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2. A Comprehensive Appraisal of Laboratory Biochemistry Tests as Major Predictors of COVID-19 Severity

Author

Aloisio, Elena, Chibireva, Mariia, Serafini, Ludovica, Pasqualetti, Sara, Falvella, Felicia S., Dolci, Alberto, and Panteghini, Mauro

Subjects
Biochemistry -- Research, Medical research, Medicine, Experimental, Biological markers -- Research, Diagnosis, Laboratory -- Methods, Health
Abstract

* Context.--A relevant portion of coronavirus disease 2019 (COVID-19) patients develop severe disease with negative outcomes. Several biomarkers have been proposed to predict COVID-19 severity, but no definite interpretative criteria have been established to date for stratifying risk. Objective.--To evaluate 6 serum biomarkers (C-reactive protein, lactate dehydrogenase, D-dimer, albumin, ferritin, and cardiac troponin T) for predicting COVID-19 severity and to define related cutoffs able to aid clinicians in risk stratification of hospitalized patients. Design.--A retrospective study of 427 COVID-19 patients was performed. Patients were divided into groups based on their clinical outcome: nonsurvivors versus survivors and patients admitted to an intensive care unit versus others. Receiver operating characteristic curves and likelihood ratios were employed to define predictive cutoffs for evaluated markers. Results.--Marker concentrations at peak were significantly different between groups for both selected outcomes. At univariate logistic regression analysis, all parameters were significantly associated with higher odds of death and intensive care. At the multivariate analysis, high concentrations of lactate dehydrogenase and low concentrations of albumin in serum remained significantly associated with higher odds of death, whereas only low lactate dehydrogenase activities remained associated with lower odds of intensive care admission. The best cutoffs for death prediction were greater than 731 U/L for lactate dehydrogenase and 18 g/L or lower for albumin, whereas a lactate dehydrogenase activity lower than 425 U/L was associated with a negative likelihood ratio of 0.10 for intensive treatment. Conclusions.--Our study identifies which biochemistry tests represent major predictors of COVID-19 severity and defines the best cutoffs for their use. doi: 10.5858/arpa.2020-0389-SA, At the end of 2019, an outbreak of atypical pneumonia of unknown cause was detected in Wuhan, the capital of the province of Hubei, China. (1) The etiologic agent of [...]

Published
2020
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6. Role and responsibilities of laboratory medicine specialists in the verification of metrological traceability of in vitro medical diagnostics

Author

Braga Federica, Infusino Llenia, and Panteghini Mauro

Subjects
uncertainty, standardization, analytical goals, Biochemistry, QD415-436
Abstract

To be accurate and equivalent, laboratory results should be traceable to higher-order references. Furthermore, their quality should fulfill acceptable measurement uncertainty as defined to fit the intended clinical use. With this aim, in vitro diagnostics (IVD) manufacturers should define a calibration hierarchy to assign traceable values to their system calibrators and to fulfill during this process uncertainty limits for calibrators, which should represent a proportion of the uncertainty budget allowed for clinical laboratory results. It is therefore important that, on one hand, the laboratory profession clearly defines the clinically acceptable uncertainty for relevant tests and, on the other hand, end-users may know and verify how manufacturers have implemented the traceability of their calibrators and estimated the corresponding uncertainty. Important tools for IVD traceability surveillance are quality control programmes through the daily verification by clinical laboratories that control materials of analytical systems are in the manufacturer's declared validation range [Internal Quality Control (IQ C) component I] and the organization of External Quality Assessment Schemes meeting metrological criteria. In a separate way, clinical laboratories should also monitor the reliability of employed commercial systems through the IQC component II, devoted to estimation of the measurement uncertainty due to random effects, which includes analytical system imprecision together with individual laboratory performance in terms of variability.

