The ultimate goal of value-based laboratory medicine is maximizing the effectiveness of laboratory tests in improving patient outcomes, optimizing resources and minimizing unnecessary costs. This approach abandons the oversimplified notion of test volume and cost, in favor of emphasizing the clinical utility and quality of diagnostic tests in the clinical decision-making. Several key elements characterize value-based laboratory medicine, which can be summarized in some basic concepts, such as organization of in vitro diagnostics (including appropriateness, integrated diagnostics, networking, remote patient monitoring, disruptive innovations), translation of laboratory data into clinical information and measurable outcomes, sustainability, reimbursement, ethics (e.g., patient empowerment and safety, data protection, analysis of big data, scientific publishing). Education and training are also crucial, along with considerations for the future of the profession, which will be largely influenced by advances in automation, information technology, artificial intelligence, and regulations concerning in vitro diagnostics. This collective opinion paper, composed of summaries from presentations given at the two-day European Federation of Laboratory Medicine (EFLM) Strategic Conference "A vision to the future: value-based laboratory medicine" (Padova, Italy; September 23-24, 2024), aims to provide a comprehensive overview of value-based laboratory medicine, projecting the profession into a more clinically effective and sustainable future.
- MeSH
- klinické laboratoře * ekonomika trendy MeSH
- klinické laboratorní techniky ekonomika trendy MeSH
- kongresy jako téma MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Clinicians trust medical laboratories to provide reliable results on which they rely for clinical decisions. Laboratories fulfil their responsibility for accurate and consistent results by utilizing an arsenal of approaches, ranging from validation and verification experiments to daily quality control procedures. All these procedures verify, on different moments, that the results of a certain examination procedure have analytical performance characteristics (APC) that meet analytical performance specifications (APS) set for a particular intended use. The APC can in part be determined by estimating the measurement uncertainty component under conditions of within-laboratory precision (uRw), which comprises all components influencing the measurement uncertainty of random sources. To maintain the adequacy of their measurement procedures, laboratories need to distinguish aspects that are manageable vs. those that are not. One of the aspects that may influence uRw is the momentary significant bias caused by shifts in reagent and/or calibrator lots, which, when accepted or unnoticed, become a factor of the APC. In this paper, we postulate a model for allocating a part of allowable uRw to between-reagent lot variation, based on the need for long-term consistency of the measurement variability for that specific measurand. The allocation manages the ratio between short-term and long-term variation and indicates laboratories when to reject or correct certain variations due to reagent lots.
- MeSH
- indikátory a reagencie MeSH
- kalibrace MeSH
- laboratoře * MeSH
- lidé MeSH
- nejistota MeSH
- řízení kvality MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Michalickova, D, Minic, R, Kotur-Stevuljevic, J, Andjelkovic, M, Dikic, N, Kostic-Vucicevic, M, Slanar, O, and Djordjevic, B. Changes in parameters of oxidative stress, immunity, and behavior in endurance athletes during a preparation period in winter. J Strength Cond Res 34(10): 2965-2973, 2020-The current study monitored markers of immunological and oxidative status in 9 male elite endurance athletes: V[Combining Dot Above]O2max: 68 ± 11 ml·kg·min, age: 24 ± 2.5 years, and training loads: 128 ± 21 metabolic equivalents-h·wk during a 3-month preparation period in winter (January-March). Self-rated state of moods evaluation (by Profile of Mood States questionnaire) was performed, and blood samples were collected at the beginning and end of the study. Spectrophotometric methods and enzyme-linked immunosorbent assay were used for parameters' determination. The level of concanavalin A (ConA)-stimulated interferon-γ (IFN-γ) from peripheral blood mononuclear cells (PBMCs) was increased (562 [147-852] vs. 1,097 [451-1842] pg·ml, p = 0.013). Also, the level of transforming growth factor-1 (TGF-β1) in serum was elevated (2.5 [1.4-5.1] vs. 7.2 [4.9-8.2] ng·ml, p = 0.015). There was no change in the level of peptidoglycan (PGN)-stimulated interleukin (IL)-10 from PBMCs. There were no significant changes in PBMCs proliferation/viability on stimulation with ConA and PGN during the study. No changes in superoxide dismutase, prooxidative-antioxidative balance, total oxidant status (TOS), and thiobarbituric acid reactive substances were observed along the study. Total antioxidant status (TAS) was increased (910 ± 174 vs. 1,090 ± 102 μmol·L, p = 0.018), and activity of paraoxonase (PON1) was decreased (523 ± 295 vs. 335 ± 183 U·L, p = 0.003) at the end of the study. Advanced oxidation protein products were increased (25 ± 7.9 vs. 42 ± 7.6 μmol·L, p = 0.011). The self-rated sense of vigor significantly declined (20 ± 2.1 vs. 14 ± 3.4, p = 0.045). In conclusion, 3 months of regular training in winter induced prominent changes in cytokines, biomarkers of oxidative stress, and antioxidative enzyme activity. These changes might increase susceptibility of athletes to disease and muscle damage and consequently lead to performance reduction.
