Look-Alike & Sound-Alike (LASA) Tests, Pre-Analytical Strategy in Reducing Diagnostic Laboratory Errors

Abstract

In modern healthcare, diagnostic laboratory tests serve as the fundamental data for clinical decision-making. Over the past decade, the clinical laboratory test menu has substantially increased in size and complexity. This is especially seen in the large number of tests added in the molecular and genomics department, which require a deeper understanding of their clinical utility, testing methods, and relevant clinical application. This has created a persistent and insufficiently recognized threat of wrong test selection because these are often look-alike (orthographic similarity: names that look visually similar, especially in handwritten prescriptions) and sound-alike (phonetic similarity: names that sound similar when spoken aloud, leading to errors in verbal orders) (LASA) tests and prone to errors by the healthcare professionals. This article compiles the primary concerns about these LASA tests for the first time, categorizing the risks, examining the fundamental causes, and highlighting significant strategies to mitigate the dangers. Confusion created by LASA tests due to inappropriate test selection can result in a delayed diagnosis and inadequate treatment, leading to significant harm to the patient. This is a very critical issue for patient safety that has to be dealt with a planned approach

Keywords

Introduction

The growth of specialized lab tests has been an important aspect of human healthcare. Diagnostic lab tests aid in health condition assessment and help doctors make individualized treatments. With advanced technology, the complexity and capability of specialized lab tests are increasing day-by-day. Nevertheless, this rise has brought with it a perplexing combination of abbreviations, short forms, and new terms/names and many of them seem like similar tests. For instance, eGFR (for kidney function), EGFR (for a genetic mutation in lung cancer), HBsAg (for an active hepatitis B infection), and Anti-HBsAg (for immune status against Hepatitis B infection) are all similar sounding tests. Healthcare professionals and patients need to know the differences between these tests so that they can get the right diagnosis and right treatment [1]. To improve patient outcomes, it is important to communicate clearly and educate patients & healthcare professionals about the purpose and applications of these specialized laboratory testing. Hence, it is very important for healthcare professionals to have internal quality control methods in place at each of the testing phases to reduce errors and ensure that the lab results are correct. Similarly, continual training and education for everyone who works on the testing process may assist in stopping errors and contribute to better patient care (Fig 1).
 
 
Fig 1. Graphical representation of LASA phenotypes and solutions in Diagnostic laboratories.
 
