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The page below is a sample from the LabCE course Evidence-Based Practice Applied to the Clinical Laboratory. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Knowledge Gaps

Imagine that you are called by your GI department and you are asked to bring in a new laboratory test that measures stool calprotectin levels. You know that your laboratory sends out 30-40 of these tests to a reference lab each month. Based on a literature review, your medical director and the GI department agree that the calprotectin test has significant clinical value. Should you now start performing this test in-house, in your own lab? Before you can answer this question you have to consider what knowledge gaps are present in your understanding of this test.
A knowledge gap is simply an area in the content, problem, or process that you have no experience with or know very little about. Knowledge gaps can exist when processes are complex or when work flows across several departments within the facility. Knowledge gaps may be the reason why treatments, technologies, or tests that are deemed "best practice" are not the treatments, technologies, or tests that are currently in use.
Some of the gaps in our example may be:
  • How difficult is the calprotectin assay to run (how much tech time does this manual test take)?
  • How are samples collected and delivered to the lab? (Stool samples are often handled differently since they are not collected on-site by a laboratory worker.)
  • How much does the assay cost to perform in-house compared to the price offered by the reference lab?
  • Would the in-house assay have the same analytical quality as the assay now performed at the reference lab?
  • Would the test be batched or run daily, and during what hours of the day?
  • Is your lab set up to bill and charge for this new test?
  • Are there controls and proficiency testing available for the test?

These knowledge gaps can be easily addressed with investigation and gathering of data and information.