2023-2024 Education Roundtable Series

Jieli Shirley Li, MD, PhD, holds the position of Assistant Professor-Clinical within the Department of Pathology and serves as Co-Director of the Clinical Chemistry & Toxicology Laboratory.  Dr. Li obtained her MD and PhD degrees from the Shanghai Jiao-Tong University School of Medicine and completed her fellowship training in clinical chemistry at the MD Anderson Cancer Center.  Her professional interests center around enhancing laboratory tests for the in vitro diagnosis, prognosis, and treatment planning of cancer, endocrine disorders, and cardiovascular diseases.  Dr. Li has authored over 40 scientific articles and contributions as an Ad Hoc reviewer for 20 different scientific journals.  She also plays a vital role in participating in guidelines writing for the Clinical & Laboratory Standards Institute (CLSI) and serving on the Expert Panel Committee of CLSI.  Furthermore, Dr. Li contributes to the field as an inspector for the College of American Pathologists (CAP) and is actively involved with CAP’s Chemistry Committee.

Cody Lewis is currently a Clinical Biochemist working for the Saskatchewan Health Authority with an academic appointment at the University of Saskatchewan. He oversees the general chemistry laboratory at St Paul’s Hospital and co-leads point of care testing in Saskatoon. Additionally, Cody has interests in testing associated with endocrine disorders. Prior to joining the team in Saskatoon, Cody completed his fellowship training 2021 in Calgary Alberta. Before that, he obtained a PhD in Cancer Sciences from the University of Alberta and an MSc from the University of Lethbridge.

• Division Head Chemistry Lab St Paul’s Hospital, Vancouver, BC since 2019
• Physician consultant Adult Metabolic Diseases Clinic, Vancouver General Hospital since 2006.
• Member of the multiple physicians and the environmental groups including Doctors for Planetary Health and the Royal College of Canada working group on CanMeds 2025 Planetary Health competencies.
  • Past Chair, Royal College of Canada National subspecialty committee in medical biochemistry.

Lawrence de Koning, Associate Professor and Clinical Biochemist, University of Clagary, Alberta Precision Laboratories and Alberta Children’s Hospital

Dr. Lawrence de Koning completed a PhD in Health Research Methodology from McMaster University in 2009, and concurrent postdoctoral fellowships in nutritional epidemiology and clinical chemistry at Harvard University from 2009-2012. He became board certified by the American Board of Clinical Chemistry in 2013 and a fellow of the Canadian Academy of Clinical Biochemistry in 2015. Dr. de Koning works as a pediatric clinical biochemist at Alberta Children’s Hospital, a consultant clinical biochemist for Rockyview General Hospital and has numerous clinical and research interests including biomarkers and epidemiology of pediatric and perinatal conditions, laboratory quality improvement, cardiovascular disease, and nutrition.

Ka Hang Brian Lam, University of California, Los Angeles

CASE 1:  Presented by Dr. Mattman:  Investigation of oxalate nephropathy

Oxalate nephropathy may be caused by primary and secondary etiologies. The investigation of oxalate nephropathy is complicated by the impact of nephropathy on oxalate concentrations in blood and urine. Nonetheless, oxalate nephropathy is responsive to etiology specific therapy – in some cases readily responsive – and so the laboratory’s role in documenting the etiology is an important piece of patient recovery.

At the conclusion of this session, participants will be able to:
1) Identify the common causes of acquired oxalate nephropathy.
2) Recognize that there are primary hyperoxaluria conditions which have distinct gene specific treatments (that area also distinct as compared to the acquired causes).
3) Identify the laboratory tests of utility in diagnosing primary and secondary hyperoxaluria

CASE 2: Presented by Dr. de Koning: Critically high ammonia in an adolescent girl

This session will review a case of repeatedly elevated plasma ammonia levels in an adolescent girl which were caused by specimen platelet contamination. Topics covered will include ammonia metabolism, urea cycle disorders, ammonia analysis, and the many preanalytical causes of elevated ammonia and how to minimize them.

At the conclusion of this sessions, participants will be able to
1) Describe the metabolism of ammonia
2) Understand the clinical manifestations of urea cycle disorders and appropriate treatments
3) Cite a number of common preanalytical causes for elevated ammonia, and identify ways to prevent them.

CASE 3: Presented by Dr. Lam: A suspected case of carbon monoxide poisoning consistent with fentanyl toxicity

This lecture sill describe a case of fentanyl poisoning that was consistent with carbon monoxide poisoning.
At the conclusion of this session, participants will be able to:
1) Understand the clinical presentation of fentanyl toxicity
2) Understand the difference between a traditional opiate immunoassay method and a synthetic fentanyl opioid immunoassay method.

Dr Doyle is a board‐certified clinical chemist and is an Associate Professor of pathology at the University of Utah. He is associate Director of the Clinical Chemistry Fellowship program and serves as the Medical Director of Special Chemistry and Endocrinology at ARUP Laboratories. He has a special interest in laboratory science education, the application of mass spectroscopy, and quality management.

