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

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.