Clinical Chemistry I Week 1 Quiz

Course Information

• Course title: Clinical Chemistry I
• Course code: 0202304
• Instructor: Mohammad Qabajah
• Email: [email protected]

Week 1: Introduction - EBM

• Objectives:
  • Explain reasons for laboratory tests
  • Describe laboratory medicine
  • Describe sub-disciplines, information handling, and ethical issues
  • State importance of confidentiality in the lab
  • Justify evidence-based laboratory medicine practices

Introduction to Clinical Laboratory Medicine

• Includes: Research, Administration, Teaching activities, Clinical services
• Laboratory testing may be used to: Confirm clinical suspicion, Exclude a diagnosis, Assist in treatment selection, optimization, and monitoring, Provide a prognosis, Screen for disease in absence of symptoms, Monitor severity of physiological disturbance

Clinical Chemistry and Laboratory Medicine

• Boundaries are becoming more blurred due to increasing molecular testing
• International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) is the current name

Laboratory Medicine

• Today's clinical labs are complex, offering diverse tests that constantly expand.
• Hundreds of millions of tests are performed annually.
• Over 70% of objective data in patient records comes from the clinical lab.
• Specific types vary greatly between institutions.

Clinical Laboratory Fields

• Chemistry/Immunoassay
• Hematology and Coagulation
• Blood Bank/Apheresis
• Endocrinology
• Immunoserology
• Microbiology (including Bacteriology, Virology, Parasitology)
• Urinalysis, Fluid Analysis, and Medical Microscopy
• Molecular Pathology
• Cytogenetics
• Tissue Typing/HLA
• Toxicology

Reference Lab

• Some labs use reference labs (often called "send-out labs").
• Reference labs provide specialized testing services for patients and healthcare providers.
• Specialized tests for infrequent orders and specialized equipment.

Laboratory Testing Process Overview

• The process flows from pre-analytic (ordering, sample collection) to analytic phase (testing) and post-analytic phase (results interpretation/action).

Laboratory Department

• Breakdown of the lab work by phase
  • Pre-Analytical Phase (laboratory): 35%
  • Analytical Phase (laboratory): 25%
  • Post-Analytical Phase (laboratory): 15%
  • Sending: 5%

Evidence Based Medicine (EBM)

• EBM is a new approach for clinical care and research.
• Physicians' responsibility to find the best current information and use it for patient benefit.

Basis of Medical Practice (Check all that apply)

• Training, clinical experience, and consultation with other professionals
• Convincing evidence (non-experimental): articles, case reports, product literature
• Patient preferences
• Active search of randomized controlled trials, systematic reviews, and meta-analysis reports
• Note - this also means EBM is in practice

Purpose of Evidence Based Medicine

• Skill development in:
  • Distinguishing evidence from propaganda
  • Differentiating probability from certainty
  • Identifying data from assertions
  • Recognizing rational beliefs from superstitions
  • Separating science from folklore
  • Differentiating theory from dogma

Evidence Based Medicine Principles

• Change in how physicians practice, teach, and handle research
  • Clinical practice: based on best current evidence
  • Patient care: compassionate and patient-oriented
  • Learning & Teaching/Research: Problem solving

Three Major Components of EBM

• Patient
• Physician
• Information (Question/Problem)

Basic Steps of EBM – 5A's

• Ask (the question)
• Acquire (the evidence)
• Appraise (the evidence)
• Apply (the evidence to the patient)
• Assess (the effect of the applied evidence)

The Clinical Question

• The first and most important step of EBM is to ask a clear clinical question.
• Asking the Clinical Question is often the hardest step

Asking Good Questions

• Skill to be learned
• Make the case easier for the user and other parties
• Important questions include: Exactly how much time did you spend on that project?
• Hmmm... Is he about to give me a BONUS? Or is he about to FIRE me?

EBM, A Good Question Must Be:

• Specific: Identifies the problem and clarifies the clinical issue
• Answerable: Through literature
• Contains multiple aspects: Patient, options, comparisons, etc.

EBM Question: Multiple factors

• P: Patient (Type of patient or population)
• E: Exposure (Environmental, personal, biological)
• I: Intervention (Clinical intervention)
• C: Comparison (Compare alternative treatments)
• O: Outcome (Clinical outcome of interest)

Next Lecture

This quiz covers the introductory concepts of Clinical Chemistry I, focusing on evidence-based laboratory medicine, the importance of laboratory tests, and the various roles within clinical laboratory medicine. Test your understanding of ethical issues, confidentiality, and the significance of laboratory practices.