🩺 Reflexive Testing in Hematopathology: Balancing Efficiency and Ethics
In modern laboratory diagnostics, there is a practice called “reflexive testing.” This is a situation where a hematopathologist, after analyzing primary results, uses their discretion to order additional tests on already existing biomaterial. This allows for faster diagnosis without repeated blood draws.
A recent study by Canadian specialists Eric McEvoy and Eileen McBride sheds light on how this mechanism works in hematopathology and what challenges physicians face. 🇨🇦
🔍 Key findings of the study:
- Widespread use: 63% of surveyed hematopathologists use reflexive testing weekly. Specialists note that it is critically important for the timely detection of hematological neoplasms and optimizing patient management tactics.
- Lack of regulation: Despite the method’s popularity, only 30% of physicians have clear institutional guidelines. This creates a situation where decisions are made based on personal clinical experience, rather than a unified protocol.
- Question of consent: The ethical aspect remains debatable. Only 27% of physicians believe that primary patient consent for analysis is sufficient for conducting additional tests. The majority (61%) believe that the need for informing depends on the type of test ordered (for example, genetic analysis requires a different approach than a complete blood count).
- Risks: 21% of respondents have faced legal claims or complaints related to ordering tests without prior notification of the treating physician or patient.
💡 Why is this important for clinical practice?
Reflexive testing reduces the time to initiation of specific therapy and spares the patient from excessive venipunctures. However, the absence of national standards creates “gray areas” regarding responsibility and payment for medical services.
Physicians support the development of this practice but point to the need for creating transparent ethical and legal frameworks. This will make diagnostics more accurate and safer for both the patient and the physician. 🧬
Source for citation: McEvoy E, McBride ER. Adding-On Wisely: Hematopathology Reflective Testing in Canada. 2026.
