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The clinical laboratory: a decision maker hub

  • María Salinas ORCID logo EMAIL logo , Maite López-Garrigós , Emilio Flores , Ester Martín and Carlos Leiva-Salinas
Published/Copyright: May 20, 2021
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 59 Issue 10

Abstract

Objectives

We aimed to share a new laboratory model based on laboratory knowledge, meaningful use of information technology, and partnership with clinicians, to lead the appropriate use of laboratory testing and clinical decision making in the diagnosis of as-yet-undiagnosed disease. More specifically, we evaluate the role of eight different opportunistic interventions to diagnose certain asymptomatic disorders, by means of the automatic registration of appropriate laboratory testing according to different scenarios.

Methods

This is a retrospective longitudinal study to evaluate the impact of laboratory interventions on the diagnosis of different diseases and on patient care, including data from January 2012 to September 2020.

Results

Overall, the above strategies have so far identified 2063 patients with clinically relevant as-yet-undiagnosed disorders who would have otherwise remained occult, such as for instance, primary hyperparathyroidism, diabetes, and hypomagnesemia.

Conclusions

We are facing a new laboratory model, a leading laboratory rather than a passive traditional laboratory, not just to intervene in clinical decision-making, but to make the clinical decision, through the identification of patients with occult disease.

Keywords: appropriateness; clinical laboratory; demand management; under-request
Corresponding author: María Salinas, PhD, Clinical Laboratory, Hospital Universitario de San Juan, Carretera Alicante-Valencia, s/n, 03550 San Juan, Alicante, Spain, Phone: +34 965169463, Fax: +34 965169460, E-mail:

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Not applicable.

  5. Ethical approval: Not applicable.

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Received: 2021-02-23
Accepted: 2021-05-05
Published Online: 2021-05-20
Published in Print: 2021-09-27

© 2021 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Ageing, ACE2 deficiency and bad outcome in COVID-19
  4. Review
  5. Harmonization status of procalcitonin measurements: what do comparison studies and EQA schemes tell us?
  6. Opinion Papers
  7. Role of ACE2 polymorphism in COVID-19: impact of age
  8. The importance of correct stratifications when comparing directly and indirectly estimated reference intervals
  9. General Clinical Chemistry and Laboratory Medicine
  10. The clinical laboratory: a decision maker hub
  11. Simultaneous measurement of 13 circulating vitamin D3 and D2 mono and dihydroxy metabolites using liquid chromatography mass spectrometry
  12. Cerebrospinal fluid hemoglobin levels as markers of blood contamination: relevance for α-synuclein measurement
  13. Novel severe traumatic brain injury blood outcome biomarkers identified with proximity extension assay
  14. Hemoglobin Yamagata [β132(H10)Lys→Asn; (HBB: c.399A>T)]: a mosaic to be put together
  15. Reference Values and Biological Variations
  16. Pediatric reference interval verification for endocrine and fertility hormone assays on the Abbott Alinity system
  17. Hematology and Coagulation
  18. Neonatal lymphocyte subpopulations analysis and maternal preterm premature rupture of membranes: a pilot study
  19. Pro-coagulant imbalance in patients with community acquired pneumonia assessed on admission and one month after hospital discharge
  20. A multi-laboratory assessment of congenital thrombophilia assays performed on the ACL TOP 50 family for harmonisation of thrombophilia testing in a large laboratory network
  21. Cardiovascular Diseases
  22. Exercise-induced changes in miRNA expression in coronary artery disease
  23. Diabetes
  24. Recommendations for proficiency testing criteria for hemoglobin A1c based on the Shanghai Center for Clinical Laboratory’s study
  25. Infectious Diseases
  26. The versatility of external quality assessment for the surveillance of laboratory and in vitro diagnostic performance: SARS-CoV-2 viral genome detection in Austria
  27. Letters to the Editor
  28. Monitoring of the immunogenic response to Pfizer BNT162b2 mRNA COVID-19 vaccination in healthcare workers with Snibe SARS-CoV-2 S-RBD IgG chemiluminescent immunoassay
  29. SARS-CoV-2 antibody assay after vaccination: one size does not fit all
  30. Analysis of leptin-adiponectin ratio and C-reactive protein as potential biomarkers of metabolic syndrome in adolescents
  31. Hb Johnstown is detected on Mindray BC 6800 Plus analyzer
  32. Long-term stability of 25-hydroxyvitamin D: importance of the analytical method and of the patient matrix
  33. Development of chronic myeloid leukemia in a patient previously diagnosed with a JAK2-positive myeloproliferative neoplasm
  34. Acquired Pelger-Huet anomaly in two patients with chronic lymphocytic leukemia treated with venetoclax
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  36. The successful inclusion of ADA SCID in Tuscany expanded newborn screening program
https://doi.org/10.1515/cclm-2021-0421
Keywords for this article
appropriateness; clinical laboratory; demand management; under-request

