Department of Medicine-DIMED, University of Padova, Padova, Italy.
Department of Laboratory Medicine, University-Hospital of Padova, Padova, Italy.
Clin Chem Lab Med. 2018 May 24;56(6):901-908. doi: 10.1515/cclm-2018-0009.
In the last few decades, laboratory medicine has undergone monumental changes, and laboratory technology, which has made enormous advances, now has new clinical applications thanks to the identification of a growing number of biomarkers and risk factors conducive to the promotion of predictive and preventive interventions that have enhanced the role of laboratory medicine in health care delivering. However, the paradigm shift in the past 50 years has led to a gap between laboratory and clinic, with an increased risk of inappropriateness in test request and interpretation, as well as the consolidation of analytical work in focused factories and megastructurers oriented only toward achieving greater volumes, decreasing cost per test and generating a vision of laboratory services as simple commodities. A careful historical revision of the changing models for delivering laboratory services in the United States leads to the prediction that there are several reasons for counteracting the vision of clinical laboratory as a commodity, and restoring the true nature of laboratory services as an integral part of the diagnosis and therapy process. The present study, which reports on internal and external drivers for change, proposes an integrated vision of quality in laboratory medicine.
在过去的几十年中，检验科发生了巨大的变化，检验科技术取得了巨大的进步，由于越来越多的生物标志物和有利于促进预测性和预防性干预的风险因素的确定，现在有了新的临床应用，从而增强了检验科在医疗保健中的作用。然而，过去 50 年的范式转变导致了检验科和临床之间的差距，检验申请和解释的不当风险增加，以及分析工作集中在专注于实现更大数量、降低每个检验成本并将实验室服务视为简单商品的工厂和大型企业中的巩固。对美国提供检验科服务的不断变化的模式进行仔细的历史回顾，预测到有几个原因可以对抗将临床检验科视为商品的观点，并恢复检验科服务作为诊断和治疗过程的一个组成部分的真正性质。本研究报告了内部和外部的变革驱动力，提出了检验科质量的综合愿景。
