The Complex Task of Measuring the Value of Laboratory Investigations and Other Diagnostic Tests: Commentary on Srivastava and Nair

Lawrence discusses the study by Srivastava and Nair on the measurement of the value of laboratory investigations and other diagnostic tests. Srivastava and Nair have built a compelling argument that the routine use of laboratory investigations, imaging studies, and other diagnostic tests for adults with psychiatric symptoms in medical emergency rooms, psychiatric emergency rooms, and inpatient settings is often low yield, rarely changes management, and is unlikely to reveal new information that is not already known from the history and physical examination. Their review provides a helpful balance to existing literature that teaches physicians always to consider the many nutritional, metabolic, immunologic, neoplastic, toxic, traumatic, and other causes of psychiatric symptoms, and it helpfully pushes back against a hospital culture that tends to expect screening labs for all patients as the standard of care.