Identifying the issue: High-risk LASA tests phenotypesThe concept of LASA drugs list in healthcare was introduced under pharmacy in early 2000 and later adoption by WHO in 2007 in its patient safety solutions, is today a well-established and recognised in controlling medical errors. However, similar confusion is created by LASA tests, which put patients at risk, but is highly under-recognized in laboratory sample workflow. The risks of LASA tests require a detail discussion by creating different groups of these tests based on how they create confusion and how they potentially harm patient. For instance, high-risk LASA phenotypes may cause prescription mistakes that might cause major misdiagnosis and delayed treatment. Healthcare professionals can take proactive steps to avoid errors, if they know about these dangers [2].
1. Antigen/antibody dichotomy: This is the most extreme group for physicians for prescribing the tests. It indicates a direct connection between harbouring a pathogen or auto-antigen and how the body responds to it. It is very important to understand the difference between antigens and antibodies to avoid misdiagnosis and wrong treatment. Healthcare professionals must be diligent in identifying and managing these high-risk LASA phenotypes to guarantee patient safety.For instance, HBsAg (for an active hepatitis B infection), and anti-HBsAg (for immune status against hepatitis B infection). The order or read the incorrect one, can be a simple mistake: placing an infected individual in the same group as a healthy person, that may lead to treatments or procedures that aren't needed and potentially impact the patients’ health. To prevent these potentially deadly mistakes, healthcare workers need to be properly trained and educated on how to recognize and tell the difference between antigens and antibodies.Side-effect: Misdiagnosing a current disease or falsely guaranteeing immunity, which has an impact on treatment, prevention, and public health reporting. Likewise, if test results are not interpreted correctly, it may lead to wrong infectious disease diagnosis, which can further lead to wrong treatment decisions and mental trauma for patients. So, it's important for healthcare professionals to choose wisely the correct antigen or antibody testing as applicable based on the clinical setting [3].
2. The "total" vs. "free" fallacy: When you test for hormones and proteins, you may get both "total" and "free" (bioactive) results. The "total" measurement includes both the bound and unbound forms of the hormone or protein. The "free" measurement, on the other hand, only contains the unbound, active form that the body may utilize right away. When looking at findings, it's vital to think about both measures to gain a whole picture of the body's hormone or protein levels.Some instances include testosterone vs. free testosterone, T4 vs. free T4, and PSA vs. free PSA.Effect: Getting the incorrect diagnosis for endocrine disorders such hypogonadism or thyroid dysfunction, or not accurately figuring out how likely it is that someone would have prostate cancer. Treatment may be erroneously initiated or neglected. Healthcare personnel must correctly interpret these parameters to guarantee appropriate diagnosis and treatment for patients. Wrong evaluations might have major effects, such as getting medicines that aren't needed or missing possible health hazards.Altogether, this shows a very serious problem in laboratory medicine: test labels that appear or sound the same yet signify quite different things in the clinic. Mixing up these combinations, such as ordering a Total Testosterone when a Free Testosterone is required, may directly lead to wrong diagnoses, wrong treatments, and compromised patient care. The risk covers a wide range of things, from antigens vs. antibodies to total vs. free hormone levels. It even includes simple mistakes like mixing up eGFR (kidney) with EGFR (cancer gene). This article emphasizes the need for meticulous accuracy in test ordering, labelling, and interpretation to guarantee patient safety[4] (Table 1).
 
