064 - L’Appropriatezza e l’EBM

D. Giavarina Abstract Since both appropriateness and Evidence Based Medicine (EBM) depend on the efficacy, they are interconnected. It is more difficult to define Evidence Based Laboratory Medicine (EBLM) than to define EBM regarding the efficacy of care. A first step to define EBLM is the accuracy. A test accurate in detecting a disease, that can be effectively treated, is appropriate. The accuracy allows to measure efficiency, but efficacy requires further features (e.g. is it possible to assess if the result helps diagnostic and/or treatment decision? are there resources for this diagnostic procedure?...). There are several tools to determine the accuracy of a test while it is more difficult to measure the effects of a test in the outcome, because the outcome depends also by the treatment prescribed after the test. EBM is helpful in evaluating diagnostic procedures; e.g. in estimating the accuracy of a test, in establishing guidelines and in auditing performances. Laboratory audit is the review against the benchmark of current best practice i.e. the review of the use of a test. Eventually, EBM can play a role in the identifying the value of a diagnostic service for a better allocation of resources.