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Focusing on practical, patient related issues, this volume provides the basic concepts of Evidence Based Medicine (EBM) as they relate to Pathology and Laboratory Medicine and presents various practical applications. It includes EBM concepts for use in the identification of cost-effective panels of immunostains and other laboratory tests and for improvement of diagnostic accuracy based on the identification of selected diagnostic features for particular differential diagnosis. EBM concepts are also put forth for use in Meta-analysis to integrate the results of conflicting literature reports and use of novel analytical tools such as Bayesian belief networks, neural networks, multivariate statistics and decision tree analysis for the development of new diagnostic and prognostic models for the evaluation of patients. This volume will be of great value to pathologists who will benefit from the concepts being promoted by EBM, such as levels of evidence, use of Bayesian statistics to develop diagnostic and other rules and stronger reliance on "hard data" to support therapeutic and diagnostic modalities.

Evidence Based Pathology and Laboratory Medicine

Table of Contents

Preface

Contributors

I. The Problem and Available Resources

1. Introduction to Evidence-Based Pathology and Laboratory Medicine

Alberto M. Marchevsky and Mark Wick

. Evidence-Based Pathology: A Stable Set of Principles for a Rapidly Evolving Specialty

José Costa and Sarah Whitaker

3. What Is Best Evidence in Pathology?

Peter J. Saunders and Christopher N. Otis

4. Biostatistics 101

Robin T. Vollmer

5. Prognostication and Prediction in Anatomic Pathology: Carcinoma of the Breast as an Illustrative Model

Mark R. Wick and Alberto M. Marchevsky

6. Principles of Classification and Diagnosis in Anatomic Pathology and the Inevitability of Problem Cases

Michael Hendrickson

7. Evaluating Oncopathological Studies: The Need to Evaluate the Internal and External Validity of Study Results

Michael Hendrickson and Bonnie Balzer

8. Power Analysis and Sample Sizes in Pathology Research

Robin T. Vollmer

9. Meta-Analysis: A Statistical Method to Integrate Information Provided by Different Studies

Eleftherios C. Vamvakas

10. Decision Analysis and Decision Support Systems in Anatomic Pathology

Michael Hendrickson and Bonnie Balzer

II. Solutions Offered by Evidence-Based Pathology and Laboratory Medicine11. Evidence-Based Approach to Evaluate Information Published in the Pathology Literature and Integrate It with Personal Experience

Alberto M. Marchevsky and Mark Wick

12. Evidence-Based Cell Pathology Re-visited: A Personal View

Kenneth Fleming

13. Development of Evidence-Based Diagnostic Criteria and Prognostic/Predictive Models: Experience at Cedars Sinai Medical Center

Alberto M. Marchevsky and Ruta Gupta

14. Evaluation and Reduction of Diagnostic Errors in Pathology Using an Evidence-Based Approach

Raouf E. Nakhleh

15. Metaanalysis 101 for Pathologists

Ruta Gupta and Alberto M. Marchevsky

16. Evidence-Based Practices in Applied Immunohistochemistry: Dilemmas Caused by Cross-Purposes

Mark R. Wick, Paul E. Swanson, and Alberto M. Marchevsky

17. Evidence-Based Pathology and Laboratory Medicine in the Molecular Pathology Era: Transition of Tests from the Research Bench into Practice

Jia-Perng Jennifer Wei and Wayne W. Grody

18. The Use of Decision Analysis Tools for the Selection of Clinical Laboratory Tests: Developing Diagnostic and Forecasting Models Using Laboratory Evidence

Ji Yeon Kim, Elizabeth M. Van Cott, and Kent B. Lewandrowski

19. Implementation and Benefits of Computerized Physician Order Entry and Evidence-Based Clinical Decision Support Systems

Stacy E. F. Melanson, Aileen P. Morrison, David W. Bates, and Milenko J. Tanasijevic

20. Evidence-Based Pathology and Tort Law: How Do They Compare?

Mark R. Wick and Elliott Foucar

Index

Stacy E. F. Melanson, Aileen P. Morrison, David W. Bates, and Milenko J. Tanasijevic

20. Evidence-Based Pathology and Tort Law: How Do They Compare?

Mark R. Wick and Elliott Foucar

Index

Mark R. Wick and Elliott Foucar

Index

19. Implementation and Benefits of Computerized Physician Order Entry and Evidence-Based Clinical Decision Support Systems

