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EBLM Flashcards

1
Q

What does Evidence-Based Laboratory Medicine (EBLM) apply?

A

Scientific research and clinical evidence to laboratory testing

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2
Q

What is one of the key objectives of EBLM?

A

Trying to improve the quality of the information being used to make decisions or diagnosis

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3
Q

What does enhancing diagnostic accuracy ensure?

A

Appropriate test selection to avoid unnecessary or misleading results

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4
Q

How does EBLM improve disease detection?

A

Uses validated biomarkers and reference ranges

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5
Q

EBM definition

A

The conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.

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6
Q

What is promoted to achieve reduced diagnostic errors?

A

Quality control and standardization of lab procedures

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7
Q

How does EBLM support clinical decision-making?

A

Provides evidence-based guidelines for test interpretation

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8
Q

What does EBLM help clinicians make?

A

Timely and informed treatment decisions

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9
Q

What is optimized through EBLM in healthcare?

A

Resource utilization

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10
Q

What does EBLM reduce to minimize healthcare costs?

A

Unnecessary testing

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11
Q

What does EBLM improve in terms of patient safety?

A

Lowers the risk of misdiagnosis and inappropriate treatments

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12
Q

How does EBLM enhance patient monitoring?

A

Through reliable follow-up testing

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13
Q

What does EBLM encourage in terms of research?

A

The development of new diagnostic technologies

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14
Q

What does EBLM integrate into routine lab testing?

A

Genomic and personalized medicine

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15
Q

By following EBLM principles, what do laboratories contribute to?

A

Higher-quality healthcare and better patient management

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16
Q

Fill in the blank: EBLM plays a crucial role in improving patient _______.

A

Outcomes

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17
Q

True or False: EBLM only focuses on reducing healthcare costs.

A

False

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18
Q

What are clinical decision support systems designed for?

A

To support clinical decision during a diagnostic or therapeutic care process based on EBLM.

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19
Q

What are the three main components of a clinical decision support system?

A
  • A user interface
  • A clinical database
  • A knowledge database
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20
Q

What is the approximate percentage of over-utilization of tests?

A

20%

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21
Q

What is the approximate percentage of under-utilization of tests?

22
Q

What solutions are put in place to address test utilization issues? + example

A

Ordercoms or E-orders.
E.g. haemoglobin alerts or reminders of the institutions restrictive transfusion policies are effective in reducing RBC transfusion overuse.

23
Q

Fill in the blank: Removing TB testing of sputum from the front screen decreased the ordering of _______.

A

TB testing

24
Q

What is the first step in implementing EBLM practices within a clinical laboratory?

A

Identify Clinical Needs & Define the Question

Work with clinicians to understand diagnostic challenges and identify where evidence-based testing can improve outcomes using the PICO model.

25
What does the PICO model stand for?
Patient, Intervention, Comparison, Outcome ## Footnote This model helps structure clinical questions about laboratory tests.
26
What is involved in the second step of implementing EBLM?
Gather and Evaluate Scientific Evidence ## Footnote Conduct a literature review, assess validity of tests, and evaluate impact on patient outcomes.
27
What are key components to assess when evaluating scientific evidence?
* Analytical validity * Clinical validity * Impact on patient outcomes ## Footnote This includes sensitivity, specificity, and predictive value.
28
What does the third step of EBLM implementation entail?
Validate & Standardize Laboratory Tests ## Footnote Perform analytical validation and ensure compliance with regulatory standards.
29
What standards should be complied with during the validation of laboratory tests?
ISO 15189 ## Footnote This ensures standardization of test protocols.
30
What is the purpose of the fourth step in EBLM implementation?
Implement Clinical Decision-Making Tools ## Footnote Develop guidelines for test selection and use decision-support software.
31
What are two strategies introduced in clinical decision-making tools?
* Evidence-based guidelines * Clinical algorithms or reflex testing strategies ## Footnote These strategies optimize diagnostic efficiency.
32
What is the focus of the fifth step in EBLM implementation?
Train Laboratory & Clinical Staff ## Footnote Provide education on EBLM principles and conduct interdisciplinary workshops.
33
What is established in the sixth step to monitor test performance?
Quality assurance programs ## Footnote These programs continuously assess test accuracy and clinical impact.
34
What should be implemented to review test utilization?
Audit and feedback systems ## Footnote This helps adjust laboratory practices based on patient outcomes.
35
What is the seventh step in implementing EBLM practices?
Engage in Continuous Improvement & Research ## Footnote Encourage participation in trials and regularly update protocols based on new evidence.
36
What is one way to foster collaboration in EBLM practices?
Collaborate with medical professionals ## Footnote This helps refine diagnostic strategies.
37
When was EBM developed?
In the past 25yrs
38
What % does lab work assists in clinical decision making?
60-70% e.g. admission, discharge, drug therapy
39
EBM assists clinical management by integrating the _____ for the use of laboratory investigations with the _____ and the _____ of patients.
best available research evidence physician’s clinical expertise needs, expectations and concerns
40
What is the offered solution to avoiding over/under-utilization or tests based on EBLM?
Clinical decision support system Involves User interface Clinical database Knowledge database
41
What is the 5As
Structured step-by-step process to approach clinical question thoughtfully - full process from question to evaluation
42
What is PICO
A framework for formulating a good clinical question PICO Patient, Intervention, Comparison, Outcome
43
What is P in PICO
Patient = what are the most important charactetristics of the patient
44
WHat is I in PICO
Intervention = What do you want tot do with the patient
45
What is the C in PICO
Comparison = What are you hoping to compare with the intervention e.g. another drug, placebo, different testing method
46
What is O in PICO?
Outcome = What are you trying to accomplish, measure, improve?
47
5 As in EBLM - what are they and their meaning
1. ASK = formulate a clear answerable critical question - use PICO. 2. ACQUIRE = search for best available evidence 3. APPRAISE = critically assess the evidence. 4. APPLY = Use evidence in clinical decision making 5. ASSESS = evaluate outcome.
48
What sources are available to acquire evidence?
Primary research - controlled clinical trial Literature reviews Systematic reviews Meta-analysis Guidelines e.g. NICE, EUCAST
49
What is a literature review?
Broad summary of existing knowledge on a topic. Can be selective and high risk of bias.
50
What is a systematic review?
A structured, methodical search and analysis of all relevant studies answering a specific question. Follows strict protocols therefore bias is minimized.
51
What is a meta-analysis?
A statistical technique that combines data from multiple studies to get a single, pooled answer. Bias is minimized by pooling data.
52
Tools to Appraise evidence
Critical appraisal skill programme 1. e.g. CASP-tools checklist. = downloadable checklist for evaulating different types of papers. 2. Joanna Briggs Institute 3. Centre of evidence based medicine

Professional Practice (11 decks)

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