Alberto M. Marchevsky and Mark R. Wick (2014) Evidence-Based Pathology: Systematic Literature Reviews as the Basis for Guidelines and Best Practices. Archives of Pathology & Laboratory Medicine In-Press.

Early Online Release

Evidence-Based Pathology: Systematic Literature Reviews as the Basis for Guidelines and Best Practices

Alberto M. Marchevsky, MD; Mark R. Wick, MD

From the Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California (Dr Marchevsky);

and the Department of Pathology, University of Virginia Medical School, Charlottesville (Dr Wick).

Context.— Evidence-based medicine has been proposed as a new paradigm for the identification and evaluation of medical information. Best available evidence or data are identified and used as the basis for the diagnosis and treatment of individual patients. Evidence-based pathology has adapted basic evidence-based medicine concepts to the specific needs of pathology and laboratory medicine.

Objectives.— To briefly review the history and basic concepts of evidence-based medicine and evidence-based pathology, describe how to perform and interpret systematic reviews, and discuss how to integrate best evidence into guidelines.

Data Sources.— PubMed (National Library of Medicine, Washington, DC) and Web of Science (Thompson Reuters, New York, New York) were used.

Conclusions.— Evidence-based pathology provides methodology to evaluate the quality of information published in pathology journals and apply it to the diagnosis of tissue samples and other tests from individual patients. Information is gathered through the use of systematic reviews, using a method that is less biased and more comprehensive than ad hoc literature searches. Published data are classified into evidence levels to provide readers with a quick impression about the quality and probable clinical validity of available information. Best available evidence is combined with personal experience for the formulation of evidence-based, rather than opinion-based, guidelines that address specific practice needs.