Published
2015

9. Prognostic Utility of a Modified HEART Score in Chest Pain Patients in the Emergency Department

Author

McCord, James, Cabrera, Rafael, Lindahl, Bertil, Giannitsis, Evangelos, Evans, Kaleigh, Nowak, Richard, Frisoli, Tiberio, Body, Richard, Christ, Michael, deFilippi, Christopher R., Christenson, Robert H., Jacobsen, Gordon, Alquezar, Aitor, Panteghini, Mauro, Melki, Dina, Plebani, Mario, Verschuren, Franck, French, John, Bendig, Garnet, Weiser, Silvia, Mueller, Christian, Twerenbold, Raphael, Katus, Hugo A., Popp, Steffen, Ordóñez-Llanos, Jorge, Santalo-Bel, Miquel, Horner, Daniel, Dolci, Alberto, Jernberg, Tomas, Zaninotto, Martina, Manara, Alessandro, Dinkel, Carina, Menassanch-Volker, Sylvie, Jarausch, Jochen, and Zaugg, Christian

Published
2017
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10. Definition of the Immune Parameters Related to COVID-19 Severity

Author

Birindelli, Sarah, primary, Tarkowski, Maciej S., additional, Gallucci, Marcello, additional, Schiuma, Marco, additional, Covizzi, Alice, additional, Lewkowicz, Przemysław, additional, Aloisio, Elena, additional, Falvella, Felicia Stefania, additional, Dolci, Alberto, additional, Riva, Agostino, additional, Galli, Massimo, additional, and Panteghini, Mauro, additional

Published
2022
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12. Novel Criteria for the Observe-Zone of the ESC 0/1h-hs-cTnT Algorithm

Author

Lopez-Ayala, Pedro, primary, Nestelberger, Thomas, additional, Boeddinghaus, Jasper, additional, Koechlin, Luca, additional, Ratmann, Paul David, additional, Strebel, Ivo, additional, Gehrke, Juliane, additional, Meier, Severin, additional, Walter, Joan, additional, Rubini Gimenez, Maria, additional, Mutschler, Eugenio, additional, Miró, Òscar, additional, López-Barbeito, Beatriz, additional, Martín-Sánchez, Francisco Javier, additional, Rodríguez-Adrada, Esther, additional, Keller, Dagmar I., additional, Newby, L. Kristin, additional, Twerenbold, Raphael, additional, Giannitsis, Evangelos, additional, Lindahl, Bertil, additional, Mueller, Christian, additional, Zimmermann, Tobias, additional, Schoepfer, Hadrien, additional, Coscia, Tania, additional, Troester, Valentina, additional, Reichlin, Tobias, additional, Kaeslin, Marina, additional, Christ, Michael, additional, Meier, Mario, additional, Badertscher, Patrick, additional, Puelacher, Christian, additional, du Fay de Lavallaz, Jeanne, additional, Potlukova, Eliska, additional, Kawecki, Damian, additional, Geigy, Nicolas, additional, Rentsch, Katharina, additional, Shrestha, Samyut, additional, Morawiec, Beata, additional, Munzk, Piotr, additional, Breidthardt, Tobias, additional, Freese, Michael, additional, Martinez-Nadal, Gemma, additional, Fuenzalida, Carolina, additional, Calderón, Sofia, additional, Rodriguez Adrada, Esther, additional, Ganovská, Eva, additional, Parenica, Jiri, additional, von Eckardstein, Arnold, additional, Campodarve, Isabel, additional, Gea, Joachim, additional, Mccord, James, additional, Nowak, Richard, additional, Body, Richard, additional, deFilippi, Christopher R., additional, Christenson, Robert H., additional, Panteghini, Mauro, additional, Plebani, Mario, additional, Verschuren, Franck, additional, French, John, additional, Weiser, Silvia, additional, and Jernberg, Tomas, additional

Published
2021
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14. Symptoms Predictive of Acute Myocardial Infarction in the Troponin Era: Analysis From the TRAPID-AMI Study

Author

McCord, James, Aurora, Lindsey, Lindahl, Bertil, Giannitsis, Evangelos, Calle-Muller, Carlos, Nowak, Richard, Body, Richard, Christ, Michael, deFilippi, Christopher R, Christenson, Robert H, Jacobsen, Gordon, Alquezar, Aitor, Panteghini, Mauro, Melki, Dina, Plebani, Mario, Verschuren, Franck, French, John, Bendig, Garnet, Weiser, Silvia, Mueller, Christian, TRAPID-AMI Investigators, UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, and UCL - (SLuc) Service des urgences

Subjects
Male, medicine.medical_specialty, Time Factors, Myocardial Infarction, 030204 cardiovascular system & hematology, Chest pain, Diagnosis, Differential, Electrocardiography, 03 medical and health sciences, 0302 clinical medicine, Predictive Value of Tests, Internal medicine, Multicenter trial, myocardial infarction, symptoms, troponin, Humans, Medicine, cardiovascular diseases, Myocardial infarction, health care economics and organizations, Aged, Retrospective Studies, biology, business.industry, Reproducibility of Results, Electrocardiography in myocardial infarction, Odds ratio, Middle Aged, medicine.disease, Troponin, Predictive value of tests, Cardiology, biology.protein, Female, Myocardial infarction diagnosis, medicine.symptom, Emergency Service, Hospital, Cardiology and Cardiovascular Medicine, business, Biomarkers, Follow-Up Studies
Abstract