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Ageing, ACE2 deficiency and bad outcome in COVID-19
  4. Review
  5. Harmonization status of procalcitonin measurements: what do comparison studies and EQA schemes tell us?
  6. Opinion Papers
  7. Role of ACE2 polymorphism in COVID-19: impact of age
  8. The importance of correct stratifications when comparing directly and indirectly estimated reference intervals
  9. General Clinical Chemistry and Laboratory Medicine
  10. The clinical laboratory: a decision maker hub
  11. Simultaneous measurement of 13 circulating vitamin D3 and D2 mono and dihydroxy metabolites using liquid chromatography mass spectrometry
  12. Cerebrospinal fluid hemoglobin levels as markers of blood contamination: relevance for α-synuclein measurement
  13. Novel severe traumatic brain injury blood outcome biomarkers identified with proximity extension assay
  14. Hemoglobin Yamagata [β132(H10)Lys→Asn; (HBB: c.399A>T)]: a mosaic to be put together
  15. Reference Values and Biological Variations
  16. Pediatric reference interval verification for endocrine and fertility hormone assays on the Abbott Alinity system
  17. Hematology and Coagulation
  18. Neonatal lymphocyte subpopulations analysis and maternal preterm premature rupture of membranes: a pilot study
  19. Pro-coagulant imbalance in patients with community acquired pneumonia assessed on admission and one month after hospital discharge
  20. A multi-laboratory assessment of congenital thrombophilia assays performed on the ACL TOP 50 family for harmonisation of thrombophilia testing in a large laboratory network
  21. Cardiovascular Diseases
  22. Exercise-induced changes in miRNA expression in coronary artery disease
  23. Diabetes
  24. Recommendations for proficiency testing criteria for hemoglobin A1c based on the Shanghai Center for Clinical Laboratory’s study
  25. Infectious Diseases
  26. The versatility of external quality assessment for the surveillance of laboratory and in vitro diagnostic performance: SARS-CoV-2 viral genome detection in Austria
  27. Letters to the Editor
  28. Monitoring of the immunogenic response to Pfizer BNT162b2 mRNA COVID-19 vaccination in healthcare workers with Snibe SARS-CoV-2 S-RBD IgG chemiluminescent immunoassay
  29. SARS-CoV-2 antibody assay after vaccination: one size does not fit all
  30. Analysis of leptin-adiponectin ratio and C-reactive protein as potential biomarkers of metabolic syndrome in adolescents
  31. Hb Johnstown is detected on Mindray BC 6800 Plus analyzer
  32. Long-term stability of 25-hydroxyvitamin D: importance of the analytical method and of the patient matrix
  33. Development of chronic myeloid leukemia in a patient previously diagnosed with a JAK2-positive myeloproliferative neoplasm
  34. Acquired Pelger-Huet anomaly in two patients with chronic lymphocytic leukemia treated with venetoclax
  35. Novel variant of MYH9 associated with mild evaluation of MYH9 related disorder in a Chinese family
  36. The successful inclusion of ADA SCID in Tuscany expanded newborn screening program
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