IFCC e-Academy Curriculum:
Evidence Based Laboratory Medicine (EBLM)
Evidence Based Laboratory Medicine (EBLM): definition, how it differs from Evidence Based Medicine (EBM) and why we need it.
The EBLM process: Ask, Acquire, Appraise; Act, Audit.
Formulation of the Question (PICO; CAPO and other formats).
Searching the Evidence; PubMed; EMBASE; Cochrane Library.
Study design: cross-sectional; cohort and randomized controlled trials (RCTs).
Sources of bias in studies of diagnostic accuracy. STARD criteria.
Evaluating the literature: Appraisal instruments; eg STEP.
Systematic Reviews versus Narrative Reviews.
Guideline development, levels of evidence and appraisal. AGREE instrument.
Sources of Guidelines. Cochrane Collaboration.
Laboratory Medicine and Clinical Outcomes; Applying the Evidence.
Economic Evaluation of Diagnostic Tests.
The Role of Clinical Audit.
EBLM: measures of diagnostic performance
Sensitivity, Specificity, Predictive Value. Effect of Prevalence.
Likelihood Ratios (and their utility), Odds Ratios – Fagan’s nomogram.
Receiver Operating Characteristic (ROC) Curve analysis.
Evidence Based Laboratory Medicine and Point of Care Testing (POCT)
Outcomes of relevance for laboratory tests, including POCT.
Examples of evidence base for POCT including HbA1c, the Emergency Department, self-monitoring of blood glucose and INR testing.
POCT troponin testing and rural health; examples from Australia.
POCT in the Primary Care environment.