【进展】Clinical Biochemistry 社论:检验医学是一门濒临灭亡了的学科吗？
这个帖子发布于 15 年零 23 天前，其中的信息可能已发生改变或有所发展。
今天闲逛Clinical Biochemistry，发现了这篇很有意思的文章。标题为：Is laboratory medicine a dying profession? Blessed are those who have not seen and yet have believed 即：检验医学是一门濒临灭亡了的学科吗？（上帝）保佑的是那些虽然没有看到前途，但是对前途充满信心的人。
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6TDD-506RN42-1&_user=2352871&_coverDate=06%2F01%2F2010&_rdoc=13&_fmt=high&_orig=browse&_srch=doc-info(%23toc%235196%239999%23999999999%2399999%23FLA%23display%23Articles)&_cdi=5196&_sort=d&_docanchor=&_ct=35&_acct=C000057039&_version=1&_urlVersion=0&_use***2352871&md5=4b8df9fbfb067f12f3494523d45c0143
文章首先用简短的语言概括了检验医学的起源、发展、在现代医学中的地位以及面临的挑战。
紧接着，作者具体阐述了目前检验医学面临的发展所面临的问题：一方面，随着个体化治疗、早期诊断等概念的深入，检验在疾病预防与治疗中发挥的作用越来越大。特别是近年来，各种“组学”技术的出现，为检验注入了新的活力；另一方面，目前临床实验室存在追求经济效益的行为，开展了一些不必要的检查，浪费了医疗资源，这些都有违“以病人为中心”的基本原则。此外，POCT强劲的发展势头也使得检验医学的生存空间越来越小，检验师可能需要重新定位自己的社会职责。
最后，作者进行了展望，指出检验医学的出路在于：
Looking at the future, however, new and different duties and jobs might be the key for survival. First, laboratory professionals have to become the patient's best source of information about laboratory results, concerning patient preparation guidelines, preanalytical issues, and interpretative counseling [27] and [28].
必须以病人为中心，做好分析前的质量控制和分析后的临床咨询工作。
Second, they have to expand the consultative assistance for physicians as regards appropriateness and interpretation, also developing practice guidelines for the appropriate use of laboratory services and in closer cooperation with the stakeholders. In particular, they have to cover the role of “translators,” allowing the rationale and effective translation of new insights and innovative tests into the daily clinical practice.
要主动联系临床医师和病人，从实验室指标的角度去解释疾病。
Third, they have to assure the quality of laboratory testing, irrespective of where they are performed (e.g., POCT), expanding the governance throughout the total testing process, to embrace all steps from test request to result utilization.
保证检验结果的质量。
Fourth, they have to better communicate the quality of laboratory data by introducing information on the assay performance (e.g., the total error) in laboratory reports, thus making the analytical uncertainty a more understandable concept for clinicians or other stakeholders, and the reference change value for serial results [29] and [30]
评价检验方法的可靠性（不确定度，RCV等）。
Finally, laboratory professionals with a medical background must maintain a close interaction with the clinical context, assuming a direct responsibility in patient management, participating in multidisciplinary teams and initiatives for defining diagnostic pathways and improving the global quality of healthcare. This seems to be advisable especially in some areas such as monitoring of oral anticoagulant therapy, hematological, autoimmune, and allergic diseases, in which highly complex and specialized laboratory findings should be merged with clinical information to reflect reliably the medical condition.
多往临床靠。
This is not an easy path to follow, but “Blessed are those who have not seen and yet have believed道路是曲折的，上帝保佑那些不抛弃，不放弃的人。
写得很有见地、很冷静的一篇文章，结尾部分颇让人感觉醍醐灌顶，推荐给大家。
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6TDD-506RN42-1&_user=2352871&_coverDate=06%2F01%2F2010&_rdoc=13&_fmt=high&_orig=browse&_srch=doc-info(%23toc%235196%239999%23999999999%2399999%23FLA%23display%23Articles)&_cdi=5196&_sort=d&_docanchor=&_ct=35&_acct=C000057039&_version=1&_urlVersion=0&_use***2352871&md5=4b8df9fbfb067f12f3494523d45c0143
文章首先用简短的语言概括了检验医学的起源、发展、在现代医学中的地位以及面临的挑战。
紧接着，作者具体阐述了目前检验医学面临的发展所面临的问题：一方面，随着个体化治疗、早期诊断等概念的深入，检验在疾病预防与治疗中发挥的作用越来越大。特别是近年来，各种“组学”技术的出现，为检验注入了新的活力；另一方面，目前临床实验室存在追求经济效益的行为，开展了一些不必要的检查，浪费了医疗资源，这些都有违“以病人为中心”的基本原则。此外，POCT强劲的发展势头也使得检验医学的生存空间越来越小，检验师可能需要重新定位自己的社会职责。
最后，作者进行了展望，指出检验医学的出路在于：
Looking at the future, however, new and different duties and jobs might be the key for survival. First, laboratory professionals have to become the patient's best source of information about laboratory results, concerning patient preparation guidelines, preanalytical issues, and interpretative counseling [27] and [28].
必须以病人为中心，做好分析前的质量控制和分析后的临床咨询工作。
Second, they have to expand the consultative assistance for physicians as regards appropriateness and interpretation, also developing practice guidelines for the appropriate use of laboratory services and in closer cooperation with the stakeholders. In particular, they have to cover the role of “translators,” allowing the rationale and effective translation of new insights and innovative tests into the daily clinical practice.
要主动联系临床医师和病人，从实验室指标的角度去解释疾病。
Third, they have to assure the quality of laboratory testing, irrespective of where they are performed (e.g., POCT), expanding the governance throughout the total testing process, to embrace all steps from test request to result utilization.
保证检验结果的质量。
Fourth, they have to better communicate the quality of laboratory data by introducing information on the assay performance (e.g., the total error) in laboratory reports, thus making the analytical uncertainty a more understandable concept for clinicians or other stakeholders, and the reference change value for serial results [29] and [30]
评价检验方法的可靠性（不确定度，RCV等）。
Finally, laboratory professionals with a medical background must maintain a close interaction with the clinical context, assuming a direct responsibility in patient management, participating in multidisciplinary teams and initiatives for defining diagnostic pathways and improving the global quality of healthcare. This seems to be advisable especially in some areas such as monitoring of oral anticoagulant therapy, hematological, autoimmune, and allergic diseases, in which highly complex and specialized laboratory findings should be merged with clinical information to reflect reliably the medical condition.
多往临床靠。
This is not an easy path to follow, but “Blessed are those who have not seen and yet have believed道路是曲折的，上帝保佑那些不抛弃，不放弃的人。
写得很有见地、很冷静的一篇文章，结尾部分颇让人感觉醍醐灌顶，推荐给大家。
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