Table 1: Pairs of high-risk LASA diagnostic tests
 
S No    LASA tests    Different tests    Diverse clinical utility of tests
1.        25(OH) vitamin D    1,25 (OH) vitamin D    Two different vitamin D metabolites used to assess nutritional status (vitamin D deficiency) and Renal function
2.        Acetylcholinesterase receptor antibody    Acetylcholinesterase    These completely different tests designed to diagnose Myaesthenia gravis and loss of NMJ function due to OPC poisoning
3.        AFP (Alpha-fetoprotein)    AFB (Acid-fast bacillus)    Different tests used for assessing liver function/tumor marker and TB infection
4.        Aldosterone    Aldolase    Aldosterone-hormone in regulation of minerals and blood pressure, aldolase- enzyme for skeletal muscles
5.        Anti-microsomal Ab    Anti-mitochondrial Ab    These are two different auto-Antibodies, cannot be used as substitute as clinical interpretation is completely different
6.        Apolipoprotein A1    Apolipoprotein B    These are different tests used for assessing lipid fractions separately for HDL and LDL
7.        ATIII antigen    ATIII activity    Though the analyte is same the activity represents the functional assessment while antigen represents the protein quantification with different ranges, units and clinical interpretation
8.        B12 total    B12 HoloTc (Holotranscobalamin)    These are two different vitamin D metabolites used to assess nutritional status (vitamin B12 deficiency)
9.        BNP    Pro-BNP    These are two different metabolites for ventricular function assessment but the sample type, analyte stability & interpretation cut off are different
10.        C3    CD34    These are different tests used for assessing complement levels and peripheral stem cell analysis
11.        C4    CD4    These are different tests used for assessing complement levels and Immune T-cell subset analysis
12.        Cyclosporine    Cycloserine    These are different tests used for TDM of two different categories of drugs as immunosuppressant and antibiotic
13.        D3butyrate    Vitamin D3    D3 butyrate- ketone body, Vitamin D3- is Cholecalciferol-vitamin D3
14.        DHEA    DHEASo4    DHEA is precursor for DHEASo4- important in assessing source for androgenicity as adrenals
15.        E2 Estradiol    E3 Estriol    These are two different metabolites for Estrogens used for assessment in hyperestrogenic states to identify the source adrenal, ovary, peripheral tissues
16.        eGFR    EGFR    These completely different tests designed to assess renal function and tumor marker (lung)
17.        Gamma GT (GGT)    GTT (glucose tolerance test)    These are different tests used for assessing liver function and Glucose intolerance
18.        HbeAg    Anti HbeAg    These are Antigen and Antibody counterparts and cannot be used as substitute as clinical interpretation is completely different
19.        HbsAg    Anti HbSAg    These are Antigen and Antibody counterparts and cannot be used as substitute as clinical interpretation is completely different
20.        HOMA IR    ROMA    These are different tests used for assessing Insulin resistance and Ovarian malignancy
21.        Hs-CRP    CRP    Though the analyte is same the measuring ranges are different and and cannot be used as substitute as clinical interpretation is completely different
22.        Lp-PLA2 (plac)    PLA2r-antibody    These completely different tests designed to assess atherosclerosis and Glomerulonephritis
23.        Noradrenaline    Adrenaline    These are two different metabolites for catecholamines used for assessment in adrenal tumors with different ranges, units and clinical interpretation
24.        Nor-metanephrine    Metanephrine    These are two different metabolites for catecholamines used for assessment in adrenal tumors with different ranges, units and clinical interpretation
25.        Nt-ProBNP    P1-NP    These are different tests used for assessing ventricular function and bone resorption
26.        Plasma renin activity    Plasma direct renin    Though the analyte is same the activity represents the functional assessment while antigen represents the protein quantification with different ranges, units and clinical interpretation
27.        Prolactin    Procalcitonin    These are different tests used for assessing reproductive hormone and early infection marker
28.        Protein C antigen    Protein C activity    Though the analyte is same the activity represents the functional assessment while antigen represents the protein quantification with different ranges, units and clinical interpretation
29.        Protein S antigen    Protein S activity    Though the analyte is same the activity represents the functional assessment while antigen represents the protein quantification with different ranges, units and clinical interpretation
30.        PSA    Free PSA    Though the hormone is same the free form is metabolic active form with different ranges, units and clinical interpretation
31.        T3    Free T3    Though the hormone is same the free form is metabolic active form with different ranges, units and clinical interpretation
32.        T4    Free T4    Though the hormone is same the free form is metabolic active form with different ranges, units and clinical interpretation
33.        Testosterone    Free Testosterone    Though the hormone is same the free form is metabolic active form with different ranges, units and clinical interpretation
34.        TG    Anti TG    These are Antigen and Antibody counterparts and cannot be used as substitute as clinical interpretation is completely different
35.        β-2 microglobulin    β-2 glycoprotein I    These are different tests used for assessing plasma cell disorders and anti-phospholipid syndrome
36.        β-HCG    Free BHCG    Though the hormone is same the free form is metabolic active form with different ranges, units and clinical interpretation
 
