Economic Evaluation and Resource Use in Thoracentesis and Paracentesis for Patients with Gynecologic Cancers
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By
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Yingao Zhang
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Olivia Foy
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Grace Pipes
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Margaret I. Liang
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July 21, 2026
Clinical Scorecard: Economic Evaluation and Resource Use in Thoracentesis and Paracentesis for Patients with Gynecologic Cancers
At a Glance
| Category | Detail |
|---|
| Condition | Gynecologic Cancers with Ascites or Pleural Effusion |
| Key Mechanisms | Evaluation of unnecessary laboratory tests in fluid studies during paracentesis and thoracentesis procedures. |
| Target Population | Patients diagnosed with gynecologic cancers undergoing paracentesis or thoracentesis. |
| Care Setting | Tertiary-care institution |
Key Highlights
- 216 patients with gynecologic cancers were analyzed.
- 78% underwent at least one paracentesis; 45% underwent at least one thoracentesis.
- 79% of fluid studies performed were deemed unindicated.
- Total cost from unindicated tests was $1,129,520.
- Higher odds of unindicated tests ordered by non-oncology clinicians.
Guideline-Based Recommendations
Diagnosis
- Routine fluid laboratory tests should not be reflexively ordered in patients with established cancer diagnoses.
Management
- Evaluate clinical scenarios before ordering laboratory tests on fluid specimens.
Monitoring & Follow-up
- Monitor for relevant clinical symptoms before conducting fluid studies.
Risks
- Unnecessary laboratory testing contributes to increased healthcare costs without discernible benefits.
Patient & Prescribing Data
Patients with advanced gynecologic cancers experiencing ascites or pleural effusions.
Therapeutic paracentesis and thoracentesis are common but should be accompanied by relevant clinical indications for laboratory tests.
Clinical Best Practices
- Incorporate oncology clinicians in multidisciplinary care.
- Targeted clinician education on appropriate laboratory test ordering.
- Optimize order sets in electronic medical records to reduce overordering.
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