., Thiemann, D., Yeh, H. C., Ardolino, M., Mandell, S., & Brotman, D. J. (2013). Impact of providing fee data on laboratory test ordering: A controlled clinical trial. JAMA Internal Medicine, 173(10), 903-908.
Lazar, D. R., & Gupta, S. (2013). Evidence brief: Role of the annual comprehensive physical examination in the asymptomatic adult. Department of Veterans Affairs.
Ngo, A., Gandhi, P., & Miller, W. G. (2017). Frequency that laboratory tests influence medical decisions. Journal of Applied Laboratory Medicine, 1(4), 410-414.