3. Pathway confusion: Tests from distinct but related metabolic or disease pathways look a lot alike, which is frightening.Gamma GT (GGT, an enzyme in the liver) and GTT (Glucose Tolerance Test, for diabetes) are two examples. Noradrenaline is a neurotransmitter and hormone that makes adrenaline. If healthcare personnel don't pay close attention to their analysis, these similarities might cause confusion and make it hard to understand test findings. Medical personnel must be aware of these possible problems and use heightened caution when interpreting test findings from associated pathways.Effect: A wrong appraisal of the organ system, which leads to a diagnostic dead end and a late correct diagnosis.
4. Functional vs. quantitative mix-up: This is crucial in hematology since it involves mixing up the quantity of a protein with how active it is.For instance, Protein C Antigen compared to Protein C Activity and ATIII Antigen compared to ATIII Activity. Impact: A lot of danger in thrombophilia workups. A patient may have normal antigen levels while having dysfunctional proteins, leading to a missed diagnosis of a hypercoagulable state and an elevated risk of life-threatening thrombosis. Also, this mix-up might cause doctors to make bad treatment choices that could hurt the patient. Healthcare practitioners must be able to tell the difference between functional and quantitative metrics in order to provide the best treatment possible [5].
5. Modern vs. legacy name trap: Tests change as science progresses ahead, yet old terminology remain the same.
Anti-microsomal Ab (old) and Anti-TPO (new) are two examples. C-ANCA (based on patterns) and Anti-PR3 (based on antigens). Healthcare professionals need to keep up with these changes in language so that they can correctly interpret test findings and treat patients properly. Not being aware of these changes might cause confusion and mistakes in diagnosis and treatment.
Impact: There is a danger that orders will be placed twice, that physicians who aren't specialists will not communicate well, and that medical records will not be comprehensive. Healthcare practitioners need to keep up with changes in medical testing language to avoid mistakes and provide patients the best treatment possible. Not recognizing changes may lead to misunderstanding, duplicate prescriptions, and inadequate medical records, which might hurt patients' health.The cause of misunderstanding by showing pairings of test names that mean the same thing. These are multiple ways of saying the same laboratory research. These pairings are not like the last list of harmful "look-alikes." Instead, they show how things might be made clearer and more consistent. For instance, knowing that Anti-microsomal Ab and anti-TPO are the same thing stops people from ordering the same thing twice and makes sure that various labs and medical records all interpret the same thing the same way [6]. It has changes that change obsolete methodological names (C-ANCA) to contemporary, accurate antigen names (anti-PR3), and it makes it clear that multiple acronyms (IGRA and TB Gold) may refer to the same test technique. Knowing these synonyms cuts down on repetition and makes it easier to talk to each other (Table 2).
 
Table 2: Harmonized laboratory test nomenclature 
 
Synonyms and equivalent tests
S No    Synonyms    Same tests
1.        Anti-microsomal Ab-Thyroid    anti TPO
2.        P – ANCA    anti MPO
3.        Cholinesterase    Pseudocholinesterase
4.        C-ANCA    anti PR3
5.        BHCG    HCG Total
6.        Prothrombin time    INR
7.        aPTT    PTT
8.        HOMA Index    HOMA IR
9.        P4    Progesterone
10.        E2    Estradiol
11.        anti -ssa    anti- Ro
12.        anti- ssb    anti- la
13.        DsDNA    NcxDNA
14.        IGRA    TB gold
15.        Mantoux    Tuberculin
16.        anti-liver kidney microsomal Ab    LKM1
17.        anti-mitochondrial Ad    AMA (M2)
18.        Anti NMO IgG    Anti- aquaporin 4 ab
19.        Anti VGKC    Anti LG1, Anti CASPr2
20.        Anti NMDA receptor    Anti NMDA (R1)
21.        25(OH)vit D    vit D3
22.        D3 butyrate    serum ketones
23.        CBC    Hemogram
24.        VDRL    RPR
25.        Microalbuminuria    Albuminuria
 
Historical nomenclature: A lot of lab words, such "microsomal," derive from ancient methods of doing things.
Specialties: A cardiologist, for instance, wouldn't know as much about rheumatology acronyms (such Anti-ssA vs. Anti-Ro) and vice versa. Not knowing about other specialties might cause mistakes and misunderstandings in patient care. 
Anti-SSA (Sjogren’s syndrome A): This was first seen in people with Sjögren’s syndrome and systemic lupus erythematosus (SLE), whereas Anti-Ro, term refers to antibodies that target two different proteins, Ro60, ribonucleoprotein that helps keep RNA quality high. Ro52 (TRIM21) is an E3 ubiquitin ligase that helps control the immune system, both are classified as anti-SSA/Ro antibodies [7].
 
