New diagnostic technologies in laboratory medicine: Potential benefits and challenges.

Laboratory tests play a central role in medicine, as they help to make diagnoses, assess prognosis, risk of disease, and monitor therapies, thus contributing to 70% of all medical decisions. This cross-sectional function offers great potential for technological and organizational innovation to influence healthcare as a whole. In recent years, a variety of technologies have emerged and entered the field of medical research, or even medical care. A new generation of biosensors allows the determination of laboratory tests at the point-of-care and enables faster medical decisions. Recent devices allow for patient-centric blood sampling, which eliminates the need for painful blood draws, patient traveling, and the workload of healthcare professionals. Analytical techniques such as metabolomics, lipidomics or proteomics can identify biomarkers extremely sensitively, even down to individual cells. Pharmacogenomics allows the determination of genetic polymorphisms that predict the response to chemotherapeutic agents. Machine-learning approaches can handle large amounts of multi-layered data for diagnostic applications. However, this enormous diagnostic potential is far from being utilized and only very few applications have been implemented in clinical practice. Why is this the case? In this article, we describe the key technology fields, discuss their medical potential and obstacles to their implementation. In addition, we present a methodological framework to support researchers, clinicians and authorities in the development and implementation of novel diagnostic approaches.