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检验医学不断变化的形势以及检验专业人员在转化医学中的作用。

The changing scenario in laboratory medicine and the role of laboratory professionals in translational medicine.

作者信息

Plebani Mario

机构信息

Department of Laboratory Medicine, Azienda Ospedaliera-Università di Padova, Via Giustiniani, 2, 35128 Padova, Italy.

出版信息

Clin Chim Acta. 2008 Jul 1;393(1):23-6. doi: 10.1016/j.cca.2008.03.013. Epub 2008 Mar 27.

Abstract

A revolution is now expected to occur in the ever-changing scenario of laboratory medicine thanks to the introduction of "omics" into clinical practice. However, our awareness of the divide between knowledge and practice, and the understandable assumption that omics research will be riddled with difficulties, has led to the concepts of knowledge translation, translational research and translational medicine. The interchangeable terms, translational research or translational medicine (hereafter referred to as translational research), currently underline the pressing need to gain practical benefit from the enormous investments made in biomedical research by the private and public sector. From the viewpoint of physicians, clinical laboratory professionals and patients, who are more directly involved in clinical practice, translational research responds to the need to obtain benefit from research, thus closing the gap between what we know and what we practice. This means transferring diagnostic and therapeutic advances that have proven effective in large well-conducted trials (and are therefore evidenced-based,) to daily medical practice. Translational research should be regarded as a two-way road: bench to bedside, and bedside to bench. However, to achieve a more effective translation process, a new road map should be implemented through interaction and cooperation between basic researchers, clinicians, laboratory professionals and manufacturers. Some examples of recent developments in clinical laboratory testing, including markers of cardiovascular diseases, clinical proteomics and recombinant allergens, attest to the importance of a careful evaluation of all variables allowing the introduction of such new insights into clinical practice in order to assure better clinical outcomes. The ability of laboratory medicine to deliver safer and more effective health care calls for a more careful evaluation not only of analytical characteristics but also of any other variables that may affect the clinical usefulness and diagnostic performances of laboratory tests thus enabling a more accurate interpretation and utilization of laboratory information.

摘要

由于“组学”引入临床实践,预计检验医学不断变化的格局将发生一场变革。然而,我们对知识与实践之间差距的认识,以及认为组学研究将充满困难这一可以理解的假设,催生了知识转化、转化研究和转化医学的概念。目前,可互换使用的术语“转化研究”或“转化医学”(以下简称转化研究)强调了迫切需要从公私部门对生物医学研究的巨额投资中获取实际益处。从更直接参与临床实践的医生、临床检验专业人员和患者的角度来看,转化研究满足了从研究中获益的需求,从而弥合了我们所知与所行之间的差距。这意味着将在大型高质量试验中已证明有效的诊断和治疗进展(因此是基于证据的)应用于日常医疗实践。转化研究应被视为一条双向道路:从 bench 到 bedside,以及从 bedside 到 bench。然而,为了实现更有效的转化过程,应通过基础研究人员、临床医生、检验专业人员和制造商之间的互动与合作来实施新的路线图。临床检验的一些最新进展实例,包括心血管疾病标志物、临床蛋白质组学和重组变应原,证明了仔细评估所有变量的重要性,这些变量使得能够将此类新见解引入临床实践,以确保更好的临床结果。检验医学提供更安全、更有效医疗保健的能力不仅需要更仔细地评估分析特性,还需要评估可能影响检验临床实用性和诊断性能的任何其他变量,从而能够更准确地解释和利用检验信息。

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