Optimized diagnostic tests can have a significant beneficial effect on clinical decision-making and health care processes. Asymptomatic patients would be screened effectively, diagnoses made solidly, reliable predictions about future clinical events could be made, and the effects of treatments are monitored sensitively. To date, we have done this job insufficiently. It appears that most laboratory tests implemented in clinical practice have not been adequately evaluated, and clinical needs are often not met. Besides, generic results are provided rather than individualized interpretations.

Recent developments in laboratory analytics, including proteomics, genomics, metabolomics, immune profiling, and the creation and linkage of clinical databases, lead to vast amounts of health-related information (multi-omics) at various levels. Optimal integration of these multi-layered data might not only result in a better understanding of the mechanisms of disease and the interaction of different biological factors, but it can also result in an individualized and more accurate diagnosis, prognosis, and management of patients. However, few integrated diagnostic and prognostic applications have been successfully implemented in routine clinical practice.

We bring a profound knowledge and wide experience in clinical medicine, laboratory medicine, and patient-oriented research methods. Besides, significant expertise exists in developing clinical prediction models and their implementation, including machine learning algorithms. Associated with the Center for Laboratory Medicine at Inselspital, we have access to a comprehensive spectrum of high-end laboratory technologies (incl. genomics, pharmacogenomics, cytomics). Besides, an extensive network of recognized experts in all areas of laboratory medicine and clinical medicine exists. The Inselspital University Hospital sees large patient numbers, including patients with severe and rare diseases. A close collaboration exists with the Inselspital Data Science Center and the Biobank Bern.

• Clinicians
  1. What does this laboratory test result mean for my patient?
• Patients
  1. What does this test result mean for me?
• Researchers
  1. How can I translate new biomarkers into clinical practice?
• IVD Industry
  1. How can this technology be implemented in clinical practice?
• Laboratory managers
  1. What is the diagnostic utility of laboratory tests provided?
• Healthcare authorities
  1. How to define rational and efficient diagnostic strategies?

Our research is supported by the Swiss National Science Foundation (https://p3.snf.ch/project-179334), the International Society on Thrombosis and Haemostasis (ISTH; https://www.isth.org/page/toradihit),  and various industry partners.

In the AgiP study, we assessed the accuracy of a rapid antigen test in diagnosing SARS-CoV-2 infection in real-life clinical settings (n=1’465; doi.org/10.1016/j.ijid.2021.07.010). We found that the sensitivity was disturbingly low, questioning the current Swiss testing strategy. This study has caused a significant media interest in Switzerland.

The SIMPLE-Xa study is a prospective multicentre cohort study aiming to study laboratory tests to monitor direct oral anticoagulants in clinical practice. More than 900 patients were included in 10 Swiss study centers. Two manuscripts are published (https://doi.org/10.1111/bjh.17470; https://doi.org/10.3389/fcvm.2021.717939), others are submitted for publication. The study is funded by several public and industry partners.

The SeProV study (Secondary prevention of venous thromboembolism) is based on an existing patient registry, cross-linked with external databases (n=6’638). We study the secondary prevention of venous thromboembolism. Industry partners fund this study. The first manuscript is published (https://www.frontiersin.org/articles/10.3389/fcvm.2021.749342/abstract).

We developed several prediction models and decision support tools for a variety of clinical questions. Access to these tools will be gradually added to this page. Additionally, we studied the performance characteristics of numerous diagnostic tests for a large variety of clinical questions. Please see publications for details.

• TORADI-HIT (Diagnosis of Heparin-induced thrombocytopenia): https://toradi-hit.dbmr.unibe.ch/
• Screening for mild bleeding disorders: coming soon
• Anticoagulation quality (Patients performing self-management of oral anticoagulation with vitamin K antagonists): coming soon
• Risk for recurrent venous thromboembolism (Patients with DVT): coming soon