Society News Now

Share Your Advancements That Bring Efficiency to the Clinical Laboratory

ASCLS is participating with the Clinical Laboratory Management Association (CLMA) on its Increasing Clinical Effectiveness™ (ICE) program designed to demonstrate positive contributions to the laboratory through increasing efficiency and value. Each year, CLMA collects abstracts that demonstrate these innovations and shares them with the laboratory community.

Health care is in the midst of unprecedented change, as it moves from a fee-for-service model to one that reimburses for value. This “volume to value” shift requires laboratories to re-think their approach to meeting the needs of their institutions or their agencies. This shift will require laboratories to broaden their focus beyond cost savings and operational efficiency to include measurable positive impact on patient outcomes.

Participate in ICE by submitting an abstract describing testing-related interventions and the quantifiable positive impact for patients produced. Winners will be recognized at CLMA's annual KnowledgeLab, March 26-29, 2017 in Nashville, Tenn. The highest rated abstract will also have the opportunity to present at the IFCC EuropMedLab 2017 in Athens, Greece, with paid airfare and registration.

Abstract submissions are due Friday, September 30. Abstracts should be 750 words or less across all four sections:

  • Statement of Problem or Background
  • Intervention/Study
  • Plan/Measures Data Analysis and Results
  • Discussion and Lessons Learned

If you have made important advancements to efficiency in the clinical laboratory field receive recognition for your contributions by submitting an abstract, sharing the results of your efforts and helping your peers learn from your experience.

Resources
Frequently Asked Questions
Library of Previous ICE Submissions
Program Requirements and Guidelines

Why do we need the ICE initiative?
In the USA, a shift in reimbursement is occurring from fee-for-service to value-based. Since the clinical laboratory represents only 3-5% of the national health expenditure, value cannot be impacted by focusing only on reducing laboratory costs. Therefore, it is imperative we shift our focus to clinical effectiveness to address the larger opportunity of waste that the IOM estimates at 30% of health expenditures.

What kinds of projects would meet the published criteria?
There are many kinds of projects that could meet the criteria. The current focus on reducing unnecessary repeat testing is an example if it can be clearly shown it is unnecessary and not just a means to save money. Data mining efforts that reduce the absence of follow-up testing associated with abnormal results is another example. Projects that increase the screening of appropriate adults for diabetes could be another. In each case, the key will be identifying appropriate outcome measures.

{/textblock_content}[/yee_text_block][/yee_column][/yee_row]

Clinical Laboratory Science Editor-in-Chief

Applications for editor-in-chief (EIC) for Clinical Laboratory Science are now being accepted.

The EIC provides leadership and direction that results in the publishing of a well-respected, peer-reviewed, scientific journal. The EIC develops and reviews manuscripts, organizes journal functions to maintain editorial integrity and evaluates and makes adjustments to the journal as appropriate. Applicants should be a member of ASCLS, have authored peer reviewed publications, and served as a section editor of the journal or a similar position with another journal.

Clinical Laboratory Science is the official journal of the American Society for Clinical Laboratory Science (ASCLS).

Interested applicants should review the complete job description.

The journal is published quarterly by Westminster Publishers and is listed in PubMed. Application can be made vie email by September 1, 2016 to ASCLS President-Elect Suzanne Campbell (suzanne.campbell@hotmail.com).

Society News Now, Special Edition, February 9, 2016

 
SNN Header

SPECIAL EDITION  February 9, 2016

NEW EXECUTIVE VICE PRESIDENT

The Board of Directors of the American Society for Clinical Laboratory Science (ASCLS) is pleased to announce the selection of James Flanigan as ASCLS Executive Vice President to succeed Elissa Passiment, who announced her pending retirement earlier last year.

James “Jim” Flanigan, CAE comes to ASCLS from the Society of Critical Care Medicine, where he was the Director of Marketing.  He is the chief revenue officer responsible for generating nearly 80% of the Society’s gross income through program and product marketing and membership programs as well as institutional and international sales and industry relations. 

Prior to joining the SCCM staff, Jim served as Director of Marketing for the American Veterinary Medical Association where he oversaw the association’s member, market and economic research as well as the AVMA’s public education campaigns and association-wide branding.  He is a 26 year veteran of the association management profession and a graduate of Iowa State University with a degree in Journalism and Mass Communications.

