Abstract
Most of the experience in evidence-based medicine has been derived from clinical medicine that seems more easily suited to the rigors of the higher tiers of quality. In pathology, it is difficult to apply many of the stringent requirements necessary to generate high quality. One manner to obtain best evidence regarding the diagnostic test would include two randomized groups of patients of similar characteristics selected but distinguished by, for example, how the carcinoma is characterized (by morphology alone or by the use of the IHC tests). The pathologist could be assigned to one study group only and blinded to the other group as well as outcome. The outcome would be the frequency of pulmonary hemorrhage in the two groups. Such a study is difficult to envision as a viable manner of determining which diagnostic criteria are best in predicting the outcome for both obvious, serious ethical as well as logistical reasons. Nevertheless, there are effective strategies to improve the quality of evidence in pathology, which have been illustrated in this chapter, building on the cornerstones of observation and clinical correlation which have heretofore defined much of what we know as pathologists about disease and diagnosis.
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Saunders, P.J., Otis, C.N. (2011). What Is Best Evidence in Pathology?. In: Marchevsky, A., Wick, M. (eds) Evidence Based Pathology and Laboratory Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-1030-1_3
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DOI: https://doi.org/10.1007/978-1-4419-1030-1_3
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