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In order to properly plan the appropriate treatment for the health problems individuals encounter in daily life, it is essential for healthcare professionals to identify and evaluate the symptoms and findings of the disease and establish an accurate diagnosis. However, after clinical evaluation, it may not always be possible to determine the correct diagnosis for every health problem. Therefore, clinical laboratory and imaging services have become an integral part of the clinical process, supporting clinicians during diagnosis, treatment, and follow-up.
What is a Clinical Laboratory?
Clinical laboratory services refer to healthcare practices that provide valuable data for making definitive diagnoses of patients' health problems, determining important parameters for treatment planning, or evaluating meaningful markers for post-treatment follow-up. Clinical or medical laboratories offer testing and measurement services across almost every discipline of medicine.
With today’s advances in medicine, improved understanding of diseases, identification of new disorders, and the development of technology, laboratory and radiological examinations have become essential, alongside clinical evaluation, during diagnosis and post-treatment follow-up. Today, clinical laboratories are a fundamental component of healthcare delivery systems such as family health centers, community health centers, and hospitals.
What Are the Functions of a Clinical Laboratory?
Medical laboratories are responsible for conducting the necessary tests that enable clinicians to make differential diagnoses, establish definitive diagnoses, or plan appropriate treatments according to the patient’s clinical condition. These tests are typically performed using biological samples such as blood, urine, cerebrospinal fluid, or tissue samples. The most common analyses performed in clinical laboratories can be summarized as follows:
Complete Blood Count (CBC): A complete blood count or hemogram measures the number and characteristics of cellular elements in the blood. It is one of the most frequently performed laboratory tests.
Blood Biochemistry: The biochemical examination of blood involves the measurement of electrolytes such as sodium, potassium, and chloride; liver enzymes such as ALT and AST; kidney function markers like creatinine and urea; as well as blood glucose, lipid levels, and many other parameters. These analyses can also be performed on other body fluids such as urine, cerebrospinal fluid, and joint fluid. Tests focusing on substances produced by or associated with the liver are referred to as liver function tests (LFTs), while those evaluating kidney-related parameters are called renal function tests (RFTs).
Urinalysis: A commonly performed examination that assesses urine density, pH, presence of protein, cells, and biochemical substances.
Cardiac Enzymes: Tests that measure substances such as myoglobin, creatine kinase, and troponin-I, which increase in blood levels in cardiac conditions such as myocardial infarction.
Acute Phase Reactants: Parameters such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and procalcitonin levels are analyzed to assess inflammatory or infectious processes. These are called acute phase reactants, as their levels increase in response to inflammation.
Coagulation Factors: Clinical laboratories perform analyses to evaluate factors that determine blood coagulation. Parameters such as INR, aPTT, fibrinogen, and D-dimer levels are commonly tested.
Hormones: Hormone tests are crucial for diagnosing and monitoring endocrine and other medical conditions. Commonly measured hormones include growth hormone, insulin, cortisol, ACTH, testosterone, and beta-hCG. Additionally, thyroid function tests (TFTs), including TSH, T3, and T4, are frequently evaluated.
Serology: Serological tests examine the presence and levels of antibodies formed in response to infectious agents, cancer cells, or autoimmune disorders. Parameters such as rheumatoid factor (RF), anti-dsDNA, anti-HBs, and anti-endomysial antibodies can be studied in clinical laboratories.
Microbiological Studies: In patients evaluated for infectious diseases, clinical microbiology laboratories may conduct culture analyses of blood and other body fluids or measure antigen or DNA levels of specific microorganisms.
Genetic Studies: Genetic testing involves chromosomal, DNA, or gene analyses using tissue or body fluid samples to diagnose genetic disorders or guide treatment planning.
Clinical laboratories may function independently, providing services to multiple healthcare institutions, or operate within a hospital as specialized units. In large hospitals, laboratories dedicated to fields such as hematology, endocrinology, biochemistry, genetics, microbiology, molecular biology, and oncology provide comprehensive clinical laboratory services.
Why Are Clinical Laboratories Important?
Clinical laboratories are one of the essential disciplines supporting the accurate, complete, and efficient execution of diagnostic, therapeutic, follow-up, and rehabilitation services in healthcare institutions. In this context, clinical laboratories fulfill the following critical responsibilities:
Conducting the tests requested by clinicians for diagnostic and follow-up purposes.
Ensuring the proper calibration and maintenance of devices and equipment used during testing.
Guaranteeing the reliability and accuracy of laboratory analyses.
Identifying incorrectly collected or transferred samples and informing clinicians when resampling is required.
Promptly notifying clinicians of results that fall outside normal reference ranges or indicate critical values.
Researching and developing more specific or advanced testing methods to improve diagnostic efficiency and clinical relevance.
Who Works in Clinical Laboratories?
Clinical laboratories are managed by medical specialists and staffed by laboratory technicians, technologists, and researchers according to their area of expertise. Depending on the laboratory’s specialization, professionals such as clinical biochemists, medical geneticists, clinical microbiologists, hematologists, endocrinologists, oncologists, molecular biologists, and medical biologists may work in clinical laboratories.
To specialize in these medical disciplines, physicians must complete a six-year medical education program and obtain a medical diploma. Subsequently, they must pass the Medical Specialization Examination (TUS), held twice a year by the Student Selection and Placement Center (ÖSYM), and qualify for a residency program in one of the relevant branches based on their scores. The duration of specialization training varies between four and five years, depending on the discipline.
Upon successful completion of their specialty thesis and examination, physicians receive a specialist certificate. In Türkiye, newly certified specialists are required by law to complete a mandatory service period. After fulfilling this obligation, they may work in public or private healthcare institutions, including independent or hospital-based clinical laboratories.
