Aculabs is proud to share that our laboratory director, Rita Khoury, MD., recently had the opportunity to present several papers at the College of American Pathologists (CAP) 2025 meeting. While at the conference, Dr. Khoury sat down and spoke about her findings regarding Vitamin D testing with Medscape, a leading healthcare publication.
“Orders for Wrong Vitamin D Test Rising,” September 11th, 2025, Medscape (Link)
Addressing Unnecessary Orders
Dr. Khoury shared findings on the rising trend of inappropriate orders for the 1,25-dihydroxy vitamin D test. This test, while critical in certain clinical situations, has been ordered far more frequently in recent years, leading to unnecessary costs, delays, and potential patient misdiagnosis.
Over 268,000 samples for 25-OH vitamin D and 5,500 for 1,25-dihydroxy vitamin D from 2011 to 2025 were analyzed by Aculabs, revealing that the ratio of 1,25-dihydroxy tests to 25-OH tests has shifted dramatically.
While the ideal ratio is approximately 1:50, it reached a peak of 1:240 in 2015. Though the ratio has since narrowed, with a current rate of 1:37 in 2025, the frequency of 1,25-dihydroxy orders has grown fourfold, with over 1,000 tests now ordered annually compared to just 230 in 2011.
Improving Online Ordering Systems
A significant driver of this rise, according to Dr. Khoury, is the automation of test ordering. Within digital ordering platforms, the 1,25-dihydroxy test often appears first in the dropdown menus when clinicians search for “vitamin D.” This automated selection can lead to unintended orders for the wrong test, especially when the 1,25-dihydroxy test is only appropriate in very specific conditions.
Such patterns amongst online-based ordering are also why Aculabs utilizes proactive measures on our online ordering web portal, like the activation of a pop-up providing more detailed information on the test being ordered. The end goal is to help the client mitigate ordering errors as much as possible.
As Dr. Khoury and the rest of our leadership team continue such advocacy, both in academic presentations and public forums, the medical community is called to consider how it can better align testing practices with clinical need, improving both patient outcomes and healthcare efficiency.