Evidence-based practice underpins the provision of healthcare to patients from the perspective of practitioners, payers, and policy makers. The principles of evidence-based medicine are necessary to support decision making at all levels and to inform the change agenda that is driving the search for better quality, decreased medical error, and improved outcomes, all the while maximizing value for money. Laboratory medicine has an important part to play in this global healthcare agenda and is crucial to achieving these goals. Laboratory medicine has a strong foundation in the translation from basic and analytical science to clinical utilization as biomarkers for disease and strategies for patient care. In part, this translation includes optimizing quantification of the biomarkers with regard to accuracy, precision, and other technical characteristics. However, technical data do not prove clinical utility, let alone effectiveness. Furthermore, the more traditional model of healthcare delivery has been resourced and managed in a "silo approach," with the fiscal performance being managed in the same way. Consequently, debate surrounding introduction of new tests, devices, and services has tended to focus on cost in isolation, rather than on value for clinical utility and integrated contributions to the outcome-let alone the change in practice that might be required to deliver that outcome. The challenges facing healthcare can be met only by adopting an evidence-based approach to the practice of laboratory medicine. This book explains the core principles and how they can be applied in all aspects of practice from study design, reports, and critical appraisal of data to integration of research data into clinical guidelines, teaching concepts to students at all levels of training, and use in day-to-day practice. The context of the discussion is designed to span the patient's journey and the interfaces among the laboratorian, the clinician, and the policy makers.

Evidence-Based Laboratory Medicine: Principles, Practice, and Outcomes, 2nd Edition

Medical Books

Christopher P. Price

Robert H. Christenson

Medicine

AACC Press

This workbook offers a step-by-step guide to applying the principles of evidence-based laboratory medicine (EBLM) in routine practice. The term "evidence-based" is increasingly becoming part of the language in the practice of clinical medicine, and in laboratory medicine. In laboratory medicine, it is also becoming clear that the "evidence" differs somewhat from that on which the specialty was founded. The foundation of laboratory medicine is an understanding of the molecular mechanisms that describe the pathology of disease, but in applying this knowledge to patient care the emphasis moves from understanding disease mechanisms to improving health outcomes. By applying EBLM to daily practice, laboratory professionals can 
<ul>
<li>Ensure appropriate use of tests at the requesting, decision-making, and application phases. </li>
<li>Make the business case for implementing new diagnostic tools and strategies that meet clinical needs. </li>
<li>Become full members of the clinical team and take an important role in implementing change.</li>
</ul> The key is understanding the question being asked-and then applying the A5 EBLM Cycle: Ask, Acquire, Appraise, Apply, Assess. This workbook walks readers through this process by providing a wide range of case studies that illustrate applications of EBLM in routine laboratory practice. Readers are then encouraged to record their own examples, consider how they might be addressed using the principles of EBLM, formulate research questions, and then follow those questions to their evidence-based solutions. Throughout the text, sidebars and exercises offer additional helpful information and highlight key concepts. Whether used alone or with colleagues, this workbook provides the knowledge and practice that will give readers confidence that they are indeed learning how to apply the best available scientific evidence to diagnostic challenges, and in the process, playing a central role in patient care.

Applying Evidence-Based Laboratory Medicine: A Step-By-Step Guide

Joanne Lozar Glenn

American Association for Clinical Chemistry

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Books by Robert H. Christenson