Stacy E. F. Melanson, Aileen P. Morrison, David W. Bates, and Milenko J. Tanasijevic

20. Evidence-Based Pathology and Tort Law: How Do They Compare?

Mark R. Wick and Elliott Foucar

Index

19. Implementation and Benefits of Computerized Physician Order Entry and Evidence-Based Clinical Decision Support Systems

Stacy E. F. Melanson, Aileen P. Morrison, David W. Bates, and Milenko J. Tanasijevic

20. Evidence-Based Pathology and Tort Law: How Do They Compare?

Mark R. Wick and Elliott Foucar

Index

19. Implementation and Benefits of Computerized Physician Order Entry and Evidence-Based Clinical Decision Support Systems

Stacy E. F. Melanson, Aileen P. Morrison, David W. Bates, and Milenko J. Tanasijevic

20. Evidence-Based Pathology and Tort Law: How Do They Compare?

Mark R. Wick and Elliott Foucar

Index

19. Implementation and Benefits of Computerized Physician Order Entry and Evidence-Based Clinical Decision Support Systems

Stacy E. F. Melanson, Aileen P. Morrison, David W. Bates, and Milenko J. Tanasijevic

20. Evidence-Based Pathology and Tort Law: How Do They Compare?

Mark R. Wick and Elliott Foucar

Index

19. Implementation and Benefits of Computerized Physician Order Entry and Evidence-Based Clinical Decision Support Systems

Stacy E. F. Melanson, Aileen P. Morrison, David W. Bates, and Milenko J. Tanasijevic

20. Evidence-Based Pathology and Tort Law: How Do They Compare?

Mark R. Wick and Elliott Foucar

Index

José Costa and Sarah Whitaker

3. What Is Best Evidence in Pathology?

Peter J. Saunders and Christopher N. Otis

4. Biostatistics 101

Robin T. Vollmer

5. Prognostication and Prediction in Anatomic Pathology: Carcinoma of the Breast as an Illustrative Model

Mark R. Wick and Alberto M. Marchevsky

6. Principles of Classification and Diagnosis in Anatomic Pathology and the Inevitability of Problem Cases

Michael Hendrickson

7. Evaluating Oncopathological Studies: The Need to Evaluate the Internal and External Validity of Study Results

Michael Hendrickson and Bonnie Balzer

8. Power Analysis and Sample Sizes in Pathology Research

Robin T. Vollmer

9. Meta-Analysis: A Statistical Method to Integrate Information Provided by Different Studies

Eleftherios C. Vamvakas

10. Decision Analysis and Decision Support Systems in Anatomic Pathology

Michael Hendrickson and Bonnie Balzer

II. Solutions Offered by Evidence-Based Pathology and Laboratory Medicine11. Evidence-Based Approach to Evaluate Information Published in the Pathology Literature and Integrate It with Personal Experience

Alberto M. Marchevsky and Mark Wick

12. Evidence-Based Cell Pathology Re-visited: A Personal View

Kenneth Fleming

13. Development of Evidence-Based Diagnostic Criteria and Prognostic/Predictive Models: Experience at Cedars Sinai Medical Center

Alberto M. Marchevsky and Ruta Gupta

14. Evaluation and Reduction of Diagnostic Errors in Pathology Using an Evidence-Based Approach

Raouf E. Nakhleh

15. Metaanalysis 101 for Pathologists

Ruta Gupta and Alberto M. Marchevsky

16. Evidence-Based Practices in Applied Immunohistochemistry: Dilemmas Caused by Cross-Purposes

Mark R. Wick, Paul E. Swanson, and Alberto M. Marchevsky

17. Evidence-Based Pathology and Laboratory Medicine in the Molecular Pathology Era: Transition of Tests from the Research Bench into Practice

Jia-Perng Jennifer Wei and Wayne W. Grody

18. The Use of Decision Analysis Tools for the Selection of Clinical Laboratory Tests: Developing Diagnostic and Forecasting Models Using Laboratory Evidence

Ji Yeon Kim, Elizabeth M. Van Cott, and Kent B. Lewandrowski

19. Implementation and Benefits of Computerized Physician Order Entry and Evidence-Based Clinical Decision Support Systems

Stacy E. F. Melanson, Aileen P. Morrison, David W. Bates, and Milenko J. Tanasijevic

