CSCC 2010 SCIENTIFIC WORKSHOPS
Sunday June 13, 2010
SUNDAY JUNE 13 08:30-11:30
2 CONCURRENT WORKSHOPS W1 (Part 1), W2
W1 Interactive Case Studies in Pediatric Clinical Chemistry (Full day)
Dr. Khosrow Adeli, Division of Clinical Biochemistry, Hospital for Sick Children, Toronto
Dr. Vijay Grey, Hamilton Health Sciences Centre, Hamilton
Dr. Nathalie Lepage, Department of laboratory Medicine, Children’s Hospital of Eastern Ontario, Ottawa
Dr. Lynn Allen, Georgetown
Level: Intermediate
This full-day workshop is being organized by the CSCC Pediatric Focus Group. I am submitting this on behalf of the focus group.
This will be an interactive workshop that will use case studies and group discussion to explore issues unique to pediatric practice. Case discussion will 1) explore the concept of pediatric critical values, 2) emphasize the importance of establishing age-related reference values, 3) discuss the approach to follow-up of positive results of screening for metabolic disease, 4) review other key areas of interest in pediatric clinical chemistry service.
Workshop Topics and Presenters:
Each topic will include case presentations by postdoctoral trainees followed by faculty presentations and discussion:
1. Critical Values – McMaster University Clinical Chemistry Fellow & Dr. Vijay Grey
2. Pediatric Reference Intervals – U of T and McMaster Clinical Chemistry Fellows & Dr. Khosrow Adeli
3. Metabolic Disease Screening and Follow Up – U of T Clinical Chemistry Fellow, Dr. Lianna Kyriakopoulou, & Dr. Nathalie Lepage
4. Vitamin D – University of Montreal Clinical Chemistry Fellow, & Dr. Edgard Delvin
5. Pediatric TDM or Clinical Toxicology– U of T Clinical Chemistry Fellow & Dr. Zulfikarali Verjee
After attending the session the participants will be able to:
1) Appreciate the significance of adequate result interpretation, b
2) Describe the basis of genetic metabolic disorders currently in the NBS panel and to describe an approach to follow-up of positive results of metabolic screen
3) Appreciate the most recent developments in pediatric clinical chemistry service.
SUNDAY JUNE 13 08:30-11:30
2 CONCURRENT WORKSHOPS W1 (Part 1), W2
W2 Qualification, Verification, Validation and Uncertainty of Measurement in the Clinical Laboratory
Dr. Edward Dunn, Burlington
Dr. Sheila Boss, Medical Support, Lifelabs Inc., Toronto
Dr. Godfrey Moses, Gamma-Dynacare Medical Laboratories, London
Level: Intermediate
In Ontario, Laboratories are accredited by the Ontario Laboratory Accreditation (OLA) program and the Quality Management Program – Laboratory Services (QMPLS). The requirements are based on the ISO standard 15189. These requirements state that validated procedures must be used and that the validations shall be as extensive as are necessary to meet the needs in the given application or field of application. The extent of method validation, the performance characteristics measured, and the approach to validation are left to the discretion of the laboratory. Some regulatory agencies have detailed requirements for validation of new methods, as do some academic journals. However, there are no prescribed requirements for validation of “commercial kits” or “in-house” methods employed in clinical laboratories. This workshop is designed to provide laboratories with a practical guide to validation of quantitative methods and instrumentation, such as automated chemical analyzers and more manual instruments like GC/MS and LC/MS/MS
The concept of Measurement Uncertainty (or Uncertainty of Measurement) has become a real issue for the medical laboratory. Furthermore, with the introduction of the ISO 15189 Standards, estimating the uncertainty associated with a measured or assigned value is also linked to Traceability. In this section of the Workshop, the various international efforts, such as those of JCTLM and other Laboratory Accreditation Bodies, towards Traceability and UM in the medical laboratory will be discussed, as well as description of some of the proposed alternative approaches and recommendation of the preferred approach for most quantitative test.
