Opinion: redefining the role of the physician in laboratory medicine in the context of emerging technologies, personalised medicine and patient autonomy (‘4P medicine’)

Abstract

<jats:p>The role of clinical pathologists or laboratory-based physicians is being challenged on several fronts—exponential advances in technology, increasing patient autonomy exercised in the right to directly request tests and the use of non-medical specialists as substitutes. In response, clinical pathologists have focused their energies on the pre-analytical and postanalytical phases of Laboratory Medicine thus emphasising their essential role in individualised medical interpretation of complex laboratory results. Across the European Union, the role of medical doctors is enshrined in the Medical Act. This paper highlights the relevance of this act to patient welfare and the need to strengthen training programmes to prevent an erosion in the quality of Laboratory Medicine provided to patients and their physicians.</jats:p>

Artificial Intelligence in Medicine: Today and Tomorrow

“…Intelligent medical technologies (i.e., AI-powered) have been met with enthusiasm by the general population partly because it enables a 4P model of medicine (Predictive, Preventive, Personalized, and Participatory) and therefore patient autonomy, in ways that could not be possible (3); smartphones are becoming for instance the go-to item to fill and distribute an electronic personal health record (4), monitor vital functions with biosensors (5) and helping to reach optimal therapeutic compliance (6), therefore gifting the patient with the spot as the main actor in the care pathway. The development of intelligent medical technologies is enabling the development of a new field in medicine: augmented medicine, i.e., the use of new medical technologies to improve different aspects of clinical practice.…”

Managing inappropriate utilization of laboratory resources

“…Laboratory medicine has become an indispensable discipline in medical care [1,2]. Blood for laboratory testing is collected from almost every patient entering a medical facility.…”

Conventional biomarkers for cardiovascular risks and their correlation with the castelli risk index-indices and tg/hdl-c

“…This predictive value of the TG/ HDL-C ratio represented an opportunity for the health system to improve the early diagnosis of insulin resistance in diabetic patients with high CVR, as well as a reduction in institutional costs, and an improvement in the access to the diagnoses that are provided by the IPSs. Here, it is important to highlight the importance achieved by the clinical laboratory service, by guaranteeing the reliability of the measurements of these routine exams, since they give rise to atherogenic indices that are discriminant and predictive of risks [34][35][36].…”