He received his Certified Association Executive (CAE) credential in 2013. 

Jim and his wife Kris have two sons.  He and his family, which includes two cats, live in Carol Stream, Illinois, a western suburb of Chicago.

Jim will be joining ASCLS March 1, 2016.  Elissa will team with Jim for a yet-to-be-determined period of transition.

The Board of Directors would like to thank the EVP Search Committee for their dedication during the search process.

Of course, the Board would also like to acknowledge Elissa’s dedication during her almost 21 years of service to ASCLS as our EVP and for her prior service as a Past President and member.  Elissa stated that she is looking forward to attending a national meeting with husband Joe and having time to socialize!

Barbara Snyderman

President

Dr. Tim Randolph receives the Alumni Humanitarian Award from the University of Illinois Springfield

 

Tim Randolph UIS 2015 Humanitarian

The University of Illinois Springfield honored the significant contributions of Dr. Tim Randolph during the university’s annual Alumni Gala on Friday, November 6, 2015 at the Abraham Lincoln Presidential Museum.

Dr. Randolph was honored with the Alumni Humanitarian Award for significant contributions of leadership or service to improve the lives of others and the welfare of humanity.

Dr. Randolph received a bachelor’s degree in medical technology 1983. He is a tenured associate professor and chairman of the department of Biomedical Laboratory Science, Doisy College of Health Sciences, at Saint Louis University Health Sciences Center. He is also founder and President of Randolph World Ministries, Inc., a medical mission ministry that establishes and develops medical services in existing clinics in Haiti.

Randolph World Ministries provides a full range of medical services to over 20 Haitian clinics by offering training, materials, consultation, and personal visits to each facility; conducting mobile clinics in remote areas of Haiti where healthcare is unavailable; developing and implementing small business start-up companies to elevate individual families and grow a local economy; providing emergency relief following natural disasters and other types of urgent needs.

Prior to his work with Randolph World Ministries, Dr. Randolph was employed as a medical technologist at Memorial Medical Center in Springfield. While earning his doctorate degree from Warnborough University, he developed a new diagnostic test for sickle cell anemia to be used in developing countries – a test which earned a U.S. patent.

A bizarre case of tapeworm-derived cancer causing cancer-like tumors in a Colombian man – Behind the scene story of the lab investigation

 

A bizarre case of tapeworm-derived cancer causing cancer-like tumors in a Colombian man – Behind the scene story of the lab investigation

A bizarre case of tapeworm-derived cancer causing cancer-like tumors in a 41-year-old Colombian man has got lot of media attention recently and emphasized again the role of laboratory analysis in complex case investigations. “The key for the diagnosis of this unusual case was combined use of various laboratory techniques – conventional pathology and advanced molecular biology, and synergy among clinicians, pathologists and lab scientists to solve this mystery,” said Dr. Julu Bhatnagar, Ph.D., one of the primary authors of the report published in the November 5 issue of the New England Journal of Medicine and Team Lead of the Molecular Pathology Section in CDC’s Infectious Diseases Pathology Branch (IDPB). http://www.nejm.org/doi/full/10.1056/NEJMoa1505892.

In 2013, doctors in Colombia asked CDC to help diagnose biopsies with strange pattern from lung tumors and lymph nodes of a HIV positive man who was non-adherent to therapy. The man presented with fatigue, fever, cough, and weight loss of several months' duration, and lung, liver and adrenal nodules and enlarged lymph nodes. “Initial histopathological analysis was very puzzling, as the growth pattern was cancer like, but the cells were about 10 times smaller than a normal human cancer cells and they were fusing together, which is rare for human cells. The question was if we were dealing with an unfamiliar, possibly unicellular, eukaryotic organism or rare type of cancer? So, it was decided to proceed for the molecular analysis of the tissue specimens.” Dr. Bhatnagar said.

