scholarly journals Laboratory medicine in modern teaching clinical physicians

2021 ◽  
Vol 26 ◽  
pp. 4385
Author(s):  
T. V. Vavilova ◽  
O. V. Sirotkina ◽  
N. Yu. Chernysh ◽  
V. S. Berestovskaya ◽  
Yu. I. Zhilenkova ◽  
...  
Keyword(s):  
High Performance ◽  
Laboratory Tests ◽  
Clinical Laboratory ◽  
Practical Experience ◽  
Laboratory Medicine ◽  
High Tech ◽  
Laboratory Diagnostics ◽  
Evidence Based ◽  
Technological Breakthrough ◽  
Based Medicine

At the end of the last century and, especially, in the first two decades of the 21st century, a significant technological breakthrough took place in clinical laboratory diagnostics in Russia. The transition from manual techniques to high-tech and high-performance automated systems has changed the potential of laboratory medicine. The laboratory has become a high-tech, rapidly developing branch of medical organizations. Following the changes in technology, the range of diagnostic tests began to alter, while the list of laboratory tests available grew. These dynamics are growing every year. Simple routine techniques, practiced for all patients, are complemented by more specific tests. The place of conventional routine tests has been determined by many years of practical experience, while modern analyzers allow the use of tests with a high evidence value of recommendations, which, in the context of evidence-based medicine, enable the clinician to conduct a personalized diagnostic search. At the same time, in order to use all the possibilities of laboratory medicine, the discipline Clinical Laboratory Diagnostics should be included in educational programs at different stages of a doctor's training.

scholarly journals The role of evidence-based laboratory medicine in health service

2002 ◽  
Vol 21 (3) ◽  
pp. 245-254 ◽  
Author(s):  
Nada Majkic-Singh
Keyword(s):  
Health Care ◽  
Clinical Experience ◽  
Evidence Based Medicine ◽  
Laboratory Tests ◽  
Laboratory Medicine ◽  
Systematic Research ◽  
Evidence Based ◽  
External Evidence ◽  
Based Medicine ◽  
The Impact

Evidence-based laboratory medicine (EBLM) is the use of the current best evidence of the utility of laboratory tests in making decisions about the care of individual patients. This practice means integrating laboratory and clinical experience with the last available external evidence from systematic research. It means that the definition of EBLM focuses on two key elements: experience and evidence from systematic research. Although the term evidence-based medicine (EBM) was created in Canada at Mc Master University by a group lad by Dr Gard Guyatt, there are various claims as to the origin of its practice. Regardless of its origins, many factors have come together over the past 30 years to drive the movement to EBM. One factor is those individual physicians, faced with numerous medical informations; the second factor is the global phenomenon of increasing health care costs and third is that patients who have generally more education, want the best in diagnostics and therapies. It means that evidence-based medicine has been driven by the need to cape with information overload, by costcontrol, and by public impatient for the best in diagnostics and treatment. Clinical guidelines care maps, and outcome measures are quality improvement tools for the appropriateness, efficiency and effectiveness of health services. Laboratory professionals must direct more effort to demonstrating the impact of laboratory tests on a greater variety of clinical outcomes. Evidence-based laboratory medicine aims to advise clinical diagnosis and management of disease through systematic researching and disseminating generalisible new knowledge that meets the standard of critical review on clinically effective practice of laboratory investigations. In laboratory medicine, the use of tests increases; new tests are constantly introduced, but "old" tests are seldom removed from the repertoire. This, together with limited public funds for the health care should underline the challenge for laboratory professionals to provide evidence for the utility of different tests. This practice means integrating laboratory and clinical experience with the best available external evidence from systematic research therefore, it is important that advice given by laboratory medicine professionals are sound and based on evidence in the pre-analytical, analytical, and post-analytical phases of the diagnostic process. This paper provides an insight into the rationale, methodology and the phases of the EBLM.

