Biomedical laboratory testing remains highly assistive towards the detection as well as management of the disease. The three major areas where the role of biomedical laboratory testing can be seen are as follow: whole population screening, disease diagnosis and monitoring. The explanation of these three methods is as follow:
Screening is the test of group of individuals which takes place to separate the well people from the individuals who are suffering from the undiagnosed disease and are at high risk. Screening enables to detect the potential disease while utilizing simple tests which remains acceptable for staff as well as for the patients. Whole population screening enables towards testing the high sensitivity area for the purpose of eliminating the chances of missing the potential disease. Moreover, Morresi, et al. (2014) depicted that the cost of biomedical laboratory testing remains cheap as large numbers of population get tested from it and the benefits of this test enables to justify the costs as it enables to screen and identify potential cases.In support of this, Carleton, et al. (2016) depicted that screening is the starting process of the biomedical testing which enables to identify the risk towards the population while showing the path for future investigation. According to the views of Dallabetta, et al. (2014), the objective of the screening test is to detect the disease in its primary stage so that it can be cured in an effective manner. Identifying the disease at its presymptomatic state enables to make the disease less widespread and easierto treat and cure. For instance, stool occult blood screening or mammography testenables to detect the cancer. Shah, Osea, & Martinez (2014) depicted that for the purpose of effective screening, it is essential to give focus towards the selecting the testing methodologies.
Dubeau‐Laramée, et al. (2014) stated that an ideal screening test needs to share many characteristics for the purpose of ideal diagnostic test. For the ideal diagnostic test, it is necessary that sensitivity, specificity, and predictive values should be close to 100%.For the diagnosisof the test, it is essential that it should be positive in the patientata large proportion with the high sensitivity or negative in a large proportion without the disease in the context of high specificity. So, the purpose of diagnosis is to establish the presence or absence of a specific disease. In both the scenario, ideally, there should be sensitivity and specificity for the test should be 100%. According to the views of Vashist, et al. (2015), the target population of diagnostic test is those individuals who are symptomatic individuals who establish diagnosis or those individuals who are asymptomatic but shows positive in screening test. The test method for diagnostic may be invasive as well as expensive too. However, it remains justifiable as it is necessary for the individual to establish the diagnosis.In the context of diagnosis of the disease, more weight is given towards accuracy rather than to patient acceptability and the diagnostic test enables to provide a definite diagnosis. Moreover, it is identified that diagnosis associates higher costs with diagnostic test. According to the views of Northrop, et al. (2015), there are basically two diagnostic uses for laboratory tests in which the first test is used for ruling out the disease absolutely and the second one is used to get the confirmation.
Monitoring plays a crucial role in various diagnostic tests and supports to monitor and control the impact of changes in the context of diet and many other risk factors too. In the views of Price, et al. (2014), when the test is repeated to track the therapeutic drug level to observe the side effects, in that situation monitoring system is remained highly assistive. In this context, sensitivity, specificity, and predictive show less relevance as compared to reliability and accuracy for instance, monitoring the therapeutic drug levels.
In the context of monitoring a serum value indicates towards measuring it repeatedly and in this perspective, reliability remains a critical task. In supports of this, Drosten, et al. (2014) stated that if serum potassium drops suddenly from 4.2 to 3.5 mmol/ L, then it represents a true change in the amount of potassium value not just a technical error or a random variation. Due to this reason, highly reliable and accurate test is needed. Due to this reason, there should be adequate monitoring device which have high reliability and accuracy. Van Cott, et al. (2015) stated that local PHLs give focus towards prioritizing the testing on population-basis for the purpose ofthe utilization of disease-control efforts in an adequate manner for the whole population, for instance, tuberculosis. It eliminates the individual patient-oriented testing which is performed in clinical laboratories as it supports to diagnose and treat the acute illnessesfor proper monitoring.
There are different pathology disciplinesand different disciplines need to carry out different tests. In this paper, microbiology and immunology disciplines are discussed while elaborating the main tests which need to be carried out for the purpose of investigation and the reason behind the test.
