Evidence-based laboratory medicine as a tool for continuous professional improvement

Abstract

Background: 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. Methods: 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. Results: 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. Conclusions: 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.