The TRAPID-AMI (High Sensitivity Cardiac Troponin T assay for rapid Rule-out of Acute Myocardial Infarction) study evaluated a rapid "rule-out" acute myocardial infarction (AMI). We evaluated what symptoms were associated with AMI as part of a substudy of TRAPID-AMI. There were 1282 patients evaluated from 12 centers in Europe, the United States of America, and Australia from 2011 to 2013. Multiple symptom variables were prospectively obtained and evaluated for association with the final diagnosis of AMI. Multivariate logistic regression analysis was done, and odds ratios (OR) were calculated. There were 213/1282 (17%) AMIs. Four independent predictors for the diagnosis of AMI were identified: radiation to right arm or shoulder [OR = 3.0; confidence interval (CI): 1.8-5.0], chest pressure (OR = 2.5; CI: 1.3-4.6), worsened by physical activity (OR = 1.7; CI: 1.2-2.5), and radiation to left arm or shoulder (OR = 1.7; CI: 1.1-2.4). In the entire group, 131 (10%) had radiation to right arm or shoulder, 897 (70%) had chest pressure, 385 (30%) worsened with physical activity, and 448 (35%) had radiation to left arm or shoulder. Duration of symptoms was not predictive of AMI. There were no symptoms predictive of non-AMI. Relationship between AMI size and symptoms was also studied. For 213 AMI patients, cardiac troponins I values were divided into 4 quartiles. Symptoms including pulling chest pain, supramammillary right location, and right arm/shoulder radiation were significantly more likely to occur in patients with larger AMIs. In a large multicenter trial, only 4 symptoms were associated with the diagnosis of AMI, and no symptoms that were associated with a non-AMI diagnosis.

Published
2019

17. Reflex Testing of Free Prostate-Specific Antigen as Effective Health Care Policy

Author

Ferraro, Simona, Caruso, Simone, and Panteghini, Mauro

Subjects
Antigens, Prostate cancer, Hyperplasia, Health
Abstract

To the Editor.--We read with interest the article by Schifman et al (1) dealing with the utilization of measurement of free prostate-specific antigen (fPSA). We would like to contribute by [...]

Published
2019

21. Coronary angiographic findings in patients with clinical unstable angina according to cardiac troponin I and T concentrations in serum; a comparative analysis

Author

Panteghini, Mauro, Cuccia, Claudio, Pagani, Franca, Turla, Claudia, Bonetti, Graziella, and Bonini, Elena

Subjects
Unstable angina -- Causes of, Angiocardiography
Abstract

Context.--Elevated cardiac troponin levels have been reported to identify unstable angina patients at high risk. Objective.--To examine the relation of cardiac troponin I (cTnI) and cardiac troponin T (cTnT) levels to findings of coronary angiography in these patients. Methods.--Samples for troponin estimation were taken every 4 hours throughout the first 48 hours after admission before angiography in 34 patients with primary unstable angina. Patients were considered to be troponin positive if the marker was increased (>0.04 [micro]g/L for cTnT and >0.03 [micro]g/L for cTnI) in at least one sample collected. Results.--An increased troponin (I or T) concentration was documented in 14 patients (41.2%). Twelve patients (35.3%) had elevations of both markers, whereas the remaining 2 patients had elevations of cTnI or cTnT alone. Patients with or without increased troponin levels did not differ with respect to degree of coronary disease at angiography. However, patients with elevated troponin concentrations had more complex lesion characteristics. In 69% of patients with increased cTnI levels and in 77% of patients with increased cTnT levels, type B2 or C lesions were documented with presence of ulcerated plaques and thrombus formation. In contrast, only 23% of the patients with elevated cTnI or cTnT levels had type A lesions compared with 71% of patients with negative troponin concentrations. Conclusions.--Patients with unstable angina who have significant release of cTnI and/or cTnT have evidence of more complex lesions on coronary angiography, supporting the hypothesis that both troponins might be used without distinction as surrogate markers for microembolization from thrombus formation on a disrupted plaque., Assays of both cardiac troponin I (cTnI) and cardiac troponin T (cTnT) provide high sensitivity for the detection of myocardial damage in patients with acute coronary syndrome, including those with [...]

