Excessive Ordering of Laboratory Tests and Medical Imaging: A Hallmark of Inadequate Clinical Judgment

Abstract

Introduction: Recent advances in laboratory diagnostics and medical imaging have greatly improved clinical decision-making. However, excessive ordering of diagnostic laboratory tests and imaging studies has become as a growing manifestation of low-value care. Empirical evidence indicates that indiscriminate testing rarely improves diagnostic accuracy or patient outcomes, while increasing false-positive results, incidental findings, unnecessary procedures, patient anxiety, radiation exposure, and healthcare costs. Contributing factors include defensive medicine, patient expectations, easy access to advanced technologies, and inadequate training in high-value diagnostic stewardship. The Choosing Wisely initiative advocates that diagnostic investigations should be guided by sound clinical indications, pre-test probabilities, and their potential to alter patient management rather than by technology availability alone. Ultimately, high-quality healthcare depends on judicious use of diagnostic resources. Professional competence is reflected not by the number of tests ordered, but by the ability to select only those investigations that provide meaningful clinical value while mitigating avoidable patient harm.