Guideline for Review of Diagnostic Test Requests

UVA Medical Laboratory Committee, February 2026

To be eligible for addition to the Laboratory Formulary as a send-out test, a test must be offered by a CAP/CLIA accredited laboratory, offer strong peer-reviewed literature evidence for clinical validity, support practical logistics, and provide clear advantages over current formulary offerings.

Review elements:

  • The name of the test
  • The clinician and clinical service requesting the test
  • Anticipated annual volume
  • The lab or vendor who provides the test with their scope of business and longevity
  • CAP/CLIA accreditation status of the lab providing the test (if a sendout request)
  • FDA approval of the test
  • Brief overview of the purpose, methodology, and clinical use of the test
  • Ordering, sampling, and result reporting logistics
    • Clinician/patient portals, sample handling, shipping, result reporting, connectivity with Epic, billing, etc.)
  • Is there overlap between the requested test and tests currently on the menu?
    • Should the requested test replace an existing test or tests?
  • Whether the test is included in any clinical guidelines
  • Availability of peer-reviewed publications related to test performance and validation
  • Summary of peer-reviewed data supporting the clinical validity of the test
  • Advantages and disadvantages vs. alternative testing strategies (if any)
  • Any other pertinent issues
  • Whether the test should be included on the UVA Epic test menu
    • Suggested name for the test in the menu, if appropriate

Notes:

  1. This guideline may be modified or streamlined based on the needs of a particular review.
  2. Test reviews are normally led by UVA Medical Laboratory section directors but may be led by clinician members of the Medical Laboratory Committee as appropriate.
  3. Clinicians requesting tests are invited to participate in the review discussion.
  4. Some review elements will be available from the test request, including literature that can provide a starting point for review. The send-out section of the UVA Lab and the vendor Web site can be sources of additional information. A brief, independent scan of the literature using Pubmed or Google Scholar is recommended. Independent validation studies (i.e., not from the test vendor) are particularly useful if available.
  5. One or two background articles should be distributed to the committee with the meeting announcement. A paper focusing on the performance of the requested test and an independent review of testing in the pertinent clinical domain is ideal.
  6. The test reviewer can set the discussion style according to their preference, but it is often useful to make a few slides to include in the meeting slide set that cover basic information about the test and summarize the data from the validation literature.
  7. The presentation will generally be followed by Q & A and discussion from the committee, then the committee will vote on whether to add the test to the local or send-out test menu of the UVA Lab. The vote is advisory to the lab and not the final decision on inclusion of the test in the UVA menu.