Contact

Daria Pašalić
Editor-in-Chief
Department of Medical Chemistry, Biochemistry and Clinical Chemistry
Zagreb University School of Medicine
Šalata ul 2.
10 000 Zagreb, Croatia
Phone +385 (1) 4590 205; +385 (1) 4566 940
E-mail: dariapasalic [at] gmail [dot] com

Useful links

Case report

 

Dunja Rogić. Evidence-based laboratory medicine: From Principles to Outcomes, Christopher P. Price and Robert H. Christenson, editors AACC Press, Washington, DC, 2003. Biochemia Medica 2006;16(2):101-2.
 
Clinical Institute of Laboratory Diagnostics, Clinical Hospital Center Zagreb, Zagreb, Croatia
 
 
There are numerous books that deal with the subject of evidence-based medicine, either with general principles or within the framework of a specific field of clinical medicine. However, this is the first publication dedicated exclusively to evidence-based laboratory medicine, EBLM. A question of what exactly EBLM deals with can be resolved simply: it attempts to answer one single question, i.e. whether a certain laboratory test is useful for a patient or not.
The editors Christopher P. Price, University of Oxford, and Robert H. Christenson, University of Maryland, have gathered numerous eminent experts worldwide as authors of individual chapters so that the book represents a unique synthesis of all available expert knowledge in this field. I can recommend the book to anybody interested in the idea, meaning and principles of evidence-based laboratory medicine.
The book may not be composed in a uniform style as its chapters have been written by various authors who, however, had to comply withone principle: they had to provide as many practical examples as possible. In most cases, these examples are described in detail, including anamnestic data and symptoms and thus allowing us to understand the meaning of each result for a specific patient. It is actully this aspect that facilitates comprehension of, often at the first glance,abstract notions like likelihood ratio, LR) or positive predictive value (PPV). Chapters need not be read in sequence as they do not follow in continuation, thereby allowing fast access to a desired subject.
I would particularly like to bring into prominence several chapters, like the one entitled “Relation between the test and the outcome” as it indicates on the example of a few typical clinical scenarios the meaning, scopesand limitations of certain widely requested tests like cholesterol, prothrombin time, cardiac markers or PSA. Also, for anybody intending to design and implement a diagnostic study, it is of high value to read the text by PM Bossuyt entitled: “Study design and the quality of evidence” and also a chapter by Klovning and Sandberg: “Searching the literature and relevant databases” which demonstrates how to search the literature efficiently for a specific subject. The chapter authored by the editor-in-chief of the journal Clinical Chemistry, David E. Bruns, is related to the process of the preparation of guidelines which represent the end product of evidence-based medicine.
In conclusion, I may relate to a part of the quotation of an unnamed professor directed to his medical students: “... from the three D’s that make the bases of clinical practice, and which are: diagnosis, diagnosis, and diagnosis...”, and claim that clearly at least one of them is laboratory medicine. The way to its proper use is EBLM, and I can therefore recommend this book to anybody interested in joining this movement whose aim is reasonable use and interpretation of laboratory test results.