Microbiology is a pathology discipline, which supports towards investigatingthe infectious diseases. Under thisdiscipline, pathologists and scientists work towards searching the specific bacteria, viruses, fungi and parasites which are causing thediseases and showing the symptoms in the patients (Richard, et al., 2016). Under this discipline, the study takes place over microscopic organisms while including fundamental research on the basis of biochemistry, physiology, cell biology, ecology, evolution and clinical aspects of microorganisms. It includes the host response towards these agents. Under this, biomedical lab also measures the susceptibility of the bacteria towards the antibiotics for the purpose of helping the patientsto treat the disease.
In this pathology discipline, the test takes place for the purpose receiving the clinical specimen testing. So, it includes swabs, urine, blood, feces, sputum, synovial fluid, cerebrospinal fluid, etc. for the purpose of investigating on the infected tissue (Plebani, & Panteghini, 2014). In this discipline, test majorly takes place over the cultures to identify the suspected pathogens which, if found, then further identification takes place on the basis of biochemical tests. Moreover, this discipline carried out sensitivity testing to determine the sensitivity or resistance of the pathogen which enables to prescribe the adequate medicine to the patient. The major test takes place under this discipline is urine test which supports to take the urine sample for the purpose of the detection of urinary tract infection. So, the test utilized under this discipline supports towardsculturing the particular bacteria in an incubator that become able to imitate the perfect environment for the microorganism (Van Cott, et al., 2015). After that the examining of the results under the microscope takes place to identify the microscopic organisms.
Immunity system plays vital role in our body and supports us to fight from the diseases. Immunity system is the central of the body’s ability and enables us to fight with the infection by producing the antibodies – proteins which are produced in response to fight with the foreign organism. In support of this, Imperiale, et al. (2014) stated that antibodies are essential in our body as its deficiency decreases the ability the power of defense of our body however; in the contrary, high levels of antibodies indicate towards auto immune disease. Balance in immunity system is necessary as it enables towards creating the balance in a body by creating the capacity of fighting from different diseases.
Immunology pathology discipline gives focus towards identifying the specialized disorders of the immune system which includes autoimmune disorders such as rheumatoid arthritis, Crohn’s disease and coeliac disease as well as also performs the tests to identify immune deficiency too. Zhu, et al. (2015) depicted that inadequate immune system can be taken place due to inherited symptom, due to the result of an infection, disease, or due toa side effect of drugs, etc. So it creates the need of treating this deficiency or the disease which is showing the symptom of inadequate immunity symptom.
According to the views of Pivovarov, et al. (2014), immune function tests supports to determine that whether the patient is allergic, and if so then to what. It is identified that there are many diseases which take place due to inadequate immune system. Due to inappropriately targeting of the immunity system, it impacts the normal organs systems, due to which auto-immune diseases take place. Due to this reason, various immunological tests is recommended for diagnose the disorders. These tests support to test the lupus, rheumatoid arthritis, diabetes and thyroid conditions. Moreover, immunological tests also support to monitor the tissue injury which has taken place due to inflammation. The major test takes place under this discipline is SLE (Systemic lupus erythematosus) test. For this purpose, blood and urine tests take place. These tests support to test the complete blood count, kidney and lever assessment, urinalysis, kidney and lever assessment, etc. (Morresi, et al., 2014). These tests support to evaluate the presence of immune system in the body.
However for the purpose of imaging test, chest x-ray and echocardiogram remains helpful. These tests support towards diagnose the immunity system and the diseases related to it. Shah, Osea, & Martinez (2014) identified that diagnosing of lupus is a difficult task as the signs and symptoms hugely vary from one person to person. The signs and symptoms of lupus differ time to time. Moreover, it also differs due to overlap of many other disorders. This is the major reason behind, nota single test can diagnose lupus. So, the combination of blood and urine test is used to identify the signs and symptoms while correlating it with the physical examination findings to diagnose the lupus.
It is identified that there are many other ways to investigate the patient accept biomedical testing. There are many other types of investigations too which is utilized by the doctor. In this context, Vashist, et al. (2015) depicted that ECG, ultra sound, MRI, CT Scan, etc. are the types of non-biomedical investigation.
In support of this, Carleton, et al. (2016) depicted that Electrocardiography (ECG) is used by the doctors for the purpose of recording the electrical activity which is generated by the heart muscle de-polarizations. In this investigation method, propagation of pulsating electrical waves takes place towards the skin. ECG electrodes are wet sensors which require the conductive gel which enable towards maximizing the conductivity between the skin as well as electrodes. ECG supports to read the heart rhythm when it is regular or in the situation when it is irregular to estimate the rate.