Laboratory Medicine: Reference Values and Evidence-Based Medicine

Neonatology ◽  
2018 ◽  
pp. 2429-2432
Author(s):  
Mariangela Longini ◽  
Fabrizio Proietti ◽  
Francesco Bazzini ◽  
Elisa Belvisi
Keyword(s):  
Reference Values ◽  
Evidence Based Medicine ◽  
Laboratory Medicine ◽  
Evidence Based ◽  
Based Medicine

scholarly journals Cost, profitability and value of laboratory diagnostics: in God we trust, all others bring data

2018 ◽  
Vol 0 (0) ◽  
Author(s):  
Giuseppe Lippi ◽  
Mario Plebani
Keyword(s):  
Laboratory Tests ◽  
Clinical Pathways ◽  
Laboratory Medicine ◽  
Scale Economy ◽  
Therapeutic Monitoring ◽  
Laboratory Diagnostics ◽  
Clinical Value ◽  
Healthcare Budget ◽  
The Impact ◽  
Diagnostic Investigations

Abstract Although laboratory tests are the most used diagnostic investigations for screening, diagnosing, prognosticating and therapeutic monitoring of most human diseases, laboratory medicine is currently seen as many other economic industries by some policymakers and administrators, and is hence subjected to scale economy and assessed accordingly, despite the incremental clinical value that laboratory tests can generate. According to a genuine economic perspective, the impact of diagnostic testing on a healthcare budget is lower than 2.5%, whilst its profitability is over 100%, a net profit margin over 7-fold larger than whatever other human industry. Even more importantly, the impact of laboratory tests on clinical outcomes is now clear and virtually incontestable, as their use will improve clinical pathways much more than any other diagnostic investigations. The many ongoing attempts to downsize the importance of laboratory medicine as costs centers, or even the concept that public laboratory services can be safely eliminated or outsourced to external private professional organizations, shall hence be challenged. Laboratory medicine not only is vital to patient care and patient flow, and will remain so for many years to come, but is also a valuable economical resource for the healthcare facilities.

scholarly journals THE PROFESSIONAL STANDARD OF A SPECIALIST IN CLINICAL LABORATORY MEDICINE AND ITS EVALUATION BY MEDICAL LABORATORY STAFF

2017 ◽  
Vol 25 (3) ◽  
pp. 63-68
Author(s):  
P. N. Zolotaryov
Keyword(s):  
Higher Education ◽  
Clinical Laboratory ◽  
Laboratory Medicine ◽  
Study Data ◽  
Medical Laboratory ◽  
Laboratory Research ◽  
Laboratory Diagnostics ◽  
Professional Standard ◽  
Laboratory Staff ◽  
Wide Range

The issue of improving the personnel service in clinical laboratory diagnostics is topical, since specialists, having modern knowledge in laboratory research, can not stay aside from active participation during their appointment and interpretation. Training of specialists of this level requires revision of the regulatory framework, namely, the development of professional standards for specialists in clinical laboratory medicine. The survey involved 83 specialists with higher education working in clinical diagnostic laboratories of various forms of ownership in the Samara Region (Russia). In the course of the study, data were obtained reflecting the readiness to perform a number of generalized labor functions of the professional standard. Prior to the evaluation of the criterion of attention paid to the labor function in each group of respondents, we expected to obtain values of 9-10 units. However, in the course of the study, we found that this indicator in various groups of respondents fluctuated in a wide range. We believe that the training of professional stuff with higher education in laboratory medicine should be implemented in parallel with the introduction of the professional standard.

scholarly journals LABORATORY DIAGNOSTICS OF MALE INFERTILITY. BIOMARKERS. PART I

2021 ◽  
pp. 57-68
Author(s):  
Zh. Yu. Sapozhkova ◽  
G. A. Milovanova ◽  
O. I. Patsap
Keyword(s):  
Male Infertility ◽  
Reproductive Medicine ◽  
Laboratory Tests ◽  
Clinical Laboratory ◽  
Diagnostic Process ◽  
Laboratory Diagnostics ◽  
Human Semen ◽  
Male And Female ◽  
Depth Study ◽  
Diagnostic Approaches

