Value is equal to outcome/costs: how to apply to laboratory medicine
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und
Abstract
The concept of value, defined as health outcomes achieved per monetary unit spent, has profoundly reshaped modern healthcare delivery. While Value-Based Healthcare models have permeated many clinical disciplines, laboratory medicine has been slow to integrate this paradigm shift. In this opinion paper, we argue for a strategic repositioning of clinical laboratories as core enablers of value in healthcare systems. Laboratory diagnostics, long considered ancillary, should be reframed as pivotal tools that support outcome-based, cost-effective decision-making. We explore how laboratory parameters contribute to clinical value through predictive accuracy, diagnostic specificity, and operational appropriateness – factors that directly influence patient outcomes and resource allocation. Examples such as vitamin D testing, albumin as a biomarker of biological age, and NT-proBNP in heart failure demonstrate the potential and pitfalls of volume-driven laboratory utilization. Beyond technical excellence, we emphasize the importance of interpretive collaboration, health literacy, and ethical stewardship of diagnostic resources. Structural challenges, including commoditization, delocalization via point-of-care testing, and the limited use of patient-reported outcomes in laboratory settings, are critically examined. Finally, we highlight emerging policy frameworks across Europe that align reimbursement models with measurable outcomes, advocating for the integration of laboratories in clinical governance and value-based procurement. In this renewed perspective, laboratories are not merely data providers but agents of personalized, sustainable, and patient-centered care.
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Research ethics: Not applicable.
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Informed consent: Not applicable.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Use of Large Language Models, AI and Machine Learning Tools: To improve language, we used Grammarly, a writing enhancement tool that provides grammar and style suggestions. No generative AI or large language model (LLM) was used for content generation or interpretation.
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Conflict of interest: The authors state no conflict of interest.
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Research funding: None declared.
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Data availability: Not applicable.
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© 2025 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
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- Multi-cancer early detection revisited: insights and lessons from the PATHFINDER 2 study
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- Does patient-based data monitoring allow us to reconsider the relationship between IQC and EQA?
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- Requiem for the Passing–Bablok nonparametric regression in assessing the agreement between two measurement methods
- Comparative analysis of ISO 15189:2022 with earlier versions with reference to ethics
- Estimated waste generation from 1 million basic metabolic panels: a multisite U.S. study
- Performance of GFAP and UCH-L1 compared to S100B in detecting intracranial injury: influence of age, hemolysis, neurodegenerative diseases, and extracranial fractures in a prospective cohort of over 1,000 patients
- Post-analytical practices in clinical mass spectrometry laboratories: an international survey across 57 countries
- Towards harmonization of autoantibody detection in relation to paraneoplastic neurological syndromes (PNS): a European Survey on laboratory practices
- Staining and serological characteristics of the AC-30 pattern in HEp-2 IIFA: a comparative study with AC-2 pattern
- Measuring neurofilament light in human plasma and cerebrospinal fluid: a comparison of five analytical immunoassays
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- Dental amalgams and blood mercury concentrations in American adults
- Reference Values and Biological Variations
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- Serum neuron-specific enolase – reference interval in Danish children and the impact of preanalytical factors
- Performance evaluation of quantitative hemoglobin A2 and fetal hemoglobin testing using commercially lyophilized vs. in-house whole blood controls in Chinese clinical laboratories: a 12-year analysis of National External Quality Assessment Data
- Hematology and Coagulation
- EQALM recommendations for the analytical performance specifications for blood smear interpretation in hematology: a need for standardization
- Cancer Diagnostics
- Flow cytometry, cytology and histology in the diagnosis of ocular hematologic neoplasms: a 15-year monocentric experience with a focus on ocular lymphomas
- Cardiovascular Diseases
- Comparison of the cardiac troponin I-cardiac troponin T-troponin C complex and cardiac troponin I and T in distinguishing myocardial infarction using a single sample at presentation
- Letters to the Editor
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- Early autoimmune signature in a young woman: palmar erythema, capillaroscopic abnormalities, and triple autoantibody positivity including anti-nucleosome
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- Adverse analytical finding with trimetazidine after ingesting contaminated melatonin tablets sold in pharmacies… leading to the suspension of the athlete
- Ionized calcium in serum exposed to air
- Congress Abstracts
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Artikel in diesem Heft
- Frontmatter
- Editorials
- Counting cells is not enough: toward a global vision for quality and training in hematology
- Multi-cancer early detection revisited: insights and lessons from the PATHFINDER 2 study
- Review
- Automated reticulocyte counting: advances, standardization challenges, and clinical accessibility
- Opinion Papers
- Expert opinion within the context of the targeted evaluation of Regulation (EU) 2017/746 on in vitro diagnostic medical devices pursuant to Article 111 and Regulation (EU) 2024/1860
- Value is equal to outcome/costs: how to apply to laboratory medicine
- Does patient-based data monitoring allow us to reconsider the relationship between IQC and EQA?
