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Essays by leading researchers on the nature and genesis of laboratory medicine.
Focusing on practical, patient related issues, this volume provides the basic concepts of Evidence Based Medicine (EBM) as they relate to Pathology and Laboratory Medicine and presents various practical applications. It includes EBM concepts for use in the identification of cost-effective panels of immunostains and other laboratory tests and for improvement of diagnostic accuracy based on the identification of selected diagnostic features for particular differential diagnosis. EBM concepts are also put forth for use in Meta-analysis to integrate the results of conflicting literature reports and use of novel analytical tools such as Bayesian belief networks, neural networks, multivariate statistics and decision tree analysis for the development of new diagnostic and prognostic models for the evaluation of patients. This volume will be of great value to pathologists who will benefit from the concepts being promoted by EBM, such as levels of evidence, use of Bayesian statistics to develop diagnostic and other rules and stronger reliance on "hard data" to support therapeutic and diagnostic modalities.
Advances in genomic and proteomic profiling of disease have transformed the field of molecular diagnostics, thus leading the way for a major revolution in clinical practice. While the range of tests for disease detection and staging is rapidly expanding, many physicians lack the knowledge required to determine which tests to order and how to interpret results. Molecular Diagnostics provides a complete guide to the use and interpretation of molecular testing in the clinical arena. No other available resource offers this emphasis, comprehensive scope, and practical utility in the clinical setting. - Serves as the definitivereference for molecular pathologists worldwide - Covers a variety of molecular techniques including next generation sequencing, tumor somatic cell genotyping, infectious and genetic disease tecting, and pharmacogenetics - Discusses in the detail issues concerning quality assurance, regulation, ethics, and future directions for the science
"Excellent…Tucker’s chronicle of the world of 17th-century science in London and Paris is fascinating." —The Economist In December 1667, maverick physician Jean Denis transfused calf’s blood into one of Paris’s most notorious madmen. Days later, the madman was dead and Denis was framed for murder. A riveting exposé of the fierce debates, deadly politics, and cutthroat rivalries behind the first transfusion experiments, Blood Work takes us from dissection rooms in palaces to the streets of Paris, providing an unforgettable portrait of an era that wrestled with the same questions about morality and experimentation that haunt medical science today.
Clinical laboratory tests play an integral role in helping physicians diagnose and treat patients. New developments in laboratory technology offer the prospect of improvements in diagnosis and care, but will place an increased burden on the payment system. Medicare, the federal program providing coverage of health-care services for the elderly and disabled, is the largest payer of clinical laboratory services. Originally designed in the early 1980s, Medicare's payment policy methodology for outpatient laboratory services has not evolved to take into account technology, market, and regulatory changes, and is now outdated. This report examines the current Medicare payment methodology for outpatient clinical laboratory services in the context of environmental and technological trends, evaluates payment policy alternatives, and makes recommendations to improve the system.
Secrets played a central role in transformations in medical and scientific knowledge in early modern Europe. As a new fascination with novelty began to take hold from the late fifteenth century, Europeans thirsted for previously unknown details about the natural world: new plants, animals, and other objects from nature, new recipes for medical and alchemical procedures, new knowledge about the human body, and new facts about the way nature worked. These 'secrets' became popular items of commerce and trade, as the quest for new and exclusive bits of information met the vibrant early modern marketplace. Whether disclosed widely in print or kept more circumspect in manuscripts, secrets helped drive an expanding interest in acquiring knowledge throughout early modern Europe. Bringing together international scholars, this volume provides a pan-European and interdisciplinary overview on the topic. Each essay offers significant new interpretations of the role played by secrets in their area of specialization. Chapters address key themes in early modern history and the history of medicine, science and technology including: the possession, circulation and exchange of secret knowledge across Europe; alchemical secrets and laboratory processes; patronage and the upper-class market for secrets; medical secrets and the emerging market for proprietary medicines; secrets and cosmetics; secrets and the body and finally gender and secrets.