Dr. Vathany Kulasingam is Division Head of Clinical Biochemistry at University Health Network and is an Associate Professor in the Department of Laboratory Medicine and Pathobiology at the University of Toronto. She is the Co-Director of the Postdoctoral Training Program in Clinical Chemistry.

Allison Venner, PhD, FCACB, Clinical Biochemist, Alberta Precision Laboratories, POCT Provincial Medical Lead, Alberta Precision Laboratories, Clinical Biochemistry Associate Section Chief, Alberta Precision Laboratories, Clinical Associate Professor, Dept. of Pathology & Lab Medicine, University of Calgary.

Dr. Allison Venner is a Clinical Biochemist with Alberta Precision Laboratories (APL). She is the Clinical Biochemistry Associate Section Chief and the Provincial POCT Medical Lead at APL. Dr. Venner is a Clinical Associate Professor with the Department of Pathology & Lab Medicine at the University of Calgary, and is certified as a Clinical Biochemist by the Canadian Academy of Clinical Biochemistry (CACB). She is past president of the Alberta Society of Clinical Chemists and the Canadian Society of Clinical Chemists. She is the current Secretary of the Alberta Association of Clinical Laboratory Doctoral Scientists (AACLDS).

Dr. Venner has a particular interest in Quality, Informatics, and Point of Care Testing (POCT), and she is involved in many related local, provincial, national and international initiatives. She is focused on education, and in bringing increased awareness of quality within and outside of the clinical laboratory to improve patient care. She has multiple publications, with a recent focus on test utilization, harmonization of reference intervals, and innovation and quality assurance in POCT. She has been an active member of the Epic and Connect Care implementation within Alberta.

Dr. Joe El-Khoury is Associate Professor of Laboratory Medicine at Yale School of Medicine and Director of the Clinical Chemistry Laboratory and fellowship program at Yale-New Haven Health. He is board certified by the American Board of Clinical Chemistry and a fellow of the Association for Diagnostics and Laboratory Medicine Academy. He currently serves on the Editorial Boards of Clinical Chemistry and Clinical Biochemistry, as Chair of the IFCC Committee on Kidney Diseases and on the Board of Directors for ADLM. He recently launched his own Youtube channel, entitled “Clinical Chemistry with Joe El-Khoury”, that infuses science with comedy and is focused on improving laboratory medicine practice. His interests including reducing preanalytical errors, biomarkers of kidney disease and injury, toxicology, mass spectrometry and science communication.

Dr. William E. (Wes) Schreiber earned an MD degree from Baylor College of Medicine and completed a residency in clinical pathology at the University of Washington. He was a consultant pathologist at Vancouver General Hospital for more than 30 years, with service responsibilities in the broad area of clinical chemistry. He was also medical director of the Provincial Toxicology Center for 10 years, which provides both forensic and clinical toxicology services for the province of British Columbia. He recently retired from LifeLabs after spending 6 years as the Clinical Director of Chemistry.

At UBC, Dr. Schreiber committed a large part of his career to the education of medical students, residents and colleagues. He directed the medical biochemistry residency program for 10 years and served as associate dean for undergraduate education at UBC from 1999-2002. He has received a number of teaching awards from students and peers, as well as recognition from professional organizations for contributions to continuing medical education.

Dr. Schreiber served as president of the American Society for Clinical Pathology (ASCP), the largest pathology organization in North America, in 2016-17.

1) discovery of mutations causing acute intermittent porphyria and their translation into diagnostic tests
2) leadership of a forensic toxicology laboratory
3) role as a clinical consultant for a large outpatient laboratory

Dr. Beriault is the Head of the Biochemistry division and the Specimen management division at Unity Health Toronto, and an Associate Professor at University of Toronto. Along with Dr. Stefan, he is one of the founding members of Toronto’s Drug Checking service.

Dr. Cristiana Stefan, PhD, DABCC (CC,TC), FADLM, Director, Clinical Laboratory and Diagnostic Services, Clinical Biochemist/Toxicologist, Centre for Addiction and Mental Health

Dr. Cristiana Stefan is the Director of the Clinical Laboratory and Diagnostic Services at the Centre for Addiction and Mental Health (CAMH) in Toronto, where she also practices as Clinical Biochemist/Toxicologist. In addition to her directorship and clinical responsibilities for Biochemistry and Point of Care Testing, Dr. Stefan oversees research and R&D services; participates in the education of clinical and medical fellows; is actively involved with professional associations. Along with Dr. Beriault, she is one of the founding members of Toronto’s Drug Checking service.

2. Stability of TCO2 Collected in Microcontainers: A stable relationship or a fizzled affair?

Dr. Amy Pyle-Eilola is currently an associate professor of Pathology at The Ohio State Wexner Medical Center and the Director of Clinical Chemistry at Nationwide Children’s Hospital. She’s active in the Association for Diagnostic and Laboratory Medicine. She is passionate about using lab data to generate evidence-based guidelines and educating clinicians about preanalytical errors.

