Diagnostic stewardship

”’Diagnostic stewardship”’ is an approach to improving patient care by optimizing the use of [[diagnostic test]]s. It has been defined as “coordinated guidance and interventions to improve appropriate use of microbiological diagnostics to guide therapeutic decisions”.<ref name=”NASEM2023″>{{cite book |author=National Academies of Sciences, Engineering, and Medicine |title=Accelerating the Development and Uptake of Rapid Diagnostics to Address Antibiotic Resistance: Proceedings of a Workshop |date=2023-05-03 |publisher=National Academies Press |location=Washington, D.C. |chapter=Diagnostic Stewardship}}</ref> It is commonly characterized as providing the “right test to the right patient at the right time” to inform clinical care.<ref name=”Curren2022″>{{cite journal |last1=Curren |first1=Emily J. |last2=Lutgring |first2=Joseph D. |last3=Kabbani |first3=Sarah |last4=Diekema |first4=Daniel J. |last5=Gitterman |first5=Steven |last6=Lautenbach |first6=Ebbing |last7=Morgan |first7=Daniel J. |last8=Rock |first8=Clare |last9=Salerno |first9=Reynolds M. |last10=McDonald |first10=L. Clifford |title=Advancing Diagnostic Stewardship for Healthcare-Associated Infections, Antibiotic Resistance, and Sepsis |journal=Clinical Infectious Diseases |volume=74 |issue=4 |pages=723–728 |date=2022-02-15 |doi=10.1093/cid/ciab672}}</ref><ref name=”Claeys2025″>{{cite journal |last1=Claeys |first1=Kimberly C. |last2=Coffey |first2=K. C. |last3=Morgan |first3=Daniel J. |title=What Is Diagnostic Stewardship? |journal=The Journal of Applied Laboratory Medicine |volume=10 |issue=1 |pages=130–139 |date=2025-01-03 |doi=10.1093/jalm/jfae130 |pmid=39749441}}</ref>

Diagnostic stewardship aims to reduce [[Medical_error#Definitions_of_diagnostic_error|diagnostic error]] and improve patient outcomes by addressing inappropriate or unnecessary testing as well as underuse of necessary tests.<ref name=”Curren2022″/> Both overutilization and underutilization of diagnostic tests can be problematic.<ref name=”NASEM2023″/> Appropriate test selection may take into account factors such as analytical performance, diagnostic yield, local epidemiology, patient characteristics, and pretest probability. The timing of a test is also important when its results need to fit into the clinical workflow and affect patient care.<ref name=”NASEM2023″/>

Diagnostic stewardship encompasses the entire diagnostic-test process, including test ordering, specimen collection and transport, test performance, and the reporting, interpretation, and communication of results.<ref name=”Curren2022″/> Interventions can therefore occur during the preanalytical, analytical, or postanalytical phases of testing. They may include [[clinical decision support system]]s, guidance on test selection and specimen collection, and interventions to improve the interpretation and communication of test results.<ref name=”Curren2022″/><ref name=”NASEM2023″/>

Diagnostic stewardship is closely related to ”laboratory stewardship”, but extends beyond laboratory processes into clinical decision-making about the selection, timing, and interpretation of diagnostic tests.<ref name=”Claeys2025″/> It is also complementary to ”[[antimicrobial stewardship]]”, particularly in infectious diseases, where appropriate diagnostic testing and interpretation can guide antimicrobial treatment and contribute to efforts to reduce inappropriate antibiotic use and [[antimicrobial resistance]].<ref name=”Curren2022″/><ref name=”NASEM2023″/><ref name=”Claeys2025″/>

==See also==
* [[Antimicrobial stewardship]]
* [[Clinical decision support system]]
* [[Medical_error#Definitions_of_diagnostic_error|Diagnostic error]]
* [[Laboratory medicine]]
* [[Medical diagnosis]]
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* [[Diagnostic excellence]]
* [[Laboratory stewardship]]
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==References==
{{Reflist}}

[[Category:Medical diagnosis]]
[[Category:Medical tests]]
[[Category:Patient safety]]