Published
2002

24. IFCC Working Group Recommendations for Correction of Bias Caused by Noncommutability of a Certified Reference Material Used in the Calibration Hierarchy of an End-User Measurement Procedure

Author

Miller, W Greg, primary, Budd, Jeffrey, additional, Greenberg, Neil, additional, Weykamp, Cas, additional, Althaus, Harald, additional, Schimmel, Heinz, additional, Panteghini, Mauro, additional, Delatour, Vincent, additional, Ceriotti, Ferruccio, additional, Keller, Thomas, additional, Hawkins, Douglas, additional, Burns, Chris, additional, Rej, Robert, additional, Camara, Johanna E, additional, MacKenzie, Finlay, additional, van der Hagen, Eline, additional, and Vesper, Hubert, additional

Published
2020
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26. Documenting metrological traceability as intended by ISO 15189:2012: A consensus statement about the practice of the implementation and auditing of this norm element

Author

Thelen Marc. Vanstapel Florent, Meško Brguljan Pika, Gouget Brnard, Boursier Guilaine, Barrett Edward, Kroupis Christos, Lohmander Maria, Šprongl Luděk, Vodnik Tatjana, Bernabeu-Andreu Francisco, Vukasović Ines, Sönmez Çiğdem, Linko Solveig, Brugnoni Duilio, Vaubourdolle Michel, Huisman Willem, Panteghini Mauro

Subjects
metrological traceability, risk management
Abstract

ISO15189:2012 requires medical laboratories to document metrological traceability of their results. While the ISO17511:2003 standard on metrological traceability in laboratory medicine requires the use of the highest available level in the traceability chain, it recognizes that for many measurands there is no reference above the manufacturer's selected measurement procedure and the manufacturer's working calibrator. Some immunoassays, although they intend to measure the same quantity and may even refer to the same reference material, unfortunately produce different results because of differences in analytical selectivity as manufacturers select different epitopes and antibodies for the same analyte. In other cases, the cause is the use of reference materials, which are not commutable. The uncertainty associated with the result is another important aspect in metrological traceability implementation. As the measurement uncertainty on the clinical samples is influenced by the uncertainty of all steps higher in the traceability chain, laboratories should be provided with adequate and appropriate information on the uncertainty of the value assignment to the commercial calibrators that they use. Although the between-lot variation in value assignment will manifest itself as part of the long-term imprecision as estimated by the end-user, information on worst-case to be expected lot- lot variation has to be communicated to the end-user by the IVD provider. When laboratories use ancillary equipment that potentially could have a critical contribution to the reported results, such equipment needs verification of its proper calibration and criticality to the result uncertainty could be assessed by an approach based on risk analysis, which is a key element of ISO15189:2012 anyway. This paper discusses how the requirement for metrological traceability as stated in ISO15189 should be met by the medical laboratory and how this should be assessed by accreditation bodies.

Published
2019

31. Laboratory tests in the Emergency Department: A consensus document by SIBioC-Medicina di Laboratorio and the Academy of Emergency Medicine and Care

Author

Lippi, Giuseppe, Panteghini, Mauro, Bernardini, Sergio, Bonfanti, Laura, Carraro, Paolo, Casagranda, Ivo, Cavazza, Mario, Ceriotti, Ferruccio, Ciaccio, Marcello, Coen, Daniele, Giavarina, Davide, Giostra, Fabrizio, Paolillo, Ciro, Plebani, Mario, Ricci, Giorgio, and Cervellin, Gianfranco

Subjects
Department, Settore BIO/12, Emergency, consensus. document, Emergency, Department, consensus. document
Published
2017

32. A summary of worldwide national activities in Chronic Kidney Disease (CKD) testing

Author

Ruiz-Arenas, Roberto, Sierra-Amor, Rosa, Seccombe, David, Raymondo, Stella, Graziani, Maria Stella, Panteghini, Mauro, Adedeji, Tewogbade A., Kamatham, Shanthi Naidu, and Biljak, Vanja Radišić

Subjects
laboratory medicine, KDIGO, national activities, chronic kidney disease (CKD), chronic kidney disease (CKD), national activities, laboratory medicine, KDIGO, Research Article
Abstract

Chronic kidney disease (CKD) is a major public health issue worldwide and is associated with adverse health outcomes, especially in low- and middle-income countries. In a cash limited healthcare system, guidelines that improve the efficiency of health care free up resources needed for other healthcare services. This short review presents some examples from national acitivities in CKD testing, including countries throughout the globe: Mexico in North America, Uruguay in South America, Italy in Europe, Nigeria in Africa and India in Asia. Considering the fact that treatment of CKD is cost-effective and improves outcomes, this observation argue in favor of including CKD in national guidelines and noncommunicable chronic disease (NCD) programs. This diverse example of national activities fullfil the very first step in achieving this goal.

