Clinical pathology

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Learning to properly stain a blood smear is an important tool for the clinical pathologist.

Clinical pathology (US, UK, Ireland, Commonwealth, Portugal, Brazil, Italy), laboratory medicine (Germany, Romania, Poland, Eastern Europe), clinical analysis (Spain), or clinical/medical biology (France, Belgium, Netherlands, Austria, North and West Africa)[1] is a medical specialty concerned with the diagnosis of disease based on the laboratory analysis of bodily fluids, such as blood, urine, and tissues using the tools of chemistry, microbiology, hematology, and molecular pathology.[2] Clinical pathologists work in close collaboration with clinical scientists (clinical biochemists, clinical microbiologists, etc.), medical technologists, hospital administrators, and referring physicians to ensure the accuracy and optimal utilization of laboratory testing. This specialty requires a medical residency and should not be confused with biomedical science, which is not necessarily related to medicine.

Clinical pathology is one of two major divisions of pathology, the other being anatomic pathology.[2] Often, pathologists practice both anatomical and clinical pathology, a combination sometimes known as general pathology.[3] The distinction between clinical and anatomic pathology is increasingly blurred by the introduction of technologies that require new expertise and the need to provide patients and referring physicians with integrated diagnostic reports.[4][5]

Similar specialties exist in veterinary pathology.

Sub-specialties

The pathology sub-specialties and other medical studies used within clinical pathology include[6][7]:

  • Chemical pathology or clinical chemistry - an area of clinical pathology that is generally concerned with analysis of bodily fluids.
  • Hematopathology - a branch of pathology which studies diseases of hematopoietic cells, which originate from the bone marrow and contribute to the cellular components of blood.
  • Transfusion medicine - a branch of medicine that is concerned with the transmission of blood and blood components to a recipient.
  • Clinical microbiology - a branch of medicine concerned with the prevention, diagnosis and treatment of infectious diseases.
  • Molecular pathology - a branch of pathology which is focused in the study and diagnosis of disease through the examination of molecules within organs, tissues, or bodily fluids.
  • Immunopathology - a branch of pathology that deals with the study of the pathology of an organism, organ system, or disease with respect to the immune system, immunity, and immune responses.
  • Cytogenetics - a branch of genetics that is concerned with the study of the structure and function of the cell, especially the chromosomes.

Differences between clinical pathology and anatomic pathology

Clinical pathology is the division that processes the test requests more familiar to the general public; such as blood cell counts, coagulation studies, urinalysis, blood glucose level determinations, and throat cultures. It typically encompasses chemistry, hematology, microbiology, immunology, urinalysis, and blood bank.[2]

Anatomic pathology relates to the processing of surgical and gynecological specimens. Its sub-specialties include surgical pathology (neuropathology, dermatopathology, etc.), cytopathology, and forensic pathology.[2]

The differences between the two may appear to be small, but the differentiation in laboratory workflow of these two medical specialties has led to the creation of different functionalities in the laboratory information systems (LISs) and pathology computer systems often utilized while practicing these specialties. Specimen collection, receipt, and tracking; work distribution; and report generation may vary — sometimes significantly — between the two types of labs, requiring targeted functionality in the utilized software.[8][9] Other differences include[10]:

  • Specific dictionary-driven tests are found in clinical pathology environments but not so much in anatomic pathology environments.
  • Ordered clinical pathology tests typically require less information than anatomic pathology tests.
  • A single clinical pathology order typically consists of one sample; anatomic pathology order may be comprised of several tissues from several organs.
  • Clinical pathology specimen collection is routinely simple, while anatomic pathology specimen collection may be a very procedural, multi-step processes.

See also

Notes

An element or two of this article is reused from the Wikipedia article.

References

  1. "Arrêté du 10 juin 2010 fixant la liste des diplômes de spécialités en biologie médicale en application de l’article L. 6213-1 (1o,a) du code de la santé publique". Journal Officiel de la République Française. Ministère de la Santé et des Sports, La République Française. 20 June 2010. http://www.legifrance.gouv.fr/jo_pdf.do?cidTexte=JORFTEXT000022363470. Retrieved 04 June 2013. 
  2. 2.0 2.1 2.2 2.3 Adelman, Howard C. (2009). Forensic Medicine. Infobase Publishing. pp. 3–4. ISBN 1438103816. http://books.google.com/books?id=x5FftcZOv1UC&pg=PA3. Retrieved 03 June 2013. 
  3. Ziegler, Ernst (1903). Warthin, Aldred Scott. ed. General Pathology. William Wood and Company. pp. 1–3. http://books.google.com/books?id=WK-aD7wNkQIC&pg=PA1. Retrieved 03 June 2013. 
  4. Friedberg, Richard. "Evolving Changes in Health Care and Implications for Pathology and Laboratory Practice". 2013 Summer Anatomic Pathology Conference. Florida Society of Pathologists; Cvent. http://www.cvent.com/events/fsp-2013-summer-anatomic-pathology-conference/agenda-dbfdefc1817a4b6dbf3c494ce107af23.aspx. Retrieved 03 June 2013. "The advent of molecular pathology and molecular imaging tools only serves to further blur the distinction between anatomic and clinical pathology..." 
  5. Paxton, Anne (February 2011). "All for one—unifying CP and AP data". College of American Pathologists. http://www.cap.org/apps/cap.portal?_nfpb=true&cntvwrPtlt_actionOverride=%2Fportlets%2FcontentViewer%2Fshow&cntvwrPtlt%7BactionForm.contentReference%7D=cap_today%2F0211%2F0211a_cp_ap.html. Retrieved 03 June 2013. "Traditionally, CP systems are based on discrete data elements while AP systems are based on blocks of text. But that distinction is starting to blur, because AP is moving to synoptic reporting, and that includes the creation of discrete data components as well as textual reporting." 
  6. Carton, James (2012). Oxford Handbook of Clinical Pathology. Oxford University Press. pp. 357. ISBN 10199591636. http://books.google.com/books?id=4dat9pT7U9QC. Retrieved 03 June 2013. 
  7. Carton, James; Daly, Richard; Ramani, Pramila (2007). Clinical Pathology. Oxford University Press. pp. 598. ISBN 0198569467. http://books.google.com/books?id=SZZCh73bY_8C. Retrieved 03 June 2013. 
  8. Henricks, Walter H. (09 October 2012). "LIS Basics: CP and AP LIS Design and Operations" (PDF). Pathology Informatics 2012. Walter H. Henricks, MD. http://www.pathinformatics.pitt.edu/sites/default/files/2012Powerpoints/01HenricksTues.pdf. Retrieved 03 June 2013. 
  9. Clifford, Lisa-Jean (August 2011). "The evolving LIS needs to be "everything" for today's laboratories". Medical Laboratory Observer. http://www.mlo-online.com/articles/201108/the-evolving-lis-needs-to-be-everything-for-todays-laboratories.php. Retrieved 03 June 2013. 
  10. Park, Seung Lyung; Pantanowitz, Liron; Sharma, Guarav; Parwani, Anil Vasdev (March 2012). "Anatomic Pathology Laboratory Information Systems: A Review". Advances in Anatomic Pathology 19 (2): 81–96. doi:10.1097/PAP.0b013e318248b787. http://ebookbrowse.com/anatomic-pathology-laboratory-information-systems-a-review-slpark-et-all-adv-anat-pathol-2012-pdf-d344405134. Retrieved 03 June 2013.