20. Evidence-Based Pathology and Tort Law: How Do They Compare?

Mark R. Wick and Elliott Foucar

Index

Stacy E. F. Melanson, Aileen P. Morrison, David W. Bates, and Milenko J. Tanasijevic

20. Evidence-Based Pathology and Tort Law: How Do They Compare?

Mark R. Wick and Elliott Foucar

Index

Mark R. Wick and Elliott Foucar

Index

19. Implementation and Benefits of Computerized Physician Order Entry and Evidence-Based Clinical Decision Support Systems

Stacy E. F. Melanson, Aileen P. Morrison, David W. Bates, and Milenko J. Tanasijevic

20. Evidence-Based Pathology and Tort Law: How Do They Compare?

Mark R. Wick and Elliott Foucar

Index

19. Implementation and Benefits of Computerized Physician Order Entry and Evidence-Based Clinical Decision Support Systems

Stacy E. F. Melanson, Aileen P. Morrison, David W. Bates, and Milenko J. Tanasijevic

20. Evidence-Based Pathology and Tort Law: How Do They Compare?

Mark R. Wick and Elliott Foucar

Index

19. Implementation and Benefits of Computerized Physician Order Entry and Evidence-Based Clinical Decision Support Systems

Stacy E. F. Melanson, Aileen P. Morrison, David W. Bates, and Milenko J. Tanasijevic

20. Evidence-Based Pathology and Tort Law: How Do They Compare?

Mark R. Wick and Elliott Foucar

Index

19. Implementation and Benefits of Computerized Physician Order Entry and Evidence-Based Clinical Decision Support Systems

Stacy E. F. Melanson, Aileen P. Morrison, David W. Bates, and Milenko J. Tanasijevic

20. Evidence-Based Pathology and Tort Law: How Do They Compare?

Mark R. Wick and Elliott Foucar

Index

Peter J. Saunders and Christopher N. Otis

4. Biostatistics 101

Robin T. Vollmer

5. Prognostication and Prediction in Anatomic Pathology: Carcinoma of the Breast as an Illustrative Model

Mark R. Wick and Alberto M. Marchevsky

6. Principles of Classification and Diagnosis in Anatomic Pathology and the Inevitability of Problem Cases

Michael Hendrickson

7. Evaluating Oncopathological Studies: The Need to Evaluate the Internal and External Validity of Study Results

Michael Hendrickson and Bonnie Balzer

8. Power Analysis and Sample Sizes in Pathology Research

Robin T. Vollmer

9. Meta-Analysis: A Statistical Method to Integrate Information Provided by Different Studies

Eleftherios C. Vamvakas

10. Decision Analysis and Decision Support Systems in Anatomic Pathology

Michael Hendrickson and Bonnie Balzer

II. Solutions Offered by Evidence-Based Pathology and Laboratory Medicine11. Evidence-Based Approach to Evaluate Information Published in the Pathology Literature and Integrate It with Personal Experience

Alberto M. Marchevsky and Mark Wick

12. Evidence-Based Cell Pathology Re-visited: A Personal View

Kenneth Fleming

13. Development of Evidence-Based Diagnostic Criteria and Prognostic/Predictive Models: Experience at Cedars Sinai Medical Center

Alberto M. Marchevsky and Ruta Gupta

14. Evaluation and Reduction of Diagnostic Errors in Pathology Using an Evidence-Based Approach

Raouf E. Nakhleh

15. Metaanalysis 101 for Pathologists

Ruta Gupta and Alberto M. Marchevsky

16. Evidence-Based Practices in Applied Immunohistochemistry: Dilemmas Caused by Cross-Purposes

Mark R. Wick, Paul E. Swanson, and Alberto M. Marchevsky

17. Evidence-Based Pathology and Laboratory Medicine in the Molecular Pathology Era: Transition of Tests from the Research Bench into Practice

Jia-Perng Jennifer Wei and Wayne W. Grody

18. The Use of Decision Analysis Tools for the Selection of Clinical Laboratory Tests: Developing Diagnostic and Forecasting Models Using Laboratory Evidence

Ji Yeon Kim, Elizabeth M. Van Cott, and Kent B. Lewandrowski

19. Implementation and Benefits of Computerized Physician Order Entry and Evidence-Based Clinical Decision Support Systems

Stacy E. F. Melanson, Aileen P. Morrison, David W. Bates, and Milenko J. Tanasijevic

