Serum folate testing is significantly overused given the “exceedingly low” rates of detected serum folate deficiencies, according to a research letter published Aug. 11 in JAMA Internal Medicine. While serum folate testing is proving financially beneficial for laboratories and medical centers, it should be significantly cut or eliminated in the name of providing high-value care, the authors suggest. The researchers retrospectively reviewed all outpatient serum folate tests performed at Beth Israel Deaconess Medical Center (Boston) from 2003 through 2013. The researchers found that over the study period, 84,187 serum folate tests were performed in 77,627 individuals. Levels were classified deficient (less than 3 ng/mL; 0.056 percent), low-normal (3-3.9 ng/mL; 0.197 percent), normal (4-19.9 ng/mL; 68.195 percent), and high (more than 19.9 ng/mL; 31.552 percent).  Ordering habits have not changed over the last decade relative to routinely ordered tests like creatinine, the authors found, despite the significant reduction in folate deficiency since folic acid fortification of processed grains began in 1998. Indicators are that folate testing is widespread nationally. The 2014 College of American Pathologists Ligand (General) K-A Proficiency Testing Survey found that 2,137 laboratories report results of serum folate and 225 laboratories report red blood cell folate. This total of […]