Evidence based laboratory medicine for beginners: getting evidence into practice

Abstract

Laboratory testing is one of the most widely used diagnostic approaches supporting medical decisions, yet evidence demonstrating the impact of laboratory testing on clinical outcomes is limited. This contributes to inappropriate test utilisation that impacts clinical- and costs-effectiveness of care and patient safety. Trainees will discuss at the workshop diagnostic outcome study designs and their limitations. Evidence-based guidelines are expected to close the gap between research and practice and to promote meaningful utilisation of laboratory medicine. The appearance of so many guidelines, however, created a new gap between their development and use and the quality and reliability of guidelines have been challenged. Therefore critical appraisal of guidelines (e.g., with the AGREE instrument, which will be demonstrated at the workshop; www.agreetrust.org/) is essential before recommendations are implemented. Passive dissemination of guidelines is not sufficient; a multifacet-ed and individualised implementation strategy should be employed including educational outreach visits, individually tailored academic detailing, electronic reminder systems, feedback on performance, and participation of doctors and laboratory professionals in pre- and post-analytical quality assessment or test selection and interpretation programmes, and clinical audits. Examples of these initiatives at the laboratory and clinical interface will be demonstrated and case scenarios will be discussed with trainees.