Factors associated with greater scrutiny:
(1) expense of the test
(2) whether the results are used or not
(3) ownership by the ordering physician of the reference laboratory performing the test
(4) who ordered the test – the physician treating the patient or someone else.
Reasons why the results of a molecular test may not be used:
(1) The patient refuses therapy.
(2) The disease is too advanced to be treated.
(3) The patient wants to go someplace else for therapy AND the other site will repeat the testing.
(4) The sample is small AND a more representative sample will be available after a surgical resection.
(5) The wrong test was ordered (appropriate for one type of tumor but not another).
(6) A panel was ordered but only one test relevant.
