Clinical pathology

The Laboratory Medicine ( " Laboratory Medicine " ) is a diagnostic medical field at the interface of science subjects such as chemistry or molecular biology.

In Germany there is a specific medical training to become a specialist in laboratory medicine, while the trade in the UK, for example, the pathologist as " Pathologist ", in France, the biologist represents a " Biologist ". As part of the harmonization of European education systems are working for a uniform, but will not be easy due to long national traditions with relevant professional codes of conduct.

Fields of activity

Laboratory physicians are cross-curricular for nearly all medical disciplines, especially but works for general medicine and internal medicine. Create laboratory findings for the diagnosis and staging of disease, progression - therapy control and prevention. Apart from the actual analysis they organize sample preparation including transport to the laboratory ( pre-analysis ) and the return transmission of laboratory results to the requesting physician, including remote data transmission and counseling ( post analysis).

Focus of the laboratory medical practice include clinical chemistry and immunochemistry, hematology and Blood Coagulation ( blood disorders ) ( blood clotting disorders ), microbiology and infectious diseases, transfusion medicine and human genetics. For some of these disciplines has its own specialist or additional names as well as scientific certificates (eg Clinical Chemists ).

Specialist for Laboratory Medicine

In order for a completed medical studies in Germany to work as a medical specialist for laboratory medicine, it requires a five-year training period:

• 1 year in Microbiology, Virology and Infectious Disease Epidemiology
• 1/2 year in Transfusion Medicine

Three years may be served with a registered doctor.

Normally, a patient with the laboratory physician is hardly personal contact, unless for blood sampling and recovery of other study materials, such as bone marrow, brain and joint fluids, semen and stool. However, laboratory physicians often offer training and advice, for example in the context of blood glucose self- testing, human genetics, tropical or preventive medicine.

Statistics

• On 1 January 2001 1,223 specialists were registered for Laboratory Medicine, of which 466 were settled in Germany. 324 exerted no medical activity.
• The laboratory medicine is regulated in Germany since 2013 also the Ban on admission as part of the physicians' requirements planning.

Only 160 of over 2000 hospital laboratories are headed by laboratory physicians ( 2005). The rest are, as a rule, a specialist in internal medicine, on whose behalf a Medical Technical Assistant or Clinical Chemist operates. Office-based laboratory practices must always be guided by a medical specialist for laboratory medicine against it.

As in other specialist areas, the number of laboratory physicians by the aging of the population and the lack of young people in medicine from now.

Methods

Among the important studies of laboratory medicine include blood tests, urine tests and other investigations, such as the cytodiagnosis of sputum.

Normal ranges

Normal ranges are typically collected at a large number of apparently healthy individuals. As a so -called normal values ​​are added to the upper and lower limits of the range in which 95 % of all measurements are. A value outside the normal range does not mean, therefore, imply that the appropriate person is sick, quite the contrary: every 20th value must lie outside the specified limits, by definition, in healthy subjects.

Since the normal ranges also depend heavily on the methodology used, the population studied, etc., the limits specified in this table are to be understood as reference values ​​only. For the evaluation of laboratory test results, the specific table of the relevant doctor in case of doubt a personal medical interpretation is valid and necessary.

Reference ranges and decision limits

Conversely, all normal ranges more or less overlaps with the values ​​, which are obtained in patients. Your readings depend, for example, the type, stage, severity, and treatment of the particular disease from: So the level of the tumor marker PSA states, for example, quite a bit about the overall size of the prostate, but virtually nothing about the benign or malignant causes an eventual enlargement. In order to obtain an optimal separation between the healthy and the sick, we therefore needed for any medical issue specific reference ranges and decision limits: If you want to, for example, in the testing of blood products for HIV infection must be excluded, you will be the upper decision limit of the assay extremely set low (even at the risk that many seemingly suspicious samples should be thus discarded), while you will start for the same test at a screening a comparatively higher limit so as not to confront Healthy with AIDS false alarm.

Reference values

See: blood test and urine test.