Trenti Tommaso
Servizio di Patologia Clinica, Ospedale degli Infermi, Ausl di Modena, Via Martiri 51, Pavullo nel Frignano, Pavullo nel Frignano, Modena I-41026, Italy.
Clin Chim Acta. 2003 Jul 15;333(2):155-67. doi: 10.1016/s0009-8981(03)00180-3.
Evidence-based medicine (EBM), defined as "the conscientious, explicit, and judicious use of the current best evidence in making decisions about the care of patients," seems a tool (a "new paradigm") able to meet individual clinical experience with robust observations. EBM has been driven by the need to manage information overload by cost control and by public request for the best in diagnostics and treatment.
The application of EBM in laboratory medicine or evidence-based laboratory medicine (EBLM) is aimed to advance clinical diagnosis by researching and disseminating new knowledge, combining methods from clinical epidemiology, statistics, and social science with the traditional pathophysiological molecular approach.
EBLM, by evaluating the role of diagnostic investigations in the clinical decision-making process with emphasis on measurable outcome, can help both in improving the quality of new scientific findings and in translating the results of good-quality research into everyday practice.
Since there is a need to integrate many educational tools to focus the strategy on promoting the implementation of best practices, the STARD proposal for robust diagnostic test primary studies, the presence of systematic reviews of high quality, and the development of valid guidelines based on the best scientific evidence may be useful to promote an a evidence-based culture for appropriateness, efficiency, and effectiveness in laboratory medicine.
循证医学（EBM）被定义为“在对患者护理做出决策时，审慎、明确且明智地运用当前最佳证据”，它似乎是一种能够将个体临床经验与可靠观察结果相结合的工具（一种“新范式”）。循证医学的发展动力来自于通过成本控制来管理信息过载的需求，以及公众对最佳诊断和治疗方法的要求。
循证医学在检验医学中的应用，即循证检验医学（EBLM），旨在通过研究和传播新知识，将临床流行病学、统计学和社会科学方法与传统的病理生理分子方法相结合，以推进临床诊断。
循证检验医学通过评估诊断性检查在临床决策过程中的作用，并强调可测量的结果，有助于提高新科学发现的质量，并将高质量研究的结果转化为日常实践。
由于需要整合多种教育工具，将策略重点放在促进最佳实践的实施上，因此，关于可靠诊断试验初步研究的STARD提案、高质量系统评价的存在，以及基于最佳科学证据制定有效指南，可能有助于在检验医学中促进基于证据的文化，以实现适宜性、效率和有效性。