When asked to compare the practice of medicine today to that of a hundred years ago, most people will respond with a story of therapeutic revolution: Back then we had few effective remedies, but now we have more (and more powerful) tools to fight disease, from antibiotics to psychotropics to steroids to anticancer agents. This collection challenges the historical accuracy of this revolutionary narrative and offers instead a more nuanced account of the process of therapeutic innovation and the relationships between the development of medicines and social change. These assembled histories and ethnographies span three continents and use the lived experiences of physicians and patients, consumers and providers, and marketers and regulators to reveal the tensions between universal claims of therapeutic knowledge and the actual ways these claims have been used and understood in specific sites, from postwar West Germany pharmacies to twenty-first century Nigerian street markets. By asking us to rethink a story we thought we knew, Therapeutic Revolutions offers invaluable insights to historians, anthropologists, and social scientists of medicine.
The essential guide by one of America's leading doctors to how digital technology enables all of us to take charge of our health A trip to the doctor is almost a guarantee of misery. You'll make an appointment months in advance. You'll probably wait for several hours until you hear "the doctor will see you now"-but only for fifteen minutes! Then you'll wait even longer for lab tests, the results of which you'll likely never see, unless they indicate further (and more invasive) tests, most of which will probably prove unnecessary (much like physicals themselves). And your bill will be astronomical. In The Patient Will See You Now, Eric Topol, one of the nation's top physicians, shows why medicine does not have to be that way. Instead, you could use your smartphone to get rapid test results from one drop of blood, monitor your vital signs both day and night, and use an artificially intelligent algorithm to receive a diagnosis without having to see a doctor, all at a small fraction of the cost imposed by our modern healthcare system. The change is powered by what Topol calls medicine's "Gutenberg moment." Much as the printing press took learning out of the hands of a priestly class, the mobile internet is doing the same for medicine, giving us unprecedented control over our healthcare. With smartphones in hand, we are no longer beholden to an impersonal and paternalistic system in which "doctor knows best." Medicine has been digitized, Topol argues; now it will be democratized. Computers will replace physicians for many diagnostic tasks, citizen science will give rise to citizen medicine, and enormous data sets will give us new means to attack conditions that have long been incurable. Massive, open, online medicine, where diagnostics are done by Facebook-like comparisons of medical profiles, will enable real-time, real-world research on massive populations. There's no doubt the path forward will be complicated: the medical establishment will resist these changes, and digitized medicine inevitably raises serious issues surrounding privacy. Nevertheless, the result-better, cheaper, and more human health care-will be worth it. Provocative and engrossing, The Patient Will See You Now is essential reading for anyone who thinks they deserve better health care. That is, for all of us.
How can a smartwatch help patients with diabetes manage their disease? Why can’t patients find out prices for surgeries and other procedures before they happen? How can researchers speed up the decade-long process of drug development? How will "Precision Medicine" impact patient care outside of cancer? What can doctors, hospitals, and health systems do to ensure they are maximizing high-value care? How can healthcare entrepreneurs find success in this data-driven market? A revolution is transforming the $10 trillion healthcare landscape, promising greater transparency, improved efficiency, and new ways of delivering care. This new landscape presents tremendous opportunity for those who are ready to embrace the data-driven reality. Having the right data and knowing how to use it will be the key to success in the healthcare market in the future. We are already starting to see the impacts in drug development, precision medicine, and how patients with rare diseases are diagnosed and treated. Startups are launched every week to fill an unmet need and address the current problems in the healthcare system. Digital devices and artificial intelligence are helping doctors do their jobs faster and with more accuracy. MoneyBall Medicine: Thriving in the New Data-Driven Healthcare Market, which includes interviews with dozens of healthcare leaders, describes the business challenges and opportunities arising for those working in one of the most vibrant sectors of the world’s economy. Doctors, hospital administrators, health information technology directors, and entrepreneurs need to adapt to the changes effecting healthcare today in order to succeed in the new, cost-conscious and value-based environment of the future. The authors map out many of the changes taking place, describe how they are impacting everyone from patients to researchers to insurers, and outline some predictions for the healthcare industry in the years to come.