Table 3: Similar diagnostic test names but different methods and importance
Test name    Test methods    Desired/recommended    Importance & relevance
ANA    IIF, ELISA    Screening- IIF    IIF method has higher sensitivity than ELISA
ANCA    IIF, ELISA    Screening-IIF, Monitoring- ELISA P-ANCA (Anti-MPO), C-ANCA (Anti-PR3)    Diagnosed case needs to monitor using Quantitative values provided by ELISA
Ds-DNA    IIF, ELISA    Screening-ELISA    ELISA method has higher sensitivity than IIF
Bcr-c-Abl    FISH, RT-PCR    Diagnosis- FISH, Monitoring –RT-PCR    Diagnosed case (CML) needs to monitor using Quantitative values provided by rt-PCR
PML-RARA    FISH, RT-PCR    Diagnosis- FISH, Monitoring –RT-PCR    Diagnosed case (APML) needs to monitor using Quantitative values provided by rt-PCR
Lamda (free light chain)    Nephlometry, Immunohisto chemistry    Diagnosis and Monitoring (Plasma cell disorders)- Serum sample, diagnosis- tissue sample    Test selection during registration to be correlated with the prescription/ TRF, and received sample type
 
Healthcare professionals need to keep learning about new terms and work together across specializations to make sure they are communicating clearly.
6. Suggested solutions to address the Challenges created by LASA
a. Designing an Electronic Health Record (EHR): If you have drop-down menus that list tests in alphabetical order, C3 (complement) can be slightly above CD34 (a stem cell marker), which might lead to selection errors. It could help to group tests by expertise or relevance to minimize confusion and mistakes when choosing them in an EHR. Adding protections like color-coding or distinct sections for various specializations may also assist make sure that the right tests are chosen [7,8]. Use of ‘‘tall-man’’ lettering for a portion of the name of tests which are similar there by highlighting it to the user to re-verify before final test selection.
Smart EHR Safeguards: When high-risk LASA combinations are selected, there should be hard stops, pop-ups that validate the choice, and visual cues (such "WARNING: This is an ANTIBODY test"). Adding color-coded warnings or flags for high-risk LASA combinations may also help prevent against prescription errors. These visual signals may help healthcare workers see and fix any problems before they happen.
b. Verbal orders and written requests: The risk is higher in high-stress locations like the ER or ICU, where "HOMA-IR" may easily be confused with "ROMA." This might have negative effects on how well patients are cared for. Healthcare institutions may reduce the chance of mistakes by employing consistent procedures for verbal commands and written requests. This includes double-checking abbreviations and acronyms that could be hard to understand.
c. Professional training and competency evaluations: 
Ongoing professional training and competence assessments are the most important ways to protect against LASA tests and potential dangers. Periodic Trainings need to include all healthcare personnel with interactive modules, simulation exercises, and mnemonic methods that reinforce safe prescription and appropriate test selection. Structured competence assessments are very important for proving that this instruction works, and tests, which might involve direct observation, case-based testing, and internal audits, objectively determine how well a person can accurately identify, distinguish, and manage LASA tests in practice. Giving healthcare professionals things like reference guides or decision assistance tools may also help them choose the right tests wisely. By necessitating and keeping records of this cycle of training and assessment, healthcare organizations need to make sure that information is not only shared but also remembered and used correctly. This creates a culture of alertness that would directly reduce the likelihood of pre-analytical inappropriate test selection errors.
d. Pre-analytical lab quality indicators: Every lab as part of good laboratory practices and Quality assurance should define Lab Quality indicators across all testing phases. Amongst the list of Pre-analytical lab quality indicators, Wrong / inappropriate test selection should be included with an appropriate benchmark (usually < 0.5%). Periodic review and monitoring of this quality indicator will help the lab in identifying and updating the LASA tests and use this information in continual staff training.
e. Standardization and forced differentiation: Professional groups (example- CAP, IFCC) can work together to get rid of imprecise heritage names and replace them with standardized, clear terminology. EHRs should use alternative primary names, as "25-Hydroxy Vitamin D" instead than simply "Vitamin D." This will help clarify things up and make sure that doctors and nurses always use clear and detailed language when prescribing or giving out drugs. Standardizing how things are named may help reduce the number of LASA tests related errors that happen in clinical practice even further.
f. Patient communication: Writing down all of the tests that patients are undergoing so they can double-check everything. This may assist keep people from being confused and make sure that patients know all they need to know about their health care. Also, getting patients to ask questions and get more information may help communication even more and lower the chance of errors.
g. Reporting and learning: Creating an environment for Just culture and not Blame culture by encouraging all healthcare professionals to report near-misses and errors with LASA tests, which enables the organization to uncover, learn and address faults in the system. Healthcare professionals encouraged for open communication and learning from their experiences in order to stop similar errors in future. This proactive strategy may help patients get better results and, in the end, improve the quality of treatment they get.
7. Test name harmonization / standardisation-
Ambiguities, inconsistencies, omissions, and other defects in the naming of laboratory tests can send test orders and results interpretation awry, particularly with some of the most common tests. The problem with lab test names is a longstanding one and it has become more evident in recent years. To add into this confusion, local institutions have their own naming standards, as do many of the large reference labs. Hence, it is imperative to have some rules set to get in standardization while assigning test names. Following are some rules highlighting important aspects of good laboratory test name practices (Table 4).
 