Currently, clinical laboratory diagnostics of male infertility is an integral part of the diagnostic process in the field of reproductive medicine. This review provides information about novel and traditional immunological, cellular, biochemical and other markers of human semen, which are used in the complex laboratory diagnostics of male infertility. Unfortunately, at present, due to the lack of updated clinical guidelines for male and female infertility diagnostics, uninformative algorithms and incompatible assessment criteria are increasingly used. This situation leads to controversial discussions, where the diagnostic functions of laboratory tests and markers are questioned. That is why the constant search is needed for innovative diagnostic approaches aimed at in-depth study of the pathogenesis of male infertility and subfertility.

scholarly journals Overview of Evidence-based Medicine: Challenges for Evidence-based Laboratory Medicine

2001 ◽  
Vol 47 (8) ◽  
pp. 1536-1546 ◽  
Author(s):  
Matthew J McQueen
Keyword(s):  
Evidence Based Medicine ◽  
Information Overload ◽  
Clinical Information ◽  
Laboratory Medicine ◽  
Evidence Based ◽  
Efficiency And Effectiveness ◽  
Care Maps ◽  
Critical Appraisal Skills ◽  
Based Medicine ◽  
The Impact

Abstract Evidence-based medicine (EBM) has been driven by the need to cope with information overload, by cost-control, and by a public impatient for the best in diagnostics and treatment. Clinical guidelines, care maps, and outcome measures are quality improvement tools for the appropriateness, efficiency, and effectiveness of health services. Although they are imperfect, their value increases with the quality of the evidence they incorporate. Laboratory professionals must direct more effort to demonstrating the impact of laboratory tests on a greater variety of clinical outcomes. Laboratory and clinical practitioners must be familiar with many of the accessible electronic and paper tools for searching for evidence. Detailed statistical and epidemiologic knowledge is not essential, but critical appraisal skills and a competent understanding of the strengths and weaknesses of systematic review and metaanalysis are necessary. Overemphasis on complexity and failure to recognize time limitations are major barriers to translating EBM into everyday practice. Emphasizing and practicing the role of the laboratory professional as a skilled clinical consultant strongly grounded in evidence as well, in addition to better integration of laboratory and clinical information and improved laboratory reports will overcome most barriers. There is a poverty of good, primary studies of test evaluations. Institution of more consistent standards for the design and reporting of studies on diagnostic accuracy should improve the situation. If nothing else, systematic reviews have demonstrated the need for more good-quality primary research in laboratory medicine.

Laboratory aspects of hemostasis in neonates

2019 ◽  
Vol 17 (4) ◽  
pp. 100-113
Author(s):  
E. M. Koltsova ◽  
E. N. Balashova ◽  
M. A. Panteleev ◽  
A. N. Balandina
Keyword(s):  
Laboratory Tests ◽  
Clinical Laboratory ◽  
Laboratory Diagnostics ◽  
Hemostasis System ◽  
Clinically Normal ◽  
Hemorrhagic Complications ◽  
Normal Functional ◽  
The Stability ◽  
Almost All ◽  
Attending Physician

Newborns have high risks of thrombotic and hemorrhagic complications. Despite the fact that the overall frequency of thrombosis and bleeding in the general population of neonates is low, the risks of both thrombosis and hemorrhage are significantly increased when a newborn has some complications, including prematurity. The mechanisms underlying the onset of thrombotic and hemorrhagic complications in newborns are not fully understood and remain controversial. The hemostasis in newborns drastically differs from adult hemostasis and even from hemostasis in children older than a year. Nevertheless, despite the presence of quantitative and qualitative differences of almost all parameters of the hemostasis system from the parameters of adults, healthy newborns as a whole have clinically normal functional hemostasis without a tendency to coagulopathy or thrombosis. Apparently, the neonatal hemostasis system is in some alternative "balance", which differs from the "balance" of hemostasis in adults. The issue regarding the stability of this balance is still open. Due to the peculiarities of the newborn's hemostasis, clinical laboratory diagnostics of the coagulation disorders is very difficult, and the attending physician is forced to focus exclusively on the clinical picture. This review provides basic information on the neonatal hemostasis system, as well as an attempt to critically evaluate existing laboratory tests in terms of applicability for this group of patients.

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