EKU Podcast: Rational testing in primary care

Estimates have suggested that 25% of primary care laboratory tests might be ‘unnecessary’, with research demonstrating unwarranted variation and overuse of specific tests including thyroid function tests, liver function tests, prostate- specific antigen tests, and vitamin D tests. In this podcast Dr Thomas Round talks to Dr Jessica Watson, GP and Consultant Senior Lecturer at the University of Bristol with an interest in evidence based rational testing, about rational testing in primary care. They explore why testing is undertaken in medicine and general practice, when doctors should use blood tests, how to share information about tests with patients, manage patient queries and demand and when to retest. They discuss the increase in testing demand, the science behind testing and what the evidence shows us regarding over testing. In addition, they review recent research and guidance e.g. accessible results practical toolkits and the PITSTOP project. They also offer top tips for everyday practice and signpost to useful resources. RCGP Podcast Feedback Your feedback plays a crucial role in helping us improve the CPD products and services we offer. We would be grateful if you could please complete our short RCGP Podcast Survey, which will take no more than 5 minutes to complete. Transcript References & Further Reading: Watson J, Burrell A, Duncan P, et al. Exploration of reasons for primary care testing (the Why Test study): a UK-wide audit using the Primary care Academic CollaboraTive. British Journal of General Practice 2024; 74 (740): e133-e140. Buss L F, Spitzer D, Watson J C, et al. Can I have blood tests to check everything is alright? BMJ 2023; 382: e075728. Smellie W S A. Spurious hyperkalaemia. BMJ 2007; 334 :693. McCormack J P, Holmes D T. Your results may vary: the imprecision of medical measurements. BMJ 2020; 368: m149. University of Bristol. Accessible Results: Accessible Results – Enabling patients with diverse needs to access and understand their blood test results online. (Toolkit will be published in November 2026). Watson J. PITSTOP: Project 823 | Using Routine Primary Care Data and Co Production to Reduce Potentially Inappropriate Testing (PITSTOP): A Mixed Methods Study. NIHR School for Primary Care Research (SPCR). Learn evidence-based methods to make more accurate diagnosis. Testing Wisely O'Sullivan J W, Stevens S, Hobbs F D R, et al. Temporal trends in use of tests in UK primary care, 2000-15: retrospective analysis of 250 million tests. BMJ 2018; 363: k4666.