At the conclusion of this session, participants will be able to:
1) Develop a strategy for the validation and/or verification of methods and equipment.
2) Define the various performance characteristics recommended to validate performance “Pre-implementation”
3) Define the various performance characteristics recommended to validate “non-standard standard analytical method”
4) Define the various performance characteristics recommended to document the method or instruments’ long term “fit for use”
5) Define Traceability and UM in Metrology Terms
6) Know how to estimate and evaluate UM using the Top-Down Alternative Approach.
SUNDAY JUNE 13 1330-1630
3 CONCURRENT WORKSHOPS (W1 (Part 2), W3, W4
W3 Serum Protein Electrophoresis: From standardized interpretation and algorithms to high resolution capillary electrophoresis
Dr. Jean-Pierre Émond, Département de biochimie, CHUM, Hôpital Notre-Dame, Montréal
Dr. Edward Randell, Laboratory Medicine, Memorial University of Newfoundland, St. John’s
Level: Advanced
Serum protein electrophoresis (SPE) is not a new test but there still exists much inconsistency in the nomenclature, testing algorithms and interpretive comments used by different laboratories. We will report on a national survey on SPE practices in Canada. We will review SPE interpretation and follow-up tests in terms of current recommendations and testing algorithms as attempts to standardize and optimize the clinical utility of the tests. New technology as high resolution capillary technology (CZE HR) used as a first line diagnostic tool promises significant advantages and may exceed the clinical utility of traditional SPE. We will alsodiscuss this and the benefits of serum free light chains testing in improving diagnosis and monitoring of monoclonal gammopathies.
1. Standardization and currents uses of serum protein electrophoresis.
Dr Edward Randell, St. John’s, Newfoundland and Labrador
2. Capillary high resolution serum protein electrophoresis everyday.
Dr Jean-Pierre Émond, CHUM, Montréal, Québec
At the end of this session, participants will be able to:
1) Discuss uses of standard serum protein electrophoresis (SPE) and professional interpretation comments;
2) Understand what is capillary electrophoresis (CZE) and high resolution (CZE HR) for serum protein electrophoresis;
3) Discuss the benefits and new utilities of CZE HR in a day-to-day service or redefinition of the role of SPE in the clinical settings.
W4 Mining for Gold in the Laboratory Database.
Dr. Ken Sikaris, Melbourne Pathology, Melbourne Australia
Level: Advanced
For thousands of years, doctors have loyally learnt the teachings of their forefathers acquired through lifetimes of experience. As science progressed, we ignored these teachings unless supported by published research. Today, our daily clinical investigations are stored in massive databases and we can retrieve, all at once, the clinical activity of thousands (or millions) of patients and acquire a modern knowledge that would have otherwise taken lifetimes to appreciate. These databases refect today’s experience rather than the outmoded experiences of the past or the artificial perspective of a rarefied study.
The natural relationships between our investigative findings and demographics are obviously useful for comparing patients against their peers (eg age, gender or gestational reference intervals). Ideally however patients should be compared against themselves, and the database similarly has stored within it the real life changes observed in thousand of patients (biological variability). These relationships can also provide diagnostic and prognostic knowledge, particularly if the database contains morbidity and mortality data (clinical or critical decision limits). The relationships that exist are as infinite as human life itself. Relevant examples include seasonal variability or the effect of daylight savings but also quality control of results, resource efficiency, workload and income projections!
This workshop will introduce participants to the software tools required to extract data, prepare it for analysis, and then explore and discover the mysterious relationships that exist within it. Feel free to bring your laptop (with Microsoft Excel installed), to work through the course CD of examples while they are demonstrated.
At the end of this session, participants will be able to:
1) Understand the value of the laboratory database.
2) Use of tools to prepare database extracts for analysis.
3) Use of tools to explore the relationships in the data