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A reflex test is a type of laboratory test ordered when the results of an initial test indicate additional testing is necessary. The reflex test can be ordered by a lab technician in response to analyzed results or ordered automatically by an automated system. Examples of tests that may require a reflex test include the check for the presence of human papillomavirus (a DNA virus) or cryoglobulins (proteins that become insoluble at a certain temperature).[1][2]
In 1998, the U.S. Department of Health and Human Services' Office of Inspector General stated the following about the reflex test:
Reflex testing occurs when initial test results are positive or outside normal parameters and indicate that a second related test is medically appropriate. In order to avoid performing unnecessary reflex tests, labs may want to design their requisition form in such a way which would only allow for the reflex test when necessary.[3]
Many clinical laboratories have opted to generate their own listing of specific tests they'll offer reflex testing for.[1][2] Though less common, users of modern laboratory information systems may optionally use built-in medical necessity checking tools in order to minimize excess reflex testing.