- Genetics and Molecular Diagnostics
- Predictive genomic medicine enlarges the spectrum of predisposing mutations for head and neck cancers via a panel of 56 genes selected for human neoplasia in Southern Italy: a pilot study
- Failure Mode and Effects Analysis (FMEA) integrating quality indicators for risk assessment of the total testing process in human papillomavirus genotyping testing: a proactive risk analysis model for molecular diagnostics
- Impact of pneumatic tube system transport and blood collection tubes on cell-free DNA analysis of plasma samples
- General Clinical Chemistry and Laboratory Medicine
- Requiem for the Passing–Bablok nonparametric regression in assessing the agreement between two measurement methods
- Comparative analysis of ISO 15189:2022 with earlier versions with reference to ethics
- Estimated waste generation from 1 million basic metabolic panels: a multisite U.S. study
- Performance of GFAP and UCH-L1 compared to S100B in detecting intracranial injury: influence of age, hemolysis, neurodegenerative diseases, and extracranial fractures in a prospective cohort of over 1,000 patients
- Post-analytical practices in clinical mass spectrometry laboratories: an international survey across 57 countries
- Towards harmonization of autoantibody detection in relation to paraneoplastic neurological syndromes (PNS): a European Survey on laboratory practices
- Staining and serological characteristics of the AC-30 pattern in HEp-2 IIFA: a comparative study with AC-2 pattern
- Measuring neurofilament light in human plasma and cerebrospinal fluid: a comparison of five analytical immunoassays
- ADORE: the performance characteristics of five automated platforms in the analysis of urinary dysmorphic erythrocytes and pathological casts
- Influence of remnant cholesterol on direct LDL and HDL cholesterol measurement accuracy
- Dental amalgams and blood mercury concentrations in American adults
- Reference Values and Biological Variations
- Establishing reference intervals for high-sensitivity cardiac troponin T in neonates and infants
- Serum neuron-specific enolase – reference interval in Danish children and the impact of preanalytical factors
- Performance evaluation of quantitative hemoglobin A2 and fetal hemoglobin testing using commercially lyophilized vs. in-house whole blood controls in Chinese clinical laboratories: a 12-year analysis of National External Quality Assessment Data
- Hematology and Coagulation
- EQALM recommendations for the analytical performance specifications for blood smear interpretation in hematology: a need for standardization
- Cancer Diagnostics
- Flow cytometry, cytology and histology in the diagnosis of ocular hematologic neoplasms: a 15-year monocentric experience with a focus on ocular lymphomas
- Cardiovascular Diseases
- Comparison of the cardiac troponin I-cardiac troponin T-troponin C complex and cardiac troponin I and T in distinguishing myocardial infarction using a single sample at presentation
- Letters to the Editor
- Critical appraisal of presepsin for diagnosing late-onset sepsis in critically ill neonates
- Beyond cut-offs: optimizing presepsin for neonatal late-onset sepsis
- Pleural effusion with a thyroid signature: diagnostic utility of pleural fluid thyroglobulin
- Early autoimmune signature in a young woman: palmar erythema, capillaroscopic abnormalities, and triple autoantibody positivity including anti-nucleosome
- Confirmation of the value of the labile HbA1c/HbA1c-ratio in the presence of a Hb J-Baltimore variant: a clinical case
- Adverse analytical finding with trimetazidine after ingesting contaminated melatonin tablets sold in pharmacies… leading to the suspension of the athlete
- Ionized calcium in serum exposed to air
- Congress Abstracts
- Annual meeting of the Royal Belgian Society of Laboratory Medicine (RBSLM): “Beyond the Surface – Clinical biology of the apparently healthy individual”
