Demonstrating The True Value of Laboratory Medicine
In an article published in 1996 in Clinical Chemistry, Rodney Forsman from Mayo Clinic wrote, ““We know that, although the laboratory represents a small percentage of medical center costs, it leverages 60–70 percent of all critical decisions, e.g. admission, discharge and therapy.“ Pathologists and laboratory administrators were elated to read this affirmation of the importance of the clinical laboratory in medical practice. Since that time, this statistic has been widely quoted and even expanded from 70 percent of critical medical decisions to 70 percent of all medical decisions.
Unfortunately, no one has published any data to support this statement. Mike Hallworth, chair of the IFCC Task Force on the Impact of Laboratory Medicine on Clinical Management and Outcomes, recently published an article in The Pathologist that debunks this statement. In this paper, he challenges laboratorians to adopt a model proposed by IFCC to measure the real clinical value of a laboratory test. This model includes helping clinicians order the correct test and interpret the results correctly. It also includes reporting the correct result to the physician to the right place at the right time. When clinical laboratories develop a new test they need to not only assess its accuracy and precision but also determine if it helps clinicians make better diagnostic decisions or improves therapeutic effectiveness.
Clinical laboratories need to undertake true medical outcomes studies. I strongly recommend that everyone read the article written by Dr. Hallworth at the link provided below.
Forsman RW. Why is the laboratory an afterthought for managed care organizations? Clinical Chemistry 1996;42:813-816
https://thepathologist.com/issues/1015/the-true-value-of-laboratory-medicine/
