Not just blood tests or – in the last year and a half – Covid swabs. Laboratory medicine is much more. Two data help to better frame the range of action of this discipline: 70% of clinical decisions are based on laboratory information, compared to an incidence on the health budget that is around 3%. In short, the role of laboratory medicine is considered crucial and will be increasingly so in the coming years. At Frontiere we talk about it with Laura Sciacovelli, president of the Italian Society of Clinical Biochemistry and Clinical Molecular Biology (Sibioc).
The role of laboratory medicine
In the collective imagination, the laboratory doctor takes care of the blood samples that patients routinely carry out for medical checks. But there is much more: what is the role and the task of those who carry out this profession? “To think that the role of the laboratory professional is so marginal and limited to the execution of blood samples is certainly wrong. Laboratory Medicine is a composite discipline that applies all modern scientific methodologies to make its contribution to the prevention, diagnosis, therapy and management of diseases ”, explains the president of Sibioc.
A ‘team’ at work
It is wrong to think that the professionals who work in the laboratory are only doctors. Laboratory Medicine is a discipline that requires the contribution of different professionals and skills. “Doctors work in the laboratory, but also biologists, chemists, biotechnologists, laboratory technicians, nurses, each with well-defined tasks and responsibilities”, continues Sciacovelli. The coexistence of different professionalism and skills allows for a broader view of the situations and allows an evaluation of the same in their complexity in the various areas in which one operates “.
The evolution of laboratory medicine
As has happened for many of the health professions, laboratory medicine has also evolved and today its role within the National Health System has also changed. Exams that were performed in small laboratories using manual procedures 70 years ago have been fully automated, so today millions of tests can be performed every year. “There has been an overwhelming scientific progress and technological innovation and the roles and skills of the laboratory specialist have had to meet the needs of this transformation and evolution that is continuous”, underlines Sciacovelli who adds: “Think, for example, of the challenges that our discipline must face today: it is fully involved in ensuring a reliable use of Big Data in order to obtain useful information in the health sector, as well as in guaranteeing the correct use of artificial intelligence and again, as the pandemic context to be Covid-19 has taught us how to implement new management tools to be more ready to face emergency situations “.
Laboratory medicine during Covid-19
Laboratory medicine was brought to the attention of the public by Covid-19 since the identification of positive or negative subjects to the disease was possible thanks to laboratory tests, in particular the molecular swab. “This was especially relevant for identifying asymptomatic subjects”, underlines the president of Sibioc. “Furthermore, the role of the laboratory in epidemiological surveillance and in the evaluation of immunization, through the search for antibodies to Sars-CoV-2, has been very important, and it will be increasingly important now in monitoring the immune response induced by vaccination. The laboratory has also played a very important role in differential diagnostics and prognosis through the determination of biomarkers, such as haematological parameters, coagulation factors or inflammation markers, commonly requested and performed in our laboratories “.
Compass-exams for oncology
Laboratory medicine has gradually become more and more precious also in the oncology field and not only for the various laboratory tests that can suggest the presence of a tumor and therefore indicate the need for further information in this regard. “Today, an innovative and important approach is available, known as liquid biopsy that allows the identification of tumor DNA isolated from patients’ blood. Liquid biopsy has enormous potential in oncology and one of the applications is the ability to monitor the molecular evolution of the neoplasm. It is a strong push for precision medicine ”, explains Sciacovelli.
The next ‘frontiers’ of the profession
Like almost all healthcare, the orientation for this discipline is that of an increasingly personalized and precision laboratory medicine, but also integrated into the various clinical teams. “Ours is a discipline that will have to involve more and more new interlocutors, the experts of Health Techology Assessment, Big Data and Artificial Intelligence in order to make the laboratory report more and more reliable and informative and that meets quality criteria, high-level traceability, consistency and efficacy “, concludes the expert, adding:” Digitization also certainly concerns laboratory medicine and will be increasingly so in the future if we think about the development objectives of medicine in the area. In this case, great commitment will be required of the laboratory specialists in terms of governance to guarantee the quality of the result wherever this is performed “.
.