"Harmonization of laboratory testing - A global activity".

The harmonization of laboratory testing is a high priority topic in Laboratory Medicine. It is more than harmonized terminology, units of reporting, methodology and reference intervals but, rather, covers a wide range of topics from the “pre-pre-analytical” phase (‘Right test at the Right time for the Right patient’) to the analytical aspects and reporting of critical results through to consumer education and the meaning of laboratory tests in lay terms (“post-post-analytical” phase). Harmonization should lead to safer andmore accurate interpretation of patient results [1]. Any new concept requires innovative and practical ideas if it is to succeed. This special themed issue of 26 articles explores how we might achieve the closer comparability of processes to achieve closer comparability of laboratory outcomes globally. Experts provide reviews, commentaries and critical opinions about the benefits of harmonization and its future directions. Aarsand and Sandberg [2] suggest practical ways of achieving harmonization of laboratory testing and describe the potential barriers. They recommend close interaction with all stakeholders including the Laboratory Medicine community, diagnostic industry, clinicians, professional societies, IT providers, consumer advocate groups and the government as essential for harmonization projects to be successful and to achieve improved clinical effectiveness of critical tests and greater patient safety. In particular, harmonization initiatives should improve procedures and processes at the laboratory-clinical interface. As Plebani and Panteghini discuss [3], it is essential to promote close relationships between laboratorians and clinicians to improve the laboratory testing process. As a practical example, Berg [4] describes the elements of a global harmonization model based on the United Kingdom harmonization initiative and the importance of marketing communications as an inclusive approach involving key pathology and clinical professional groups. Misra and Barth [5] go on to describe how when being developed guidelines on test selection require an integral interaction between clinicians and laboratory specialists, and that this should help to harmonize practice, reduce inappropriate test selection and reduce treatment variations secondary to analytical variations. Harmonizing the pre-analytical phase requires use of standardized operating procedures for correct test selection, sample collection and handling. However, standardized protocols for patient preparation for laboratory testing are currently lacking. Simundic et al. [6] for the European Federation of Clinical Chemistry and Laboratory Medicine Working Group on the Pre-analytical Phase (EFLM WG EFLM WG-PA) discuss the need to provide a framework for the harmonization of definitions for fasting requirements for laboratory tests. In a more contentious article, Dolci and Panteghini [7] raise the possibility of harmonizing automatic hemolysis index (HI) assessment and, in particular, the need to develop a harmonized response for reporting results of