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Clinical Utility and Performance in Test Utilization Interventions for Paraneoplastic Antibody Panel Orders: A Delicate Balance.

The article in this issue of JALM —Utilization Review of Paraneoplastic Neurological Syndrome Antibody Screening Panels: A Single Institution Experience at a Tertiary Academic Health Center—presents an example of addressing a pervasive issue in modern laboratory medicine: specialty tests ordered (sometimes frequently) by key providers and sometimes by generalists, with questionable evidence that there is utility in the practice, and with potentially low pretest probability of disease. In the feature, authors Kim and Harris detail their process of evaluating sequential orders and results for 2 paraneoplastic antibody panels offered at their institution via 2 different reference laboratories and attempt to characterize the clinical performance of the 2 panels used for the majority of the data collection period (2011–2016) (1). This study represents the initial approach to a difficult discussion with providers about test practices at the authors' institution, because …