Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Parkville, Victoria, Australia; School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia.
Dept. of Experimental Medicine, University Tor Vergata, Rome, Italy..
Clin Chim Acta. 2019 Aug;495:570-589. doi: 10.1016/j.cca.2019.05.021. Epub 2019 May 28.
This review advances the discussion about the future of laboratory medicine in the 2020s. In five major topic areas: 1. the "big picture" of healthcare; 2. pre-analytical factors; 3. Analytical factors; 4. post-analytical factors; and 5. relationships, which explores a next decade perspective on laboratory medicine and the likely impact of the predicted changes by means of a number of carefully focused questions that draw upon predictions made since 2013. The "big picture" of healthcare explores the effects of changing patient populations, the brain-to-brain loop, direct access testing, robots and total laboratory automation, and green technologies and sustainability. The pre-analytical section considers the role of different sample types, drones, and biobanks. The analytical section examines advances in point-of-care testing, mass spectrometry, genomics, gene and immunotherapy, 3D-printing, and total laboratory quality. The post-analytical section discusses the value of laboratory medicine, the emerging role of artificial intelligence, the management and interpretation of omics data, and common reference intervals and decision limits. Finally, the relationships section explores the role of laboratory medicine scientific societies, the educational needs of laboratory professionals, communication, the relationship between laboratory professionals and clinicians, laboratory medicine financing, and the anticipated economic opportunities and outcomes in the 2020's.
这篇综述探讨了 21 世纪实验室医学的未来。在五个主要主题领域:1. 医疗保健的“大局”;2. 分析前因素;3. 分析因素;4. 分析后因素;5. 关系,通过一系列精心聚焦的问题,探讨了实验室医学的下一个十年前景以及预测变化的可能影响,这些问题借鉴了自 2013 年以来的预测。医疗保健的“大局”探讨了变化的患者群体、脑对脑循环、直接访问测试、机器人和全实验室自动化以及绿色技术和可持续性的影响。分析前部分考虑了不同样本类型、无人机和生物库的作用。分析部分考察了即时检测、质谱、基因组学、基因和免疫疗法、3D 打印以及全实验室质量的进展。分析后部分讨论了实验室医学的价值、人工智能的新兴作用、组学数据的管理和解释,以及常见的参考区间和决策限。最后,关系部分探讨了实验室医学科学协会的作用、实验室专业人员的教育需求、沟通、实验室专业人员与临床医生之间的关系、实验室医学融资,以及 21 世纪的预期经济机会和结果。