Evidence in Action: Applying Evidence-Based Methods to Laboratory Medicine Decision-Making

Robert H. Christenson, PhD, DABCC, FACB

Susan R. Snyder, PhD, MBA

March 2010


The Laboratory Medicine Best Practices (LMBP) Initiative was launched by the U.S. Centers for Disease Control and Prevention in 2006 to develop and pilot evidence-based methods to evaluate the effectiveness of laboratory medicine quality improvement practices. Challenges to applying evidence-based methods to laboratory medicine include the limited quality and quantity of studies available in peer-reviewed publications plus the variability of laboratory practice. New LMBP systematic review methods incorporate the evaluation of unpublished quality improvement studies conducted in many laboratory settings.

This presentation explains how an evidence-based approach can improve decision making in laboratory medicine, the purpose and objectives of the LMBP Initiative, new LMBP methods for quality improvement evidence reviews, and how data from quality improvement projects can be used as evidence of practice effectiveness.




Robert H. Christenson
Dr. Christenson is Professor of Pathology and Professor of Medical and Research Technology at the University of Maryland School of Medicine in Baltimore, Maryland. Clinically, Dr. Christenson is Director of the Clinical Chemistry, Toxicology, and Core Laboratories at the University of Maryland Medical Center, where he is also Director of Point of Care Services. Dr. Christenson is certified as a Diplomate of the American Board of Clinical Chemistry and is a Fellow of the National Academy of Clinical Biochemists. He has an active research program in the area of cardiac biomarkers. Dr. Christenson directs the Clinical Chemistry Research Laboratory (CCRL) at University of Maryland which is a CLIA licensed and CAP accredited facility that conducts clinical and biomarker trials. He holds three patents and has published 185 peer-reviewed manuscripts, over 220 abstracts, four books, and 45 book chapters and monographs. He is director of a fellowship program in clinical chemistry and is active in teaching residents and fellows from numerous specialties including pathology, internal Medicine, cardiology and emergency medicine. Dr. Christenson is involved in several professional organizations, including the American Association for Clinical Chemistry (AACC) and International Federation for Clinical Chemistry and Laboratory Medicine (IFCC). He has a particular interest in evidence based medicine (EBM), serving as vice chair of AACC’s EBM Committee and chair of the IFCC’s Committee on EBLM. Dr. Christenson has long been involved in guideline development: he chaired the National Academy of Clinical Biochemistry’s (NACB) Laboratory Medicine Practice Guidelines for Cardiac Biomarkers of Acute Coronary Syndromes and Heart Failure. He is vice chair of the NACB’s practice guidelines for utilization of emerging markers of long-term risk assessment for coronary artery disease. Dr. Christenson is currently a member of a IFCC Collaborative Working Group for Development of a Candidate Reference Immunoassay Measurement Procedure for Cardiac Troponin I (cTnI).


Susan R. Snyder
Susan R. Snyder is a Senior Health Economist with the U.S. Centers for Disease Control and Prevention (CDC), and is currently the Evidence-Based Performance Evaluation Team Leader in the Laboratory Practice Evaluation and Genomics Branch, Office of Surveillance, Epidemiology, & Laboratory Services. Her work primarily involves managing and contributing to multiple projects developing and applying evaluation methods related to research and evidence including systematic reviews, performance measures, impact analyses and economic evaluations focused on improving health care quality and public health. She leads multiple laboratory medicine quality initiatives dedicated to improving health outcomes including CDC’s Laboratory Medicine Best Practices. Her previous CDC experience included contributing to the Guide to Community Preventive Services, including economic evaluations, methods, and evidence reviews and analyses in diabetes, violence prevention, and vaccination. Prior to joining CDC, her previous work experience included health services research focusing on financing and reimbursement for the Health Policy Center at Georgia State University, and private sector employment in medical economics, managed care, employee benefits consulting, and corporate finance for large national U.S. firms. Her degrees include a PhD in Economics from Georgia State University with specialties in health care and labor economics, an MBA in finance from the University of California Berkeley, and a BS in Economics from the Wharton School of the University of Pennsylvania.

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