Sunday June 21 Lunch
Monday June 22 Breakfast
- 0700-0800: V2201 Update on WHO Classification for MPNs: A Case-Based Approach
- 0730-0830: V2202 Implementing a New QC Program in the UK: Drivers for Change
- 0730-0830: V2203 Advances in Toxicology Testing and Trends in Novel Psychoactive Drugs
- 0730-0830: V2204 Working together to achieve Optimal Laboratory Utilization – the CSCC and Choosing Wisely Canada
Monday June 22 Afternoon
- 1600-1700: V2221 Utilisation pratique des biomarqueurs en Insuffisance cardiaque / Practical use of Biomarkers in Heart Failure
- 1600-1700: V2222 Process Innovation, the Key to Leveraging the Full Value of Your Automation Investment
Tuesday June 23 Breakfast
- 0700-0800: V2301 Optimizing Patient Care in the Era of Precision Medicine: A Partnership between Medical Oncologists and Pathologists
Tuesday June 23 Afternoon
- 1600-1700: V2321 Reducing patient visits to the ER: A story of the epoc® Blood Analysis System and Edmonton’s EMS Community Care Program
- 1600-1700: V2322 Improving Turnaround Time Using Plasma Specimens in Clinical Chemistry
- 1600-1700: V2323 New Advancements in High Throughput LC-MS Solutions for Clinical Research Applications
- Review the importance of molecular testing in NSCLC.
- Understand the impact molecular testing has on treatment decisions.
- Discuss patient case studies to highlight the role of the pathologist.
Christian Couture, MD, MSc, FRCPC, Anatomopathologiste, Directeur, programme de résidence en anatomopathologie, Université Laval, Chef de service, anatomopathologie et cytology, IUCPQ (Hôpital Laval)
Why is Molecular Testing in Lung Cancer so Important?
Marie Florescu, MD, FRCPC, Hémato-oncologue, Centre Hospitalier de l’Université de Montréal
How Molecular Testing Makes a Difference: Case Review
Christian Couture, MD, MSc, FRCPC, Anatomopathologiste, Directeur, programme de résidence en anatomopathologie, Université Laval, Chef de service, anatomopathologie et cytology, IUCPQ (Hôpital Laval)
Q & A and Conclusion
At the end of the session, participants will be able to:
- Recognize classification and differential diagnosis of MPNs.
- Summarize the upcoming changes to the WHO classification of MPNs and the clinical implications of these changes.
- Discuss the progression pattern of PV.
Recent breakthroughs in identifying mutations acquired in myeloproliferative neoplasms (MPNs) are facilitating diagnostic accuracy and drug target discovery. This case-based symposium will review the proposed changes to the WHO classification criteria for MPNs with a focus on and how these changes are expected to impact the clinical management of MPNs, including diagnosis, treatment, appropriate follow-up, and outcomes.
Chair: Anna Porwit, MD, PhD
Professor, University of Toronto, Hematopathologist, Toronto General Hospital
Speaker: Hans Michael Kvasnicka, MD, PhD
Senckenberg Institute of Pathology, University of Frankfurt, Germany
At the end of the session, participants will be able to understand the benefits of analyte consolidation when optimizing their quality control program. This will be discussed through the first hand experiences of users in the UK, including the process undertaken to implement a new QC program in their laboratory and the key drivers for change.
Laboratories in the UK headed by Tony Dedman have been using Technopath Quality Control products since 2000 – a true third party control. Performance led to the subsequent implementation at other NHS laboratories. The Multichem™ range is human based and mimics the performance of patient samples. Multichem™ also adheres to the integrated solutions trend witnessed throughout the automated chemistry platforms of today. Analyte range includes a full menu for both chemistry and immunoassay offering benefits with respect to cost, efficiency and performance.
The main driver for change was a mandate to consolidate and improve workflow efficiencies. Reduced physical cost coupled with a reduction in staff time proved significant. Technopath allowed extended lot sequesters, reducing the frequency of target value establishment and associated costs. This presentation will review storage and delivery schedules customized for the laboratory in addition to the superior technical support received from Technopath.
The ability to capture and review generated QC Data on most software systems is relatively poor. Technopath IAMQC software allows the laboratory to become fully ISO compliant, with real time data capture with a powerful and fully customizable reporting feature. As a result the open flexibility allows users to satisfy all report requests from varied regulatory agencies. The presenter will discuss his experience using the IAMQC program with Multichem™.