“Every year, IDPB receives thousands of tissue specimens to provide assistance in investigations of infectious disease of unknown etiologies, unexplained illnesses/deaths and outbreaks; consequently, the Molecular Pathology Lab has uniquely developed more than 150 polymerase-chain-reaction (PCR)-based assays and other cutting edge techniques such as pyrosequencing, in-situ hybridization (ISH) and laser microdissection for the identification of wide-array of pathogens, including bacteria, viruses, parasites and fungi from tissue specimens. Since in this case, initial suspicion was on plasmodial slime mold because of syncytia formation, I started with some broad-range PCR tests targeting slime mold (Myxogastria) and other eukaryotes using DNA extracted from the tissue specimens. By gel electrophoresis of initial PCRs, I saw some faint bands of DNA (PCR products), I decided to make PCRs less stringent and repeated. This time, I got the bands of DNA that I was able to sequence. The result of sequence analysis was completely surprising, as the DNA sequences matched with Hymenolepis nana, a dwarf tapeworm. I could not believe my own results. I tried another PCR, this time specifically targeting cestodes. The resulting DNA sequencing showed 99% identities with Hymenolepis nana again. I searched the literature and interestingly found a case report from Dr. Olson’s group (Natural History Museum, London) related to H. nana infection that showed an image of similar tiny cells in a HIV-positive man.  Feeling more confident now, I sent the results to Dr. Atis Muehlenbachs, a pathologist handling the case, other pathologists of the group and Dr. Sherif Zaki, Chief of the IDPB. They were as surprised as I was. One of them actually predicted in advance and said, “This is really exotic -- case of the decade!” It was concluded after further review that the tiny cells in the lymph nodes of our patient was certainly very similar to the ones showed in Dr. Olson’s case report. Although there were some unanswered questions, Dr. Muehlenbachs quickly contacted doctors in Colombia and informed about the diagnosis. However, unfortunately, patient was in palliative care at that time and died 72 hours after the diagnosis. No specific treatment was attempted.”

“Even though the patient died, our investigation continued, as there was a question if we could actually localize H. nana DNA in those tiny cells to confirm that the cells originated from a tapeworm,” said Dr. Bhatnagar. “Dr. Zaki suggested attempting in-situ hybridization. I designed and prepared DNA probes using H. nana DNA that we amplified from the patient’s samples. Simultaneously, probes targeting human Alu DNA sequences were prepared. In-situ hybridization was attempted and this time showed what we were expecting - H. nana DNA probe signals were detected in the proliferative tiny cell clusters, while human Alu probe signals detected in the surrounding human tissue. So, this issue was resolved.”

“The next goal was to confirm the species and to obtain more information about the phylogeny,” Dr. Bhatnagar said. “For this, I tried hymenolepidid-species specific PCR targeting mitochondrial gene CO1 and sequenced the DNA obtained from the PCR products. This case had never seized to amaze us – the sequence was beautiful, but I found some gene mutations. I repeated the sequencing twice and the results remained the same. I shared the sequences with Dr. Muehlenbachs, and he almost jumped out of his chair. He thought the mutations were very similar to the ones that we see in human cancer. I could not agree more. All the papers that I read during my early training years while getting my Ph.D. related to the gastrointestinal tumor markers were coming back to mind.”

“Now, the big question was- if the tapeworm had the cancer or muteted geneS for cancer? We thought we could only get the answer by deep-sequencing of the whole genome of the H. nana. But, at that time, we did not have next-generation sequencing facility in our lab. Next day, Dr. Muehlenbachs and I was sitting in the office of Dr. Michael Frace, Ph.D., CDC’s Biotechnology Core facility to discuss about the project. He mentioned that comparative deep sequencing could be attempted, but could we get him DNA from normal H. nana control? Dr. Muehlenbachs contacted Dr. Olson and others to get us control DNA/tissue so that we can prepare specially treated DNA for deep sequencing. Deep sequencing of the specimens from the patient revealed 6 insertional mutations (5 associated with protein coding genes) and comparative analysis identified H. nana structural genomic variants that are compatible with mutations described in cancer.”

“To a certain extent, mystery solved for this case.” said Dr. Bhatnagar. “Still, there are several unanswered questions and I am optimistic that if experts of several different areas work together collaboratively, some day we will find all the answers and unravel many new facts.” However, Dr. Bhatnagar, who was previously involved in several interesting case investigations including Clostridium sordellii septic shock syndrome associated with medical abortions, has cautioned against reading too much from a single case investigation.