Published
2017

35. IFCC Working Group Recommendations for Assessing Commutability Part 1: General Experimental Design

Author

Miller, W Greg, primary, Schimmel, Heinz, primary, Rej, Robert, primary, Greenberg, Neil, primary, Ceriotti, Ferruccio, primary, Burns, Chris, primary, Budd, Jeffrey R, primary, Weykamp, Cas, primary, Delatour, Vincent, primary, Nilsson, Göran, primary, MacKenzie, Finlay, primary, Panteghini, Mauro, primary, Keller, Thomas, primary, Camara, Johanna E, primary, Zegers, Ingrid, primary, and Vesper, Hubert W, primary

Published
2018
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36. IFCC Working Group Recommendations for Assessing Commutability Part 3: Using the Calibration Effectiveness of a Reference Material

Author

Budd, Jeffrey R, primary, Weykamp, Cas, primary, Rej, Robert, primary, MacKenzie, Finlay, primary, Ceriotti, Ferruccio, primary, Greenberg, Neil, primary, Camara, Johanna E, primary, Schimmel, Heinz, primary, Vesper, Hubert W, primary, Keller, Thomas, primary, Delatour, Vincent, primary, Panteghini, Mauro, primary, Burns, Chris, primary, and Miller, W Greg, primary

Published
2018
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37. IFCC Working Group Recommendations for Assessing Commutability Part 2: Using the Difference in Bias between a Reference Material and Clinical Samples

Author

Nilsson, Göran, primary, Budd, Jeffrey R, primary, Greenberg, Neil, primary, Delatour, Vincent, primary, Rej, Robert, primary, Panteghini, Mauro, primary, Ceriotti, Ferruccio, primary, Schimmel, Heinz, primary, Weykamp, Cas, primary, Keller, Thomas, primary, Camara, Johanna E, primary, Burns, Chris, primary, Vesper, Hubert W, primary, MacKenzie, Finlay, primary, and Miller, W Greg, primary

Published
2018
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39. The Asian project for collaborative derivation of reference intervals: (1) strategy and major results of standardized analytes

Author

Ceriotti, Ferruccio, Tam, Tran Huu, Sueyoshi, Shigeo, Poon, Priscilla M.K., Thong, Mee Ling, Higashiuesato, Yasushi, Wang, Xuejing, Kataoka, Hiromi, Matsubara, Akemi, Shiesh, Shu-Chu, Muliaty, Dewi, Kim, Jeong-Ho, Watanabe, Masakazu, Lam, Christopher W.K., Siekmann, Lothar, Lopez, Joseph B.Lopez, and Panteghini, Mauro

Subjects
standardization, multicenter study, nested ANOVA, common reference interval, regionality
Published
2013

40. The Use of Very Low Concentrations of High-sensitivity Troponin T to Rule Out Acute Myocardial Infarction Using a Single Blood Test

Author

Body, Richard, Mueller, Christian, Giannitsis, Evangelos, Christ, Michael, Ordonez Llanos, Jorge, de Filippi, Christopher R., Nowak, Richard, Panteghini, Mauro, Jernberg, Tomas, Plebani, Mario, Verschuren, Franck, French, John K., Christenson, Robert, Weiser, Silvia, Bendig, Garnet, Dilba, Peter, Lindahl, Bertil, Nowak, Richard M., Horner, Daniel, Dolci, Alberto, Zaninotto, Martina, Manara, Alessandro, Menassanch Volker, Sylvie, Jarausch, Jochen, and Zaugg, Christian