Table 4. Guidelines for good laboratory test name practices in diagnostics
 
First word or Term    Use specific analyte or panel name or its ubiquitous abbreviation eg- WBC
Analyte and Panel names    Spell out completely, if possible, must be ubiquitously understood even if abbreviated, full name may be followed by equivalent and more commonly used abbreviation enclosed in paranthesis. Do not use Parent company/ branded IVD provider test/kit names eg TB Quatiferon should replaced by IGRA
Necessary components    Include all necessary components for correct interpretation (does not apply to panels)
Medication (drug) levels    Put level after the name of the analyte eg Vancomycin level
Antibody test    Do not prefic with ‘Anti-“ include specific antibody eg- IgG, IgM – just after the analyte name or use antibody or Ab for total antibody tests
Panels    Specify components analyzed < or = 3 and when sufficient character space 
Special characters    Do not use forward slashes to represent and accept w/ for with and w/o for without. Forward slashes can be confused with ratios. Do not use apostrophe(‘), asterisk(*), at symbol (@), pound sign- as they perform unanticipated functions or flag errors in information systems
Specimen type    Do not include specimen type in the name if the specimen is peripheral blood, blood derivative or test performed on multiple specimens- eg- tissue culture. Unless necessary to differentiate from similar name tests. For all other tests performed on single specimen types, add specimen types after test name
Condition or time    If the test should only be used for a specific condition or time, add it after the analyte name eg- fasting, peak
Reflex test    Add the word “Reflex” after analyte name to indicate the ordering clinician that the test includes a reflex test. Identify reflex test names if sufficient space available
Superfluous information    Do not include information that is unnecessary for ordering (eg- do not include test method if there is only one method available)
 
