Radioassay Profiles: A Laboratory Response to Cost Containment

A clinical laboratory profile is a cadre of tests that addresses a medical problem in a more cost-effective manner than the performance of each test individually and sporadically. Nonisotopic profiles as well as radioassay profiles have been offered by reference loboratories for several years. Most hospital-based loboratories have been directed away from instituting disease-oriented profiles because certain profile tests are only rarely requested, which makes them economically impractical to perfonn. There is also a tendency in teaching hospitals to indivUlualize each requested test because of the belief that it enhances physician analytical skills. Recent experience in our laboratory has shown that by carefully developing an aminoglycoside profile in close collaboration with the hospital pharmacy phannacokinetic service the cost for the drug assays and the expense to the assaying laboratory can be reduced while significantly improving patient care. We can provide a gentamicin or tobramycin profile, consisting of three or more blood samples and run as batch assay, at a cost that is less than the price of two indivUlual assays. This has been done without creating a significant revenue loss to our laboratory.