[Clinical laboratory's trends in the 21st century]

The new century presents numerous challenges and opportunities for the clinical laboratory scientists. Japan's economic recession has affected health care system directly. Clinical laboratories in particular have been hard hit financially. Laboratory people have striven for financial efficiency and balance within their own fields but now must broaden their view beyond this familiar field to the wider sphere of economics and medicine as whole. As laboratory professionals, we must be able to anticipate and respond to the current changes in disease frequencies, the fewer number of children in the nation, the health needs of the aging society, and the resulting economic implications. We, Japanese scientists, bring into the 21st century two major achievements. One is establishment of a fully automated laboratory system equipped with a transfer module. The second is reduced variation in inter-laboratory test results. Greater uniformity in the test results has been provided for by the supply of certified and calibrated reference materials as well as the dissemination of standard procedure for the measurement of catalytic amounts of enzymes published by the Japan Society of Clinical Chemistry(JSCC). Advances in the fields of diagnostic imaging were marvelous and received widespread attention. No less important were advances in high sensitivity immunoassay systems molecular biology-based diagnostic systems, and miniaturization of laboratory systems. The immediate future of laboratory medicine will be built upon these advanced technologies.