Use of LOINC CODES - In addition, the Logical Observation Identifiers Names and Codes (LOINC) system is also an important informatics tool for reducing risk in the context of a LASA tests. Training programs usually concentrate on medicine/test names and methods, but lab test labels that are unclear or not standardized may also lead to diagnostic and treatment errors, even if they aren't as recognisable. In general, accurate LOINC codes for laboratory and clinical observations can solve this problem by making test orders and findings clear. LOINC makes definite that every test, such a "BUN" (Blood Urea Nitrogen) or a "Creatinine, Serum," has a unique, machine-readable code. This cuts down on the chance of misunderstanding that may happen when tests use similar-sounding acronyms or naming standards that are exclusive to an organisation. When this standardization is added to computerized provider order entry (CPOE) and EHRs, it makes the data layer safer and more reliable. This makes sure that the proper diagnostic information is used to guide safer therapeutic treatments, and prevents errors that aren't caused by the medicine itself, but by the tests that demonstrate for clinical interpretations [9].
8. The Bad Effects: More than a Typo
If you make a mistake using LASA tests, the results are quite bad:
Direct harm to the patient: the wrong treatment (such chemotherapy, immunosuppressants, or anticoagulation).
Diagnostic Delay: The "wrong" result is looked for instead of the "right" test, which makes the illness worse.
Psychological Distress: People and their families are worried when they get the incorrect vital diagnosis. These mistakes may also get healthcare practitioners in trouble with the law, which can lead to malpractice lawsuits and harm to their professional image. Also, LASA errors may make people lose faith in the healthcare system, which might make them less happy with their care and less likely to follow their treatment plans.
Unnecessary tests, consultations, and treatments waste a lot of healthcare resources.
Mitigation Strategies: A Call for a Multidisciplinary Approach
Everyone in the healthcare system has to work together to cope with LASA tests related risks. This involves making rules for double-checking, making it easier for healthcare practitioners to talk to each other, and getting patients involved in their own treatment to avoid errors. Also, continual education and training on how to safely order tests will help lower the chances of LASA test related errors [10].
DISCUSSION
It may be hard to read lab findings because "look-alike, sound-alike" (LASA) tests are so common. These tests confuse both patients and healthcare workers. To get the right diagnosis and treatment, you need to know how these tests work. Estradiol (E2) and estriol (E1) are two separate estrogens that have different jobs in women who are not pregnant and women who are pregnant. In the same way, total testosterone and free testosterone look at separate parts of hormonal activity, much as comparing total bank savings versus cash on hand. Anti-microsomal antibodies, also known as anti-TPO antibodies, should not be confused with anti-mitochondrial antibodies (AMA), which are used to find liver illness. Also, important screening tests like Gamma GT (GGT) and Glucose Tolerance Test (GTT) show how a little change in the name may have big effects on how patients are treated. Patients must engage in clear communication on test nomenclature, including the verification of acronyms and the clarification of whether a value represents a total or a free level. Healthcare personnel need to be careful to make sure that test orders and interpretations are correct, since a simple mistake might change the whole diagnostic procedure. It's interesting that several words might mean the same thing, which can help clear up any misunderstanding. For example, BHCG means the same thing as Total HCG, and Anti-NMO IgG means the same thing as Anti-Aquaporin-4. In the end, knowing lab data gives patients more control and leads to improved health outcomes..
CONCLUSION
Inappropriate test selection can lead to patient harm through misdiagnosis, delayed or unnecessary treatment and sometimes unnecessary procedure. LASA diagnostic tests are becoming an emerging problem, especially with widened scope of tests in this era of advancing laboratory medicine. They are not just a small annoyance; they represent a major risk to patient safety that is built into the medical terminology which is used in clinical practice. To get rid of this toxic alphabet soup, we need a multi-pronged approach that includes standardizing test names, overcoming technical hurdles, and ongoing education of healthcare professionals. The first and most important step to getting the appropriate diagnosis and safe care is making sure that the right test is done on the right patient. To conclude right test selection in right way and at right time is important & failing to do so compromises patient safety.
Acknowledgments: The authors are thankful to the Management, Apollo Diagnostics Global Reference Lab, Hyderabad 500037 India for their support during the study.
Funding: This research received no external funding.
Conflict of interest: The authors declare no conflict of interest.
Author Contributions: Conceptualization, E. Maruthi Prasad (EMP), and Rajesh Bendre (RVB); Investigation, Resources, Data curation, Writing – original draft- EMP, and RVB review & editing, Supervision- EMP, and RVB. All authors have read and agreed to the published version of the manuscript.
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