- MeSH
- afekt fyziologie MeSH
- biologické markery MeSH
- cytokiny metabolismus MeSH
- dospělí MeSH
- ELISA MeSH
- fyzická vytrvalost imunologie fyziologie MeSH
- leukocyty mononukleární metabolismus MeSH
- lidé MeSH
- longitudinální studie MeSH
- metabolický ekvivalent fyziologie MeSH
- mladiství MeSH
- mladý dospělý MeSH
- nutriční stav MeSH
- oxidace-redukce MeSH
- oxidační stres fyziologie MeSH
- sportovci * MeSH
- spotřeba kyslíku fyziologie MeSH
- zátěžový test MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
There is a growing body of evidence that tomato consumption reduces the risk of cardiovascular disease, through antioxidative, anti-inflammatory and hypotensive effects. We compared the effects of polyphenol-enriched and standard tomato juice on parameters of lipid and oxidative status and blood pressure in subjects with stage 1 hypertension. The experimental group (n = 13) was supplemented with 200 g of tomato fruit juice enriched with 1 g of ethanolic extract of whole tomato fruit, while the control group (n = 13) was consuming 200 g tomato fruit juice. Before and after the treatment, blood samples were collected, and blood pressure was measured. Markers of oxidative stress and antioxidative defense: paraoxonase (PON1), thiobarbituric acid reactive substances (TBARS), total antioxidant status (TAS), total oxidant status (TOS), pro-oxidant-antioxidant balance (PAB) and C reactive protein (CRP) were determined in serum. Prothrombin time (PT) was measured in the whole blood samples. Parameters of lipid status, as well as susceptibility to copper-induced oxidation of LDL particles in vitro were also determined. There was a significant reduction in total cholesterol and LDL-C only in the control group at the end of the study. No significant differences were observed in the remainder of the assessed parameters along the study. In conclusion, tomato juice may have favorable effects on lipid metabolism, but polyphenol fortification does not constitute additional beneficial cardiovascular effects.
- MeSH
- antioxidancia farmakologie MeSH
- biologické markery analýza MeSH
- hypertenze prevence a kontrola MeSH
- jednoduchá slepá metoda MeSH
- kardiovaskulární nemoci prevence a kontrola MeSH
- krevní tlak účinky léků MeSH
- lidé středního věku MeSH
- lidé MeSH
- lipidy analýza MeSH
- ovocné a zeleninové šťávy analýza MeSH
- oxidační stres účinky léků MeSH
- polyfenoly farmakologie MeSH
- potravní doplňky MeSH
- Solanum lycopersicum chemie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky MeSH
- randomizované kontrolované studie MeSH
- srovnávací studie MeSH
A randomized, double-blind, placebo-controlled study was conducted, in order to evaluate if Lactobacillus helveticus Lafti® L10 (Lallemand Health Solutions, Montreal, Canada) supplementation during three months could influence oxidative markers in the population of elite athletes: triathletes, cyclists and endurance athletes. Twenty-two elite athletes were randomized to either placebo (n = 12) or probiotic (n = 10) groups. The probiotic group received 2x1010 colony forming units of Lafti® L10. Before and after the supplementation serum samples were collected. Markers of oxidative stress and anti-oxidative defense: superoxide dismutase (SOD), paraoxonase (PON), advanced oxidation protein products (AOPP), malondialdehyde (MDA), total antioxidant status, total oxidant status, pro-oxidant-antioxidant balance, oxidative stress index, bilirubin, uric acid and albumin were determined in serum. Parameters of lipid status, as well as susceptibility to copper-induced oxidation of LDL particles in vitro were also determined. There was a significant interaction effect for MDA (p = 0.039), with a decrease in MDA in the probiotic group only (p = 0.049). There was a significant interaction effect for AOPP (p = 0.037), with a significant decrease in the probiotic group (p = 0.045). Interaction effect for SOD was approaching to formal significance (p = 0.108) and the post-hoc test showed a significant decrease in the probiotic group (p = 0.041) only. A significant correlation between AOPP and SOD (p = 0.012, r = -0.40) was found in the probiotic group at the end of the study. PON1 activity was decreased in both the probiotic (p = 0.032) and placebo group (p = 0.035). No significant changes in the remainder of the evaluated parameters were noted. In conclusion, probiotic strain Lafti® L10 exerts certain antioxidant potential, but further research is needed.
- Publikační typ
- časopisecké články MeSH
- Publikační typ
- abstrakt z konference MeSH
