Could Low-Value Diagnostic Tests be Compounding Access Block? A Single-Site, Cross-Sectional Study
Walker, Heidi, West, Courtney, Lawton, Luke, Emeto, Theophilus I., and Gangathimmaiah, Vinay (2025) Could Low-Value Diagnostic Tests be Compounding Access Block? A Single-Site, Cross-Sectional Study. Emergency Medicine Australasia, 37 (4). e70100.
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Abstract
Objective: The study aimed to evaluate the prevalence and impact of low-value diagnostic tests at a regional, major-referral, mixed Emergency Department (ED). Methods: A single-site, cross-sectional study was conducted at Townsville University Hospital in April 2022. Adult patients (aged 18 years and above) who underwent one of 10 specified diagnostic tests were included. The tests encompassed coagulation studies, urine cultures, blood cultures, cranial computed tomography (CT) in syncope, cranial CT in minor head injury, cervical spine CT in neck trauma, ankle X-ray in acute ankle trauma, duplex lower extremity ultrasound in suspected deep vein thrombosis, CT pulmonary angiography in suspected pulmonary embolism, and CT kidney ureter bladder in renal colic. Tests were classified as low-value based on Choosing Wisely recommendations, with their value determined by a research assistant using clinical documentation, prior to the availability of test results. Emergency clinicians were blinded to the study conduct. Results: Of all diagnostic tests performed, 48.2% (276/572) were deemed low-value, including 50.6% of laboratory tests (246/486) and 24.4% of imaging tests (21/86). The median ED length of stay was 6.1 h (IQR 3.9–8.5). Low-value imaging tests contributed to 152 lost bed-hours per 100 tests. Conclusion: A substantial proportion of diagnostic tests were low-value, exacerbating access block and reducing the availability of ED beds, thereby delaying timely emergency care. The implementation of evidence-based, effective strategies is imperative to mitigate patient harm associated with low-value diagnostic tests.
| Item ID: | 87842 |
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| Item Type: | Article (Research - C1) |
| ISSN: | 1742-6723 |
| Keywords: | access block, diagnostic tests, emergency medicine, low-value care |
| Copyright Information: | © 2025 The Author(s). This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. |
| Date Deposited: | 27 Feb 2026 03:54 |
| FoR Codes: | 32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320207 Emergency medicine @ 100% |
| SEO Codes: | 20 HEALTH > 2001 Clinical health > 200105 Treatment of human diseases and conditions @ 100% |
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