Subjects
Male, medicine.medical_specialty, Acute coronary syndrome, Chest Pain, Myocardial Infarction, 030204 cardiovascular system & hematology, Chest pain, Cohort Studies, 03 medical and health sciences, Electrocardiography, 0302 clinical medicine, Troponin T, Internal medicine, Troponin I, medicine, Blood test, Humans, cardiovascular diseases, 030212 general & internal medicine, Myocardial infarction, Prospective Studies, Acute Coronary Syndrome, Aged, Retrospective Studies, Aged, 80 and over, medicine.diagnostic_test, business.industry, General Medicine, Middle Aged, medicine.disease, humanities, Emergency Medicine, Cardiology, Female, Myocardial infarction diagnosis, medicine.symptom, business, Biomarkers
Abstract

Recent single-center and retrospective studies suggest that acute myocardial infarction (AMI) could be immediately excluded without serial sampling in patients with initial high-sensitivity cardiac troponin T (hs-cTnT) levels below the limit of detection (LoD) of the assay and no electrocardiogram (ECG) ischemia.We aimed to determine the external validity of those findings in a multicenter study at 12 sites in nine countries.TRAPID-AMI was a prospective diagnostic cohort study including patients with suspected cardiac chest pain within 6 hours of peak symptoms. Blood drawn on arrival was centrally tested for hs-cTnT (Roche; 99th percentile = 14 ng/L, LoD = 5 ng/L). All patients underwent serial troponin sampling over 4-14 hours. The primary outcome, prevalent AMI, was adjudicated based on sensitive troponin I (Siemens Ultra) levels. Major adverse cardiac events (MACE) including AMI, death, or rehospitalization for acute coronary syndrome with coronary revascularization were determined after 30 days.We included 1,282 patients, of whom 213 (16.6%) had AMI and 231 (18.0%) developed MACE. Of 560 (43.7%) patients with initial hs-cTnT levels below the LoD, four (0.7%) had AMI. In total, 471 (36.7%) patients had both initial hs-cTnT levels below the LoD and no ECG ischemia. These patients had a 0.4% (n = 2) probability of AMI, giving 99.1% (95% confidence interval [CI] = 96.7% to 99.9%) sensitivity and 99.6% (95% CI = 98.5% to 100.0%) negative predictive value. The incidence of MACE in this group was 1.3% (95% CI = 0.5% to 2.8%).In the absence of ECG ischemia, the detection of very low concentrations of hs-cTnT at admission seems to allow rapid, safe exclusion of AMI in one-third of patients without serial sampling. This could be used alongside careful clinical assessment to help reduce unnecessary hospital admissions.

Published
2016

42. Laboratory testing in the emergency department: An Italian Society of Clinical Biochemistry and Clinical Molecular Biology (SIBioC) and Academy of Emergency Medicine and Care (AcEMC) consensus report

Author

Lippi, Giuseppe, primary, Panteghini, Mauro, additional, Bernardini, Sergio, additional, Bonfanti, Laura, additional, Carraro, Paolo, additional, Casagranda, Ivo, additional, Cavazza, Mario, additional, Ceriotti, Ferruccio, additional, Ciaccio, Marcello, additional, Coen, Daniele, additional, Giavarina, Davide, additional, Giostra, Fabrizio, additional, Paolillo, Ciro, additional, Plebani, Mario, additional, Ricci, Giorgio, additional, and Cervellin, Gianfranco, additional

Published
2017
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47. Serial Sampling of High-Sensitivity Cardiac Troponin T May Not Be Required for Prediction of Acute Myocardial Infarction Diagnosis in Chest Pain Patients with Highly Abnormal Concentrations at Presentation.

Author

Mueller-Hennessen, Matthias, Mueller, Christian, Giannitsis, Evangelos, Biener, Moritz, Vafaie, Mehrshad, deFilippi, Christopher R., Christ, Michael, Ordóñez-Llanos, Jorge, Panteghini, Mauro, Plebani, Mario, Verschuren, Franck, Melki, Dina, French, John K., Christenson, Robert H., Body, Richard, McCord, James, Dinkel, Carina, Katus, Hugo A., and Lindahl, Bertil

Published
2017
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48. The Future of Laboratory Medicine: Understanding the New Pressures

Author

Panteghini, Mauro

Subjects
Mini Review
Abstract

Since the future role of Laboratory Medicine is strongly and equally challenged by economic and new technological pressures, it is essential to take a broad view of the discipline and present to the administrators and other decision-makers the full spectrum of activities and benefits Laboratory Medicine can provide. In particular, the importance and the true impact of Laboratory Medicine can only be achieved by adding value to laboratory tests, represented by their effectiveness in influencing the management of patients and related clinical outcomes.

Published
2004

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