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Evidence-based principles in pathology: existing problem areas and the development of "quality" practice patterns
Mark R Wick1, Alberto M Marchevsky
1Department of Pathology, University Hospital, University of Virginia Health System, Room 3020, 1215 Lee St, Charlottesville, VA 22908-0214, USA. mrw9c@virginia.edu
Archives of Pathology & Laboratory Medicine
|October 29, 2011
Summary
Evidence-based medicine (EBM) principles are underutilized in laboratory medicine, impacting pathology practices. Applying EBM can improve quality and reduce healthcare costs.
Area of Science:
- Laboratory Medicine
- Pathology
- Evidence-Based Medicine
Background:
- Evidence-based medicine (EBM) principles are not consistently applied in various aspects of laboratory medicine, including anatomic and clinical pathology.
- Non-EBM practices stem from inadequate education, habit, or overreliance on empirical factors by laboratory service consumers, and sometimes from pathologists themselves.
Purpose of the Study:
- To identify problem areas in laboratory medicine where EBM is not applied, such as metastatic malignancies, targeted oncologic therapy, and data utilization.
- To explore the application of EBM principles for improving hospital pathology practices and establishing quality standards.
Main Methods:
- A review of current English literature on EBM in pathology and laboratory medicine.
- Incorporation of authors' practical experience in identifying and addressing non-EBM practices.
Main Results:
- Several key areas in laboratory medicine were identified as lacking EBM implementation.
- Specific examples include the management of metastatic malignancies, oncologic therapies, laboratory testing, coagulation defects, blood product administration, and hepatic iron overload.
Conclusions:
- Adoption of EBM principles offers a pathway to optimize laboratory services and enhance the quality of pathology practices.
- Implementing EBM is crucial for controlling overall healthcare expenditures.
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