20. Evidence-Based Pathology and Tort Law: How Do They Compare?

Mark R. Wick and Elliott Foucar

Index

Stacy E. F. Melanson, Aileen P. Morrison, David W. Bates, and Milenko J. Tanasijevic

20. Evidence-Based Pathology and Tort Law: How Do They Compare?

Mark R. Wick and Elliott Foucar

Index

Mark R. Wick and Elliott Foucar

Index

19. Implementation and Benefits of Computerized Physician Order Entry and Evidence-Based Clinical Decision Support Systems

Stacy E. F. Melanson, Aileen P. Morrison, David W. Bates, and Milenko J. Tanasijevic

20. Evidence-Based Pathology and Tort Law: How Do They Compare?

Mark R. Wick and Elliott Foucar

Index

19. Implementation and Benefits of Computerized Physician Order Entry and Evidence-Based Clinical Decision Support Systems

Stacy E. F. Melanson, Aileen P. Morrison, David W. Bates, and Milenko J. Tanasijevic

20. Evidence-Based Pathology and Tort Law: How Do They Compare?

Mark R. Wick and Elliott Foucar

Index

19. Implementation and Benefits of Computerized Physician Order Entry and Evidence-Based Clinical Decision Support Systems

Stacy E. F. Melanson, Aileen P. Morrison, David W. Bates, and Milenko J. Tanasijevic

20. Evidence-Based Pathology and Tort Law: How Do They Compare?

Mark R. Wick and Elliott Foucar

Index

Mark R. Wick and Alberto M. Marchevsky

6. Principles of Classification and Diagnosis in Anatomic Pathology and the Inevitability of Problem Cases

Michael Hendrickson

7. Evaluating Oncopathological Studies: The Need to Evaluate the Internal and External Validity of Study Results

Michael Hendrickson and Bonnie Balzer

8. Power Analysis and Sample Sizes in Pathology Research

Robin T. Vollmer

9. Meta-Analysis: A Statistical Method to Integrate Information Provided by Different Studies

Eleftherios C. Vamvakas

10. Decision Analysis and Decision Support Systems in Anatomic Pathology

Michael Hendrickson and Bonnie Balzer

II. Solutions Offered by Evidence-Based Pathology and Laboratory Medicine11. Evidence-Based Approach to Evaluate Information Published in the Pathology Literature and Integrate It with Personal Experience

Alberto M. Marchevsky and Mark Wick

12. Evidence-Based Cell Pathology Re-visited: A Personal View

Kenneth Fleming

13. Development of Evidence-Based Diagnostic Criteria and Prognostic/Predictive Models: Experience at Cedars Sinai Medical Center

Alberto M. Marchevsky and Ruta Gupta

14. Evaluation and Reduction of Diagnostic Errors in Pathology Using an Evidence-Based Approach

Raouf E. Nakhleh

15. Metaanalysis 101 for Pathologists

Ruta Gupta and Alberto M. Marchevsky

16. Evidence-Based Practices in Applied Immunohistochemistry: Dilemmas Caused by Cross-Purposes

Mark R. Wick, Paul E. Swanson, and Alberto M. Marchevsky

17. Evidence-Based Pathology and Laboratory Medicine in the Molecular Pathology Era: Transition of Tests from the Research Bench into Practice

Jia-Perng Jennifer Wei and Wayne W. Grody

18. The Use of Decision Analysis Tools for the Selection of Clinical Laboratory Tests: Developing Diagnostic and Forecasting Models Using Laboratory Evidence

Ji Yeon Kim, Elizabeth M. Van Cott, and Kent B. Lewandrowski

19. Implementation and Benefits of Computerized Physician Order Entry and Evidence-Based Clinical Decision Support Systems

Stacy E. F. Melanson, Aileen P. Morrison, David W. Bates, and Milenko J. Tanasijevic

20. Evidence-Based Pathology and Tort Law: How Do They Compare?

Mark R. Wick and Elliott Foucar

Index

Stacy E. F. Melanson, Aileen P. Morrison, David W. Bates, and Milenko J. Tanasijevic

20. Evidence-Based Pathology and Tort Law: How Do They Compare?

Mark R. Wick and Elliott Foucar

Index

Mark R. Wick and Elliott Foucar

Index

19. Implementation and Benefits of Computerized Physician Order Entry and Evidence-Based Clinical Decision Support Systems

Stacy E. F. Melanson, Aileen P. Morrison, David W. Bates, and Milenko J. Tanasijevic

