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The pre-analytical phase of laboratory medicine

Published on March 31, 2026   31 min

A selection of talks on Methods

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0:00
I am Giuseppe Lippi. I am a full professor of clinical biochemistry at the University of Verona, and I'm also a member of the EFLM working group on the pre-analytical phase. I would like to express my sincere gratitude for the honor of being invited to deliver this focused lecture on the pre-analytical phase, an important and often overlooked topic in laboratory medicine. It is a privilege to be here today sharing insights on all aspects of laboratory medicine that plays a crucial role in ensuring the accuracy and reliability of our diagnostic processes.
0:39
The pre-analytical phase, although frequently underestimated, is the foundation upon which the rest of the testing process depends. Without a deep understanding of its complexities and challenges, the quality of our work can be compromised, affecting not only the accuracy of test results but also patient outcomes. As we explore this topic together, I hope to shed light on the significance of this phase and the steps we can take to improve it.
1:10
Before delving into the specific issues related to the pre-analytical phase, it is important to briefly revisit the broader context of the total testing process as was originally conceptualized by George Lundberg in the early 80s. Lundberg's model portrays the testing process as a continuous loop beginning with the clinical question process in the physician's brain and ultimately returning to the same point after passing through the pre-analytical, analytical, and post-analytical phases. This cyclical nature emphasizes the critical role that each phase plays in the overall diagnostic journey. The pre-analytical phase, as we commonly define it, encompasses a series of crucial activities that begin with test ordering and continue through the preparation of the sample before testing. This phase sets the stage for the accuracy and reliability of the entire diagnostic process. However, it is important to recognize that errors can occur at any stage throughout the interior testing loop. While the frequency of these errors may vary, they have the potential to impact the quality of test results across the entire process. Understanding this continuous cycle and the opportunities for errors are essential for improving the overall diagnostic accuracy and patient care.

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