LAUSR

Poor understandability of laboratory test names increases risk for inappropriate test utilization and medical errors. Yet, human understandability has not been a major consideration in existing laboratory test names or naming guidelines. TRUU-Lab (Test Renaming for Understanding and Utilization for Laboratory Test Names) is a national initiative that now has more than 45 members representing more than 20 academic and industry organizations, the CDC, the FDA, and organizations outside of the US. The goals of the initiative include: 1) Identify root causes and challenges in understanding and using laboratory test names; 2) Share resources related to potential solutions; 3) Develop consensus guidelines for laboratory test naming; 4) Establish consensus names for existing laboratory tests; and 5) Promote the adoption and implementation of consensus laboratory test names. Previous studies have addressed the first two goals of this initiative by identifying problematic test names and features of test names that contribute to misutilization. We also identified advantages and limitations of current test naming guidelines and previous standardization efforts. This study addresses goals 3 and 4 of the TRUU-Lab initiative. We have adopted an iterative process of guideline development, to make use of feedback from establishing consensus names to improve guidelines and vice versa. Preliminary work in this area has focused on definition of optimal laboratory test names from a human understandability perspective. By analysis of test characteristics through the process of test name redefinition, we found that the requirements for optimal understandability vary with respect to clinical scenario and provider background. This highlights the need for naming guidelines to permit flexibility in the components and presentation format for laboratory test display names. We are using results from this work to construct idealized candidate test names given an appropriate clinical scenario. Candidate names will be evaluated by survey studies through the Brand Institute, which offers expertise in pharmaceutical name and brand identity development. We are assessing different laboratory test names under controlled conditions, with studies conducted in two phases. The first phase, conducted through pilot surveys sent to primary care providers, assesses intuitive name preferences given a short and specific prompt. The second phase will use a simulated electronic medical record environment to present mock clinical scenarios, which surveyed physicians will use to select an appropriate test. We expect that results from survey studies will directly inform the development of TRUU-Lab naming guidelines, in turn permitting development of better optimized laboratory test names. This process represents a new strategy for intentional design of laboratory test names that are understandable and promote correct provider utilization.