20. Evidence-Based Pathology and Tort Law: How Do They Compare?

Mark R. Wick and Elliott Foucar

Index

19. Implementation and Benefits of Computerized Physician Order Entry and Evidence-Based Clinical Decision Support Systems

Stacy E. F. Melanson, Aileen P. Morrison, David W. Bates, and Milenko J. Tanasijevic

20. Evidence-Based Pathology and Tort Law: How Do They Compare?

Mark R. Wick and Elliott Foucar

Index

13. Development of Evidence-Based Diagnostic Criteria and Prognostic/Predictive Models: Experience at Cedars Sinai Medical Center

Alberto M. Marchevsky and Ruta Gupta

14. Evaluation and Reduction of Diagnostic Errors in Pathology Using an Evidence-Based Approach

Raouf E. Nakhleh

15. Metaanalysis 101 for Pathologists

Ruta Gupta and Alberto M. Marchevsky

16. Evidence-Based Practices in Applied Immunohistochemistry: Dilemmas Caused by Cross-Purposes

Mark R. Wick, Paul E. Swanson, and Alberto M. Marchevsky

17. Evidence-Based Pathology and Laboratory Medicine in the Molecular Pathology Era: Transition of Tests from the Research Bench into Practice

Jia-Perng Jennifer Wei and Wayne W. Grody

18. The Use of Decision Analysis Tools for the Selection of Clinical Laboratory Tests: Developing Diagnostic and Forecasting Models Using Laboratory Evidence

Ji Yeon Kim, Elizabeth M. Van Cott, and Kent B. Lewandrowski

19. Implementation and Benefits of Computerized Physician Order Entry and Evidence-Based Clinical Decision Support Systems

Stacy E. F. Melanson, Aileen P. Morrison, David W. Bates, and Milenko J. Tanasijevic

20. Evidence-Based Pathology and Tort Law: How Do They Compare?

Mark R. Wick and Elliott Foucar

Index

Stacy E. F. Melanson, Aileen P. Morrison, David W. Bates, and Milenko J. Tanasijevic

20. Evidence-Based Pathology and Tort Law: How Do They Compare?

Mark R. Wick and Elliott Foucar

Index

Mark R. Wick and Elliott Foucar

Index

19. Implementation and Benefits of Computerized Physician Order Entry and Evidence-Based Clinical Decision Support Systems

Stacy E. F. Melanson, Aileen P. Morrison, David W. Bates, and Milenko J. Tanasijevic

20. Evidence-Based Pathology and Tort Law: How Do They Compare?

Mark R. Wick and Elliott Foucar

Index

Mark R. Wick, Paul E. Swanson, and Alberto M. Marchevsky

17. Evidence-Based Pathology and Laboratory Medicine in the Molecular Pathology Era: Transition of Tests from the Research Bench into Practice

Jia-Perng Jennifer Wei and Wayne W. Grody

18. The Use of Decision Analysis Tools for the Selection of Clinical Laboratory Tests: Developing Diagnostic and Forecasting Models Using Laboratory Evidence

Ji Yeon Kim, Elizabeth M. Van Cott, and Kent B. Lewandrowski

19. Implementation and Benefits of Computerized Physician Order Entry and Evidence-Based Clinical Decision Support Systems

Stacy E. F. Melanson, Aileen P. Morrison, David W. Bates, and Milenko J. Tanasijevic

20. Evidence-Based Pathology and Tort Law: How Do They Compare?

Mark R. Wick and Elliott Foucar

Index

Stacy E. F. Melanson, Aileen P. Morrison, David W. Bates, and Milenko J. Tanasijevic

20. Evidence-Based Pathology and Tort Law: How Do They Compare?

Mark R. Wick and Elliott Foucar

Index

Mark R. Wick and Elliott Foucar

Index

19. Implementation and Benefits of Computerized Physician Order Entry and Evidence-Based Clinical Decision Support Systems

Stacy E. F. Melanson, Aileen P. Morrison, David W. Bates, and Milenko J. Tanasijevic

20. Evidence-Based Pathology and Tort Law: How Do They Compare?

Mark R. Wick and Elliott Foucar

Index

Stacy E. F. Melanson, Aileen P. Morrison, David W. Bates, and Milenko J. Tanasijevic

20. Evidence-Based Pathology and Tort Law: How Do They Compare?

Mark R. Wick and Elliott Foucar

Index

Mark R. Wick and Elliott Foucar

Index