At the same time, ultra sound scanning test or sonography supports towards using the high-frequency sound waves which enable towards capturing the live images inside the body of living being. The technology which is used in this investigation is similar to the technology which is used by sonar and radar to help the military for the detection of the planes or ships. Sonography is a painless test which is usedby utilizing the sound waves rather than radiation. It is one of the safest tests (Shah, Osea, & Martinez, 2014). In this test, doppler and duplex scans are used for the purpose of visualising the blood or fluids flowing inside the body.
MRI (Magnetic Resonance Imaging) scanner is a large tube which contains powerful magnets. In this technique, patient needs to lie inside the tube at the time of scanning (Frisch, et al., 2014). MRI scanning is used by the pathologist to examine almost all the parts of the body, which includes brain, spinal cord, bones, blood vessels, joints, heart, breasts, and even internal organs, such as liver, prostate gland, womb, etc. MRI scan remains helpful to diagnose the conditions and enables towards plan treatments while assessing the effect of previous treatment. In like manner, Baker, et al. (2014) stated that MRI scanning is a painless and safe procedure and it does not give any harm to the patients. However, a patient can feel uncomfortable if he has claustrophobia, however in major cases patients find this investigation manageable due to radiographer.
CT scanning is the investigation method which combines a series of X-ray images and support to offer the images with different angles (Park, et al., 2016). In this method, computer processing is used to create cross-sectional images of the blood vessels, bones, soft tissues, etc. CT scan images remain highly assistive to offer detailed information as compare to plain X-rays. This investigation tool is particularly remain well-suited for quickly examine the internal injuries from accidents or any other types of trauma too which supports to diagnose the disease and injury and enables to plan for medical, surgical or radiation treatment as well.
According to the views of Northrop, et al. (2015), the diagnosis of the lever cancer at the first stage is a consultation with a GP. However to evaluate the risk, it is essential to test the patient at a regular basis. If a person finds a signs or symptoms of liver cancer then it is essential to consult the doctor and to go for investigation. For the purpose of the investigation of liver cancer, biomedical as well as non-biomedical investigation method is carried out. For the purpose of biomedical test, biopsy investigation remains helpful however, for non-biomedical investigation ultrasound remains assistive. These techniques remain highly supportive towards the diagnosis of this disease condition in an effective manner.
In the views of Park, et al. (2016), at present, new ultrasound technique is developed by the pathologists and scientists, which enables to diagnose and track the liver fibrosis as well as tumors. ARFI is an ultrasound technique and it does not produce ionizing radiation which is produced by X-rays or CT scan. Moreover, this new technique is relatively cheaper as compared to other imaging modalities. So, it enables to use the non-biomedical investigation in a more frequent manner to track the progress of fibrosis. It supports to provide the image of entire liver which is not possible in biopsy as it can only examine a small sample of the liver. However, in the contrary, Aziz, et al. (2014) depicted that the quality of an ultrasound image is mostly operator-dependent, as this test requires locating the liver in an image display by the operator to keep the detector at a right place. This investigation technique supports towards easily get a clear image of the liver and the fibrotic tissue in a quick manner.
At the same time, Plebani, & Panteghini (2014) depicted that diagnostic techniques such as MRI, Ultrasound, CT scan, etc. are very useful for the diagnosis of the disease conditions however in the case of lever cancer, doctor also prefers to take biomedical test to get the sample of the suspected cancer. In this context, Zhu, et al. (2015) identified that biopsy is one of the best biomedical investigation techniques as it supports towards removal of a sample. Biopsies only require a sample of blood or any other bodily product such as urine, saliva, etc.
There are basically two types of biopsies. One is tissue biopsies and other is liquid biopsies. Tissue biopsies include types of tissue, fine needle aspiration, core needle biopsy, etc. However, liquid biopsies include blood, saliva, sputum, breathe, urine, and stool test. Park, et al. (2016) depicted that in most types of cancer, biopsy remains the only way for the doctor to remain confirm about the cancer. The samples taken by biopsy are investigated under the microscope.
So, biomedical as well as non-biomedical investigation method needs to be used for the purpose of effective investigation of liver cancer. Both these methods have their different importance in their arena.
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