Insight will be provided on Multichem™ analytes which are endogenous at levels appropriate for clinical use but are not mentioned on the appropriate kit inserts. Lastly the presenter will offer his vision for future products.
Tony Dedman was first appointed as a junior in 1980, then qualified and became licenced to practice in the UK in 1983 with a Fellowship in Clinical Biochemistry at the Institute of Biomedical Sciences (IBMS) in 1985. Tony has been a member of the LTG (formerly London Toxicology Group) since 1999, and Association of Clinical Biochemistry since 2000. For the past twelve years he has lectured in Pathophysiology and biomedical science at the University of Hertfordshire. He has contributed to the teaching profession as an assessor for the IBMS and Health Care & Professions Council (HCPC) for the award of Certificate of Competence and then HCPC registration and as an IBMS specialist portfolio examiner for immunology and clinical biochemistry. In addition, Tony was responsible for the implementation of CPA (UK) Ltd and later ISO15189 training programmes in a number of laboratories. Currently he is employed as Training Coordinator and Method Development Scientist at Homerton University Hospital. Tony is responsible for research and development and the incorporation of new methods into the routine laboratory such as teicoplanin, TB drugs, Fat soluble vitamins, antibiotics and antiepileptic’s primarily by HPLC, LCMS or GCMS. His current role includes commissioning a new GCMS system complete with thermal desorption to examine the potential of breath analysis as a diagnostic/prognostic tool in both primary and secondary care. His experience with chromatography techniques is contributing to the research for novel early biomarkers for Alzheimer’s disease for which he is currently completing a PhD at the University of Middlesex.
At the end of the session the participants will be able to understand the significant use of Designer Drugs and how best to detect them within their laboratory using advanced technologies.
Please join us to learn about advances in toxicology testing as well as New Psychoactive Substances trends and prevalence in various countries /regions in North America, Middle East, Latin America, Europe and Asia-Pacific. A special focus will be placed on the changing dynamics of Synthetic Cannabinoids use in North America. Other discussion points include the latest news on Designer Drugs, New Psychoactive Substances and Synthetic Drugs, and how the cutting-edge BioChip Immunoassay Array technology from Randox can assist your laboratory in detecting these ever changing drugs. A urine drug screen comparison study assessing the performance of multiple Drugs of Abuse (DoA) Arrays against the Liquid-Chromatography/High Resolution-Mass Spectrometry (LC-HR/MS) Orbitrap technology is presented. Join us to learn about the impact of this evaluation on the growing needs of today’s clinical laboratory including but not limited to automation, turn-around-time and cost-effectiveness.
Pankaj Sinha is the Business Manager for North America at Randox Toxicology and he manages the business operations for the company for the area. He has 15 years of experience in working for clinical and toxicology labs. He works with lab heads and health systems to understand the toxicology testing needs and trends. He works closely with the Research and Development teams at corporate Randox HQ to Upcoming drugs and New Psychoactive Substances (NPS) provide the most advanced solutions.
Dr. Cristiana Stefan PhD, is certified Clinical and Toxicological Chemist at the Centre for Addiction and Mental Health (CAMH) in Toronto, ON, Canada. She has wide expertise in drugs of abuse (DoA) testing and consultancy, apart from an ongoing interest in evaluating and implementing state-of-the art technologies in the clinical laboratory to ensure best patient care in a rapidly changing DoA market.
At the end of the session the participants will be able to participate in efforts by the laboratory to develop and support appropriate laboratory utilization, including collaborative efforts with physician and other healthcare providers.
Laboratory Utilization has historically been a issue that the laboratory has had to manage in isolation. This has invariably created a confrontational situation with physicians and other health care providers, and success has been limited and not sustainable. History has taught us that laboratory utilization is not driven by the laboratory and that physicians are the primary driver, thus realistic solutions must incorporate collaborative solutions involving the laboratory and physicians. Choosing Wisely Canada is a physician-initiated campaign focused on limiting low-value or unnecessary testing and treatments. This workshop will discuss the development of the initiative in Canada to date, including implementation and evaluation issues, as a potential vehicle by which the issue of inappropriate laboratory utilization can be addressed. Working together, the laboratory and physicians need to determine the best laboratory testing strategies that will provide the best patient care, maximizing positive clinical outcomes and minimizing negative clinical outcomes, while making best use of funding. The laboratory is positioned to provide the data relating to test utilization and test costs, informing collaborative laboratory and physician teams making recommendations. The laboratory can also play an important role in educating laboratory users on best practices and reinforcing positive action.
