Challenges, questions and opportunities with regard to the new relationship between clinical practice and the haemostasis laboratory: the path towards personalized medicine.

Hemostasis laboratory tests to diagnose hemostasis are among the most complex processes in clinical medicine. The diagnostic approach to hemostatic alterations should not be simple or direct. In fact, the notion that a single test should be sufficient for diagnosis, which is valid for most conditions, is not usually applicable to hemostatic alterations. Standardization of the different techniques is still an unattained goal and the calculation of the normal reference ranges for the different tests varies widely across different labs. Moreover, new treatments are emerging in the realm of hemostasis whose mechanisms of action are entirely different from classical ones. Beside, the vast amounts of information generated by newly developed technologies represent formidable challenges.