Sunday May 10th 2020
17:00 – 18:00 Registration desk open and welcome drink for all participants both at the 12th floor of the L!ndner hotel; top floor with a dazzling view
20:00 Speakers dinner in town
Day 1 Monday May 11th 2020
09:00 – 09:05 Welcome and opening conference
chairman Henk Goldschmidt
co-chairman Stacey Walz
09:05 – 09:40 Anne Vegard Stavelin (Noklus, Norway).
General info on POCT
The Noklus quality system uses different tools to obtain harmonization and improvement: (1) external quality assessment for the pre-examination, examination and post examination phase to monitor the harmonization process and to identify areas that need improvement and harmonization, (2) manufacturer-independent evaluations of the analytical quality and user-friendliness of POC instruments and (3) close interactions and follow-up of the participants through site visits, courses, training and guidance (Harmonization activities of Noklus – A quality improvement organization for point-of-care laboratory examinations. Clinical Chemistry and Laboratory Medicine. 57: 106-114.) How is the problem of sample origin solved? What are the recommendations for quality? (Essential aspects of external quality assurance for point-of-care testing. Biochemia Medica. 27: 81-85.) What to do with discrepancies between POCT and CL?
09:40 – 10:15 Annette Thomas (Weqas, UK).
General info on POCT
How real is the support of an EQAS scheme in POCT? Let us go to real live and back to the basics. How good or bad is the quality of POCT? In general, in comparison with the central laboratory? Is it possible to measure POCT quality using minute whole blood samples? What can we demand and expect from non-laboratory workers? Are building checks possible and how can EQAS contribute?
10:15 – 10:45 coffee break
10:45 – 11:20 Kathy Freeman (Syn Labs, TDDS Labs, UK).
POCT quality in veterinary laboratory testing. One of Kathy Freeman favorite quotes is “Better to trust the man who is frequently in error than the one who is never in doubt.” As an inspired scientist Kathy has a broad view on veterinary sciences. Being a veterinary clinical pathologist she will enlighten us on the subject of biological variation within medical laboratory testing of many species, humans being one of them. Her current professional activities are being a clinical pathologist at SYNLAB-Veterinary Pathology Group, Exeter, UK, Veterinary Information Network Consultant, and member ECVCP Committee for Laboratory Standards and member Quality Assurance and Laboratory Standards Committee, ASVCP. The main question here is: what can we learn from each other? Where is the field of veterinary science with regard to quality compared to human medical diagnostics, and vice versa. The concept of biological variation and the battle between GUM and TAE is relevant in veterinary diagnostics as well? Is POCT common practice? How is the quality of POCT defined and regulated? All of this with a touch of brexit ….
11:20 – 12:00 Sharon Ehrmeyer (WU, USA).
Regulations and guidelines
POCT quality what the regulations say. More than 250 years ago, one of the founding fathers, Benjamin Franklin, published a yearly almanac that contained a collection of useful information and advice for the American colonists. Titled Poor Richard’s Almanack, it was one of the first bestsellers of America. For decades, Franklin’s almanac provided indispensable advice and encouragement to struggling settlers in the new world. Summoning that spirit, Dr. Sharon S. Ehmeyer has written The Poor Lab’s Guide to the Regulations, a plain-language discussion of the rules, requirements and regulations that govern medical laboratories, with a focus on US medical laboratories. Sharon will also report on a POCT global survey – state of the art, changes to improve, recently published in JALM.
Q: How to organize QC for POCT?
A: Ask Sharon
12:00 – 12:35 Sten Westgard (Westgard OC Inc., USA).
Training: bring your own case
Workshop “The future of Quality Control Testing in POCT”.
Sten explained: “Laboratories have not significantly modified their QC procedures for almost half a century. It’s time for laboratories to bring quality control into the 21st century and adopt more efficient, effective procedures. The Westgard rules have been used by laboratories around the world for many years, allowing the detection of both random and systematic errors, but application of full Westgard rules may not be necessary to maintain standards for highly reproducible, automated laboratory testing. If an assay is of sufficiently high quality, and suitably rigorous maintenance schedules are in place, then the risk of erroneous results is significantly reduced. In these cases, we can redesign QC testing strategies to reflect the reliability of the assay, freeing up staff time and other resources.” Sten is traveling the world – what is really new in quality thinking in laboratory medicine? Sten will conduct an interactive session that will give us an opportunity to form an opinion of what kind of QC should be used in POCT testing.
12:35 – 14:00 Lunch break
14:00 – 15:00 James Westgard (UW, USA).
Introduction to “The Right QC”, even for POCT? Being a rock star in the scientific area of statistics in laboratory medicine, Jim Westgard devoted much of his time to explaining the rules that have to be applied to guarantee an appropriate quality. He visited the Antwerp conference many times and in each meeting we learned a lot. But the ultimate challenge: how to define quality in a POCT setting; or does the setting not matter? The YouTube
presentation (https://youtu.be/qojpEVoTHCc) on EP23 gives maybe part of an answer …
Seeing the future from history (从历史中看未来) including rules for the new generation instruments.
15:00 – 15:30 Tea break
15:30 – 16:15 Ester Talboom – Kamp, Maarten Kok (TWIHC, The Netherlands).
What’s up? We have news!
Together we innovate health care with the acronym TWIHC is Esther Talboom – Kamp’s spin-off of the laboratory she is running. It does not sound very scientific but the way a test result is used defines the desired quality to a large extent. She knows as GP as well as director of the laboratory very well how to put the patient in the spotlight. Besides of that she has a neck for practical innovations and does not, primarily, bother about existing political structures. However being a senior scientist at the university of Leiden as well, she stresses the fact that innovations should be evidence-based. Maarten Kok speaks the language of medical laboratory diagnostics and can ease us into the far-fetched ideas of Esther. An inspiring Podcast (in Dutch) on BNR radio is worth listening to; it reveals many of the ideas behind TWIHC.
16:15 – 16:30 Westgard award ceremony
16:30 – 17:00 Westgard awardee Vanessa Ghislain.
Why is laboratory testing not flawless?
After obtaining a Master’s degree in biomedical sciences in 2002 (Vrije Universiteit Brussel), Vanessa Ghislain worked for 11 years as a scientific collaborator at the pathology department of the Brussels University Hospital. She started with executing, supervising and developing molecular biology assays dedicated to cancer diagnosis and therapy, mainly FISH (fluorescent in situ hybridization). As from 2009 an ISO 15189 accreditation for molecular testing became mandatory, she took on the role of quality manager of the department. Later on, she started performing dissection of routine surgical pathology and biopsy specimens. She was also involved in several research projects of molecular oncology and reproductive medicine.
In 2013, she joined the former Institute of Public Health (WIV-ISP), now Sciensano, to work as a scientific collaborator at the Department Quality of medical laboratories. As coordinator of the national external quality assessment (EQA) program for the Belgian pathology laboratories, she is now responsible for the execution and development of quality assessment schemes in the field of pathology.
Quality of laboratories
EQA for histopathology and immunohistochemistry
Pathology and molecular pathology
EQA programs have become imperative to give confidence in the quality of laboratory testing and to ensure delivery of consistent and accurate results that, ultimately, impact a patient diagnosis. They enable laboratories to evaluate their performance and methods compared with that of their peers or with the whole laboratory community.
This report provides an insight into the Belgian EQA program for the immunohistochemical assessment of HER2 expression, estrogen receptor and progesterone receptor status in breast cancer.
17:00 – 17:05 Closing
Evening prgram at Restaurant August a former cloister of Parisian nuns
19:00 – 23:45 Reception and dinner
Admission only with a dinner ticket
The dinner speech will address The Quality of Life by Strahinja Medić (VetLab doo, Belgrade, Serbia)
Quality of life is put in the spotlight! Laboratory medical diagnostics contributes to the quality of our life. Can this be increased and in what way? Is genetic testing a blessing or a curse? Is POCT a blessing or a curse?
Jules Bordetstraat 5
A former Augustinian cloister becomes a modern-day sanctuary under the guidance of legendary Belgian architect Vincent Van Duysen. The August site is a combination of five buildings. The biggest challenge for Van Duysen and his team was to link them together in an optimal way without falling foul of heritage restrictions. The nuns’ former private chapel will be the main lounge and bar area.
There are two terraced townhouses with gardens adjacent to the site, one of which will accommodate a spa complete with an outdoor swimming pool with its own filtering reed bed. The building behind the chapel, which was the nuns’ living quarters, will contain most of the guestrooms, the kitchen, and a guests’ library.
Day 2 Tuesday May 12th 2020
09:00 – 09:05 Opening: back to business
09:05 – 09:35 Stacey Walz (Arkansas State University, USA)
Q: How to proceed with POCT?
Stacy Walz is the Chair of the Clinical Laboratory Sciences program at Arkansas State University.
Understanding Analytical Characteristics and Their Impact on Cardio Clinical Care with Cardiac Troponin Assays POCT as well as from the centralized laboratory, will be commented on.
A: This power girl is very well able to enlighten us on her ideas upon the US POCT situation. Is home testing the future? What kind of tests is and will be offered by Walgreen? A review of POCT risk management is constructed. Risk meaning what are the changes that the POCT is wrong as opposed the central laboratory testing (Point Of Laboratory Testing versus Point of Care Testing). Risk of damaging the patient’s health through POCT because it took to long to get the answer.
09:35 – 10:00 Oral poster presentation
10:00 – 10:30 Coffee break
10:30 – 11:10 Ivan Brandslund (SDU, Denmark)
We have more news!
The solution we never thought ourselves but Ivan did!
Thinking outside the box is a rule of life for Ivan. Next to that he is an inspiring and challenging colleague. From his point of view is POCT not really a need for in Denmark because his lab processes samples extremely fast. Why is POCT fake news? Or isn’t?
11:10 – 11:30 Huub van Rossum (Antoni van Leeuwenhoek hospital,
Amsterdam, The Netherlands)
The moving average (MA) method is one of the oldest in QC in LM: can it be applied to POCT as well? Let us ask one of the experts. Huub van Rossum is member of the IFCC working group on the subject and will share his ideas.
New insights in the understanding and practical application of patient based real time quality control also known as moving average quality control (MA QC) have been obtained. MA QC differs in several ways from statