In this Blog, the Network’s Lead for Laboratory Medicine, Dr Owen Driskell tells us all about pathology’s roles in clinical research.
What is pathology?
Pathology is the study of disease. In healthcare, pathology staff study disease by performing diagnostic tests on patient samples to help them get the right care for them. This means they work with the doctors, nurses and other healthcare professionals in hospitals and GP surgeries to diagnose, treat and prevent illness.
Pathology is made up of many different specialties focusing on different aspects of disease and requiring different expertise and training. The different specialties make up the different departments within an NHS pathology service. For example the largest four specialties are Clinical Biochemistry – the study of the biochemical basis of disease, Haematology – the study of disorders of the blood, Histopathology – the study of disease in human tissue and Microbiology – the study of infection.
What does pathology do?
Pathology departments are staffed by a number of different healthcare professionals such as Doctors, Clinical Scientists and Biomedical Scientists. They are highly trained to design, run and interpret a wide range of analytical procedures on patient samples. Getting information from human samples is extremely challenging. Some tests are the equivalent to detecting a grain of salt in a swimming pool. The scarcity of the things pathology tests can detect in patient samples is just one of the challenges the technology needs to overcome. Have you heard of polymerase chain reaction, mass spectrophotometry, confocal microscopy or flow cell cytometry? These extremely sophisticated technologies are behind the so called ‘simple’ blood tests you sometimes hear about in the news. Pathology staff are able to translate this science into the information required to inform healthcare decisions.
Nearly 800 million pathology tests are performed for our patients every year in the NHS. 95% of all clinical care pathways rely on access to pathology services with around 70% of all clinical decisions made in the NHS depending on a component of pathology testing. The tests are used in screening, diagnosis, prognosis, prediction and monitoring of a great number of health conditions with earlier detection allowing earlier and more appropriate care for patients.
What does pathology do for clinical research?
Research is a core function of the NHS. We need the evidence from research to deliver better care. Pathology departments are also a vital part of the successful delivery of research in the NHS. Pathology is involved throughout the research pathway from identifying areas for research, designing, setting up and running research studies, reporting the results and publishing the results so they can inform practice.
Research might be led by laboratory professionals themselves, or healthcare professionals from outside the laboratory, but studies often require the services provided by pathology. Results from pathology departments help define whether individual patients are eligible to take part in a study (they rule in or out health conditions that would bias study results). Pathology results are monitored for signs of health or ill health during studies in order to keep patients safe. In some cases pathology testing is used to see how a drug moves through the body (Pharmacokinetics). Pathology results can also inform researchers whether treatments, new diagnostic tests or changes in care provision, are successful and so are used as outcomes measures to answer the research questions.
Research ready and responsive pathology services work with the research community to achieve efficient study set up and delivery. This means that studies open faster and recruit patients sooner. This is key to the success of the study and its ability to recruit the patients it needs answer the question it was funded to answer and makes the NHS a world class places to do health research.
Pathology shaping the future of healthcare through research
Pathology’s part in healthcare and clinical trials is set to become even more important. Diagnostics is central to the explosion in genomics and our growing knowledge of how genetics influence disease risk and response to treatment. Personalised and stratified medicine where treatments are tailored to individuals and groups of patients on the basis of test results. From biomarkers informing the rapid treatment of trauma and combating antimicrobial resistance, to blood tests diagnosing dementia or delivering personalised medicine, the clinical demand for pathology tests is ever expanding. Through its continued leadership in research pathology plays a vital role in clinical research and informing the science and innovation of clinical practice.
For more information about National Pathology Week visit this site:
For more about NHS pathology services :
A good place to find out more about testing: http://labtestsonline.org.uk/
Pathology in research: http://bit.ly/2iqacRI
To truly reflect the global nature of research here is one explanation of how pathology contributes from Australia: https://vimeo.com/218395474