The value-based score in laboratory medicine: results of a European pilot study

Value in healthcare has been defined as the ratio between clinical outcomes and costs, providing a valuable framework for laboratory medicine as well. Implementing this concept in laboratory medicine - referred to as Value-Based Laboratory Medicine (VBLM) - requires a shift from volume-driven activities to outcome-oriented practice. In particular, the value-based score (V-BS) represents a pragmatic tool for assessing and benchmarking laboratory performance.

The V-BS was designed by the experts of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Committee on the Value-Based Score (C-BS) and piloted in 12 European clinical laboratories of different sizes. Participating laboratories completed a structured Excel-based questionnaire covering five domains. Scores were assigned from 0 to 1 for each requirement and weighted to generate a final score out of 100. Descriptive statistics were used to summarize total and domain-specific performance.

All invited laboratories completed the pilot evaluation. Total scores ranged from 44.64 to 86.18, with a mean of 68.90 and a median of 71.21. The highest scores were observed for indicators related to traceability throughout the total testing process and quality of laboratory information, whereas clinical interaction was consistently the weakest domain.

The data reported by the clinical laboratories participating in the pilot study demonstrate strong interest in this initiative. Although relevant differences in value-based laboratory performance were observed across the 12 participating sites, overall satisfactory performance was achieved for most indicators related to traceability and quality of laboratory information. In contrast, indicators related to clinical interaction consistently received the lowest scores.