Pathology Grand Rounds: “Bridging the Diagnostic Divide in Global Health: The Case for Academic Centers for Global Pathology”

My academic focus is at the intersection of clinical informatics and health services research, using decision analytic approaches to model and improve the impact of laboratory medicine. My research includes two broad areas. The first entails global health diagnostics, and includes surveys and modeling of laboratory capacity and quality in low- and middle-income countries. This body of work led to the World Health Organization establishing the Model list of Essential Diagnostics in 2018, a number of landscaping studies of availability of testing offered in global settings, a Gates Foundation Grand Challenges grant to create an online service marketplace to improve the transport of specimens between health facilities and laboratories in Ghana, and an NIH funded R01 to map and model the most effective and efficient design of a national laboratory network, using Ghana as examplar. This work led to participating in the Lancet Commission on Diagnostics where I developed a model to generate a tier-specific national Essential Diagnostics List and published a comprehensive analysis of the Service Provision Assessments for diagnostic readiness in ten countries. The second area of research includes mining the electronic medical record as a resource to derive new clinical laboratory knowledge and inform system-level improvements. To this end, I have developed and published on an algorithm for ongoing accuracy assessment of POC testing demonstrating efficacy for both glucose and Hb A1c instruments, automated generation of reference intervals using collections of medicines and ICD10 codes in supervised as well as unsupervised algorithms, developed a model to predict the performance of rapid SARS-CoV-2 assays with different specimen types in different populations, and conducted numerous laboratory stewardship projects to ensure optimal use of diagnostic resources.

-Dr. Lee Schroeder, MD, PhD