Wallach’s Interpretation of Diagnostic Tests 11th Edition

Book Preface

Laboratory tests cost-effectively improve quality of patient care by objectively determining the presence or absence and extent of the disease and aid in monitoring treatment effectiveness. Approximately 60%–70% of all clinical decisions on patient management is based on laboratory tests, and these tests are rapidly evolving with advances in technology and based on clinical needs. There are three major areas that will have a positive and long-lasting impact in laboratory medicine: (1) disruptive technologies and solutions for reducing costs and improving quality of care, (2) consumerism in health care, and (3) artificial intelligence (AI) in laboratory medicine.

DISRUPTIVE TECHNOLOGIES AND SOLUTIONS
FOR REDUCING COSTS AND IMPROVING
QUALITY OF CARE
Laboratory medicine plays a vital role in all health care decisions, and new technologies will continue to disrupt health care as long as these disruptive technologies drive significant cost reductions while improving quality of patient care. With government and commercial payers reducing reimbursement rates, the need for higher productivity and efficiency to lower laboratory costs will be enabled by disruptive technologies. Advanced laboratory diagnostic tests will see the most reduction in costs as a result of disruptive technologies. In the near future, health care will be tailored to your individual genome or your lifestyle. Physicians will use genomic data to determine what therapies you should receive based on genetic traits you have inherited from family, your daily habits, and where you live.

CONSUMERISM IN HEALTH CARE
As more of the health care costs are pushed to consumers, consumers are playing a decisive role regarding diagnostics tests and have become more actively engaged in ensuring they are getting the best value for their money. They are expecting price transparency and demanding better health care consumer experience. The success of health care providers will depend on their ability to meet consumers’ needs and expectations and providing educational tools and health care data to enable consumers to make their decisions

AI IN LABORATORY MEDICINE
Laboratory medicine is a data business, and deriving actionable insights from the data is key for preventing, predicting, diagnosing, and treating disease. In the next few years, AI will interpret important data both at individual patient level and patient cohorts, advise on the value of other diagnostic tests, and integrate information to guide physicians to enable early detection and individualized treatment plans. AI will enable clinicians to spend more time with patients, providing compassionate care while reducing time spent by health care providers integrating and interpreting vast data. AI is here to stay, and it will be transformational in health care.
In the eleventh edition of this text, authors include the latest advances in laboratory testing as well as incorporate ongoing feedback from readers and health care providers. Authors updated this gem of a text book in laboratory medicine and made it simple, effective, and efficient in both the print text and eBook formats to meet and exceed the dynamically changing needs in health care.

KARTHIK KUPPUSAMY, PHD
Vice President & General Manager, North Region Quest Diagnostics, Marlboro, Massachusetts

In the eleventh edition of Wallach’s Interpretation of Diagnostic Tests, the authors continue to modify the content and organization based on feedback from readers as well as to keep pace with a rapidly changing health care environment. The primary focus of this book is to stress the most accurate and efficient use of clinical lab testing. This edition is not an exhaustive catalog of all disease states but a more practical guide.
We modified the format by bringing the individual test section to the front of the book. In the first chapter, for convenience, we also include a tabular form of most frequently ordered tests. This table is also provided in a perforated tear-out version at the end of the book for clinical use. Also, we updated the genetic, molecular diagnostics, and neurology testing chapters with the most current, cutting-edge information.
We expanded the index, thus enabling the reader to locate more efficiently subjects of interest. Enhancements to the electronic version will now include hypertexting of tests mentioned in the disease section, referring back to the individual test section. This book does not cover, for the most part, references to pathophysiology, therapy, and treatment. Common pitfalls and limitations of testing are addressed.
As in previous editions, this book is geared to primary care physicians, subspecialists, physician assistants, nurse practitioners, and medical and nursing students. We would appreciate continued feedback and comments about changes we have implemented.

L. V. RAO, PHD
L. MICHAEL SNYDER, MD