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Evidence Levels for Publications in Pathology and Laboratory Medicine

Alberto M. Marchevsky MD, Mark R. Wick MD
DOI: http://dx.doi.org/10.1309/AJCPC2Q7YSWKCTGS 366-367 First published online: 1 March 2010
Key Words:
  • Evidence-based practice
  • Evidence-based medicine
  • Evidence-based pathology
  • Levels of evidence
  • Quality of care
  • Error reduction

The standardization of various medical procedures, an evaluation of “quality” care, and the development of formal approaches to error prevention are becoming increasingly important processes in modern medicine.1 Procedural and interpretative algorithms, evidence-based practice protocols, and other guidelines have been published by various medical societies, and others are sure to follow.2 Compliance with their use is usually regarded as a “yardstick” for quality evaluation by health care administrators, and such information is used by payers and licensing agencies; it is even electronically published on the Internet.3 Accordingly, most medical specialties currently sponsor the development of “evidence-based” practice guidelines that are developed by using various concepts that fall under the rubric of “evidence-based medicine” (EBM).4 As a group, however, pathologists have been slow to adopt a similar approach, which can be termed evidence-based pathology.5,6

Literally hundreds of evidence-based medical protocols are already readily available through the National Guideline Clearinghouse, the Institute of Medicine, the American Cancer Society, the Cochrane Collaboration, and other Web sites.2,79 These documents are based on data in medical publications, which are generally referenced as …

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