Clinical chemistry in laboratory medicine in Europe--past, present and future challenges

European experts in clinical laboratory sciences have different backgrounds, and development of expertise in this field started more than 100 years ago. Specific national activities have created the heterogeneity that now exists amongst the academic professional membership of more than 40 scientific societies in Europe. The recent political changes have in addition contributed to the rapidly changing profile of Clinical Chemistry and related fields. Based on a questionnaire answered by 31 national representatives, the past, present and future aspects of the European Clinical Laboratory are reviewed. Of the more than 30,000 members of national societies, the majority studied medicine (40.1%), chemistry (27.2%) and pharmacy (21.1%) with large national differences in relative percentages. Post-graduate education is provided by two thirds of the national societies. In most European countries the same experts cover not only clinical chemistry but also haematology, haemostaseology, immunology and transfusiology. National quality assurance programmes are said to be established in 25 countries, but mandatory in only 11 of them. Of the future challenges, the implementation of request strategies were named most often, with interpretative reports and preanalytical aspects estimated as similarly important. It was thought that information technology and new scientific developments would make the greatest impact in the coming years, with economic pressure being the major limiting factor. Despite these limitations an increase in the number of tests is anticipated by most representatives, supporting the assumption of an increasing role of the clinical laboratory in future clinical medicine.