Michael Reid is a Clinical Chemist with Alberta Precision Laboratories in Calgary, Alberta. He received his BSc in Chemistry from Thompson Rivers University in 2012 and his PhD in Analytical Chemistry from the University of Alberta in 2018. He completed his Clinical Chemistry Fellowship at the University of Calgary in 2023 before starting his position at Alberta Precision Laboratories. His areas of interest include endocrinology, assay interferences, and teaching.

Dr. McCudden is a Clinical Biochemist at the Ottawa Hospital. He is a Professor and Vice Chair of the Department of Pathology & Laboratory Medicine at the University of Ottawa. He serves as the Deputy Chief Medical Scientific Officer and Medical Director of Informatics and Information Technology for the Eastern Ontario Regional Laboratory Association. His interests include automated chemistry, laboratory informatics & machine learning, quality improvement, plasma cell dyscrasias, and audit and feedback for laboratory stewardship.

Lei Fu is a clinical biochemist in the Precision Diagnostics and Therapeutics Program, at the Sunnybrook Health Sciences Centre. She completed her training at the McMaster University Clinical Chemistry Postdoctoral Fellowship Program. She was certified by the Canadian Academy of Clinical Biochemistry. She was also certified by the American Board of Clinical Chemistry in all three disciplines, Clinical Chemistry, Toxicological Chemistry, and Molecular Diagnostics. She is actively engaged in clinical service, teaching, and research. Her research interests are focused on biomarkers in maternal and fetal health, and clinical applications of pharmacogenetics.

Dr. Sally Ezra is currently a senior clinical chemistry fellow at Alberta Precision Laboratories and the University of Calgary. She obtained a Ph.D. in Biochemistry, Cell, and Molecular Biology from the University of Toronto, focusing on the pathophysiological and molecular mechanisms of rare connective tissue disease-causing mutations. Dr. Ezra is interested in autoimmune testing, developing clinical mass spectrometry methods for endocrine testing, and implementing testing algorithms to streamline laboratory processes, enhance diagnostic accuracy, and improve test utilization.

#2.  Fangze Cai, Alberta Precision Laboratories and University of Calgary

Dr. Fangze Cai is the junior Clinical Biochemistry Fellow in Alberta Precision Laboratories and University of Calgary. She earned her PhD in Biochemistry at the University of Alberta. Her PhD research was focused on drug development targeting cardiac troponin complex using nuclear magnetic resonance (NMR). She is still exploring different areas of clinical chemistry, and currently is interested in tumour marker, endocrinology and toxicology.

Celiac disease (CD), an autoimmune disorder triggered by dietary gluten, impacts approximately 1% of the global population, with Alberta reporting a prevalence of 48 cases per 100,000 individuals. Serology tests, notably anti-tissue transglutaminase (anti-tTG) and anti-endomysial antibody (anti-EMA) testing, are crucial for CD screening, diagnosis, and monitoring. In this presentation, we delve into the study we’ve conducted, examining 124,308 pediatric and adult patients who underwent CD serology testing between April 2020 and August 2022 in Alberta. Our analysis scrutinizes the agreement between anti-tTG IgA and anti-EMA IgA tests and evaluates the clinical validity of our local CD testing algorithm, reflexing all positive anti-tTG results for anti-EMA testing. Through our findings, we shed light on the interplay between anti-tTG IgA levels and concordance rates, offering insights for refining CD serology testing algorithms and bolstering diagnostic accuracy.

At the conclusion of this session, participants will be able to:
1) Describe the pathophysiology of celiac disease (CD).
2) Discuss the clinical utility of serology testing in CD screening, diagnosis, and monitoring.
3) Evaluate strategies for optimizing CD serology testing algorithms to enhance test utilization and diagnostic accuracy.

Colorectal cancer (CRC) is the third most common cancer worldwide. Regular screening is crucial for early detection and prevention of CRC. This lecture will describe methods used to screen for CRC with a specific focus on the Fecal Immunochemical Test (FIT). We will discuss the current state of FIT testing and strategies to improve utilization of CRC screening.

At the conclusion of this session, participants will be able to:
1) Describe methods used to screen for colorectal cancer (CRC)
2) Understand current state of CRC screening
3) Describe strategies to improve utilization of CRC screening

Dr. Josh Raizman is a clinical biochemist with Alberta Precision Labs and Associate Clinical Professor in the department of Laboratory Medicine and Pathology at the University of Alberta. He supports Special Chemistry testing at the University of Alberta Hospital and core chemistry laboratories at regional tertiary hospital centres. One of his interests is involving undergraduate students in hands on laboratory projects, then applying this work to solve laboratory problems. This is exemplified in the work being presented today.

Dr. Launny Lowden is a Diagnostic and Clinical pathologist (previously General Pathology) at the East Kootenay Regional Hospital in Cranbrook, BC. She is the department head of Pathology and Lab Medicine for the Kootenay Area and the Medical Director of Patient Safety for Interior Health. She is passionate about environmental issues and lives off grid on a mountain farm with her husband, toddler, and forest friends.