title: Interaction between clinic and laboratory.
abstract: Clinicians order laboratory tests to diagnose, monitor, and screen for diseases, to evaluate or confirm previously abnormal results and to develop prognoses. The rigorous quality assurance programs, large automated processes and economic constraints may induce direct challenges to tailored diagnosis. Clinicians will have to gain an understanding of the underlying principles of laboratory technologies without losing their ability to practice 'the art of medicine' at their primary focus - the patient. Specialized laboratory services and expertise play especially important roles in coagulation hematology. Assays are technically demanding and often based on functional properties of proteins, producing results that are far more than plain numbers. Interpretation of laboratory data poses many challenges, such as pre-analytical and patient-dependent factors, of which the laboratory is often not well informed, but which the clinicians are required to take into account. The laboratory scientist needs to understand the multiple clinical circumstances causing variance or interference in the laboratory results. Direct interaction between clinic and laboratory is needed. When laboratory-specific issues are uncertain to the clinician, the laboratory scientist should become the clinician's primary consultant. The better the education and knowledge of both directions, the better the outcome. Regular multidisciplinary rounds by the clinicians and the laboratory scientists are of great benefit. This interaction at its best fosters research and development by identifying new mechanisms and tools.
authors.affiliation: Coagulation Disorders, Hematology and Clinical Chemistry (HUSLAB Laboratory Services) Helsinki University Central Hospital, Helsinki, Finland. anna-elina.armstrong@hus.fi
authors.forename: Elina
authors.initials: E
authors.lastname: Armstrong
authors.forename: Lotta
authors.initials: L
authors.lastname: Joutsi-Korhonen
authors.forename: Riitta
authors.initials: R
authors.lastname: Lassila
mesh_terms: D001778:Blood Coagulation Disorders / Q000097:blood / Q000175:diagnosis / Q000628:therapy; D015510:Clinical Medicine; D003299:Cooperative Behavior; D006801:Humans; D007753:Laboratories; D010348:Patient Care Team