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In this issue of Hospital Pediatrics, Narayanan et al1 report that acquisition of serum magnesium levels, although commonplace, changes clinical management in only a small and predictable subset of hospitalized children (ie, those with oncologic abdominal surgery requiring total parenteral nutrition, solid organ transplant, and short bowel syndrome diagnoses). Serum magnesium levels ordered in other pediatric inpatient contexts are rarely helpful. Checking a simple magnesium level may not seem to have a profound financial impact initially, but the authors quickly point out that the cumulative financial burden is substantial.
The high frequency of unnecessary laboratory testing revealed here is a prime example of overuse in medical care and is likely applicable to myriad other laboratory, radiology, and ancillary services.2 For hospitalized children, consider the repeat abdominal radiograph after a constipation clean out (do we really need radiographic evidence that the bowels …
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