David W. Kinniburgh, PhD, FCACB, Director, Alberta Centre for Toxicology
Samuel Shortt, MD, PhD, FCFP, Vice-Chair, Choosing Wisely Canada
At the end of the session the participants will be able to guide their clinicians in efficiently prescribing NT-proBNP testing according to the recent Heart Failure guidelines recommendations from the Canadian Cardiovascular society.
The Canadian Cardiovascular Society recently updated their guidelines with a special focus on biomarkers. Establishing diagnosis and selecting optimal therapy for any patient are current challenges. In this update, the role of circulating biomarkers for the management of patients with HF are reviewed, with a focus on their role in monitoring for disease progression. In addition on supporting natriuretic peptide testing to rule-out HF and prognostication for known HF patients, a recommendation has been added for guided therapy management especially for patients aged under 75 years old. Finally, the importance of predischarge natriuratic value has been added to the recommendation supported by evidence of reduced readmission rate and death.
Dr. Anique Ducharme is an associate professor of medicine at Université de Montréal. She is also the founder and director of the Heart Failure Clinic at the Montreal Heart Institute (MHI) and a Senior FRQS Clinical Research Scholar.
Dr. Ducharme graduated from Université de Montréal in 1991 and completed her residency in cardiology there in 1996. She also received additional research and clinical training in echocardiography at the MHI (1996-1998). In 1999, she went on to study molecular biology, echocardiography and heart failure and trained under Dr. Marc Pfeffer and Dr. Richard T. Lee at Brigham and Women’s Hospital at Harvard Medical School in Boston. Since her return to the MHI, she has worked as a cardiologist with the team that uses non-invasive techniques (ultrasound, heart failure and transplantation). In 2009, she did a clerkship in advanced heart failure and mechanical circulatory support at the Cleveland Clinic Foundation under the supervision of Dr. David O. Taylor.
Dr. Ducharme has published over 80 peer-reviewed articles, 12 book chapters and 97 abstracts. She currently sits on the Executive Committee for the AVOID-HF and EARTH studies. She has been and/or is currently a member of many committees (Steering Committee and Endpoint Committee) for large-scale studies, such as STICH, AF-CHF, CANSAVER, EARTH, RELAX-AHF, MOXCON and CHARM. She has also sat on of a number of review committees for journals that include Circulation, Journal of the American College of Cardiology (JACC), Journal of Cardiac Failure, Journal of Heart & Lung Transplantation (JHLT), Canadian Medical Association Journal (CMAJ) and Canadian Journal of Cardiology.
At the end of the session, participants will understand the critical role of technology, culture and innovative processes to improve laboratory performance while maximizing the return on capital equipment investment dollars.
The most pressing concerns to many lab operations revolve around quality and turnaround time commitments. Successful labs understand that those two critical issues, and many others, are at their core, management issues. Automation and IT implementation are valuable tools in beginning to address shortcomings in those areas but at the end of the day, you can’t solve management issues with technology alone. A robust and innovative process surrounding technology implementation that leads to a change in culture is the main driver of sustainable improvements in your lab operations.
Sergio Sanchez Manchinelly, Sr. Manager Continuous Improvement Programs, Beckman Coulter
- Identify key factors for collaboration between pathologists and medical oncologists in accelerating targeted treatment.
- Inform on targeted molecular cancer therapeutics and identify the associated molecular diagnostics tools.
- How to efficiently implement and maintain precision medicine in clinical laboratories.
Significant advances in precision medicine have transformed cancer patient treatment. At the center of the implementation of targeted therapies lies the collaboration medical oncologists and pathologists. This session aims to highlight key success factors when integrating precision medicine into clinical practice.
Three speakers from disciplines at the forefront of precision medicine will be involved in this one-hour symposium. The session will end with a roundtable discussion.
Dr. Gerald Batist, Medical Oncologist. Chairman of the Department of Oncology, McGill University. Director of the McGill Centre for Translational Research in Cancer; Professor, Departments of Medicine and Oncology, McGill University
Dr. Leon Van Kempen, PhD., Chief Operating Officer and Scientific Director of the JGH Molecular Pathology Centre. Dept of Pathology, McGill University
Dr. Alan Spatz, Pathologist – Director, Department of Pathology, Jewish General Hospital; Director, Molecular Pathology Center at JGH; Director, X chromosome and Cancer lab, Lady Davis Institute, Professor of Pathology & Oncology, McGill University
At the end of this session, participants will be able to:
- Describe the structure of an EMS Community Care program and its role in reducing patient visits to the ER.
- Discuss the suitability of the epoc® Blood Analysis System to provide diagnostic testing within this program.
- Describe additional considerations for successful implementation of the epoc® Blood Analysis System in such a program.
Hospitals emergency rooms (ER) across Canada are experiencing a growing problem with overcrowding. To reduce ER visits Alberta Health Services recently introduced a new Emergency Medical Services (EMS) Community Care program in Edmonton which brings diverse medical services, including point-of-care testing (POCT), to continuing care facilities. The goal of the program is to provide rapid clinical & laboratory assessment in order to triage patients on-site and thereby decrease ER visits. This workshop will describe the implementation of the epoc® Blood Analysis System within this program. Topics that will be discussed include: (1) the structure and role of the program in reducing ER visits, (2) reasons for choosing the epoc® system over other POC devices, (3) validation of the epoc® system in the hands of nurse practitioners and paramedics, (4) additional implementation and post-implementation support provided by the central POCT office, and (5) current satisfaction of the program with the epoc® system.
Dr. Anna K Fuezery, PhD, DABCC, FACB, Regional Clinical Chemist, Alberta Health Services, Assistant Clinical Professor of Laboratory Medicine, University of Alberta
At the end of the session, the participants will be able to list the benefits and limitations of serum and plasma, and identify key questions to help determine whether conversion to plasma can help improve turnaround time while maintaining sample quality.
Improving turnaround time and laboratory process efficiency are important objectives for many laboratories. Turnaround time is also an important metric for clinicians, and a key measure of the laboratory’s service quality. A number of approaches have been used to improve turnaround time, and in clinical chemistry the choice of plasma vs. serum as sample type can have a significant impact. While specimens collected in serum tubes require time for the blood to clot, specimens collected in plasma tubes can be processed immediately to obtain plasma for testing. Serum and plasma have different benefits and limitations, and different underlying factors which influence sample quality. Understanding these factors will assist the laboratory in determining whether conversion to plasma can help improve turnaround time while maintaining sample quality.
Jeffrey Chance, PhD, is currently a Senior Clinical Scientist in the Medical Affairs department of BD Life Sciences – Preanalytical Systems. In this role, he is responsible for reviewing, designing and managing clinical evaluations of blood collection tubes, from initial feasibility studies through validation and regulatory submission. Dr. Chance joined BD after completing the Clinical Chemistry Postdoctoral Training Program at the Johns Hopkins Medical Institutions in 1999. He received his Ph.D. in Analytical Chemistry from McGill University in 1997.
- Understand the high-throughput LC multi-channel technology.
- Learn about the Q-Orbitrap mass spectrometry.
- Hear from a user’s experience on technology transfer for analysis of large sample volume to support clinical research.
Liquid chromatography (LC) coupled to mass spectrometry (MS) has become a reliable and robust analytical technique widely used in the clinical research and forensic toxicology fields. The growing volume of samples analyzed with LC-MS methods demanded high throughput analytical solutions. This workshop will present applications using an ultra-high throughput LC-MS system that provides 1 minute acquisition times for biological samples processed with simple sample preparation methods. Since chromatographic separation is very brief in high-throughput systems, selectivity is gained by using a high resolution mass spectrometer.
This workshop will present the design and functions of a high throughput multi-channel system along with principles of the ultra-high resolution mass spectrometry with focus on Thermo Scientific™ Orbitrap™ technology.
Examples of data acquisition experiments will be discussed, and examples of implementation in clinical research will be shown. A user’s experience will be presented discussing implementation of high-throughput LC-MS solution in supporting a large clinical research study for analysis of antiretroviral drugs in donors plasma samples.
Marta Kozak, Manager, Applications, Thermo Fisher Scientific, San Jose, California
Autumo Breaud, Clinical Laboratory Manager, Johns Hopkins Hospital, Baltimore, Maryland