This issue of Clinics in Laboratory Medicine entitled “Risk, Error and Uncertainty: Laboratory Quality Management in the Age of Metrology will be guest edited by Sten Westgard, James Westgard, and David Armbruster. The issue will cover a broad range of topics related to management in the laboratory including but not limited to: Metrology Perspectives; Biologic Variation Approach to Daily Laboratory; Clinical Outcome Approach to Goal Setting; Six Sigma Quality Management System; Traceability and Comparability; MU, Risk, and Sigma-metrics at Sunway; and Quality Indicators for the Total Testing Process, among others.

This issue of Clinics in Laboratory Medicine, edited by Dr. Steven Billings, will cover Dermatopathology. Topics covered in this issue include Blue nevi and related lesions, sentinel lymph node biopsies in melanoma, Spitzoid melanocytic neoplasms, Tumor immunology related to melanoma, Molecular aspects of melanoma, Merkel cell carcinoma, Cutaneous Squamous Cell Carcinoma, Cutaneous T-cell lymphomas, Cutaneous B-cell lymphomas, Myeloid neoplasms, among others.

This issue of Clinics in Laboratory Medicine, edited by Drs. Nahed Ismail, A. William Pasculle, and James Snyder, will cover a wide variety of Emerging Pathogens. Topics covered in this issue include, but are not limited to West Nile Virus; Zika Virus; Ebola and Marburg Heamorrhagic Fever; Rift Valley Fever; Carbapenem Resistant Enterobacteriacae; Closteridium Difficuile; and Chikungunya, among others.

In October of 2011, CLSI published a new guideline EP23A on “Laboratory Quality Control Based on Risk Management. In March, 2012, CMS announced its intention to incorporate key concepts from EP23A into its Interpretative Guidelines and QC policy for “Individualized Quality Control Plans. Thus begins a new era of Quality Control in the Age of Risk Management. This issue is intended to help laboratories with the transition between traditional QC practices and the new risk management approach. Laboratories face a steep learning curve to apply risk analysis for identifying and prioritizing failure-modes, developing and implementing control mechanisms to detect those failure-modes, and assessing the acceptability of the residual risks that exist after implementation of a QC Plan. One of the main benefits of the new risk analysis based QC Plans should be an integration of all the control mechanisms that are needed to monitor the total testing process, including pre-analytic, analytic, and post-analytic controls. One of the main risks of the new approach is an expectation that Statistical QC is no longer important, even though SQC still remains the most useful and flexible approach for monitoring the quality of the analytic process. The key to the future is the successful integration of all these control mechanisms to provide a cost-effective quality system that monitors all phases of the total testing process. This issue should help laboratories understand the evolution of QC practices to include risk management, but also to recognize the need to maintain traditional techniques such as Statistical QC, especially during the transition to well-designed and carefully-validated QC Plans. Risk analysis may be risky business unless laboratories proceed carefully and cautiously.

Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.

Scores of talented and dedicated people serve the forensic science community, performing vitally important work. However, they are often constrained by lack of adequate resources, sound policies, and national support. It is clear that change and advancements, both systematic and scientific, are needed in a number of forensic science disciplines to ensure the reliability of work, establish enforceable standards, and promote best practices with consistent application. Strengthening Forensic Science in the United States: A Path Forward provides a detailed plan for addressing these needs and suggests the creation of a new government entity, the National Institute of Forensic Science, to establish and enforce standards within the forensic science community. The benefits of improving and regulating the forensic science disciplines are clear: assisting law enforcement officials, enhancing homeland security, and reducing the risk of wrongful conviction and exoneration. Strengthening Forensic Science in the United States gives a full account of what is needed to advance the forensic science disciplines, including upgrading of systems and organizational structures, better training, widespread adoption of uniform and enforceable best practices, and mandatory certification and accreditation programs. While this book provides an essential call-to-action for congress and policy makers, it also serves as a vital tool for law enforcement agencies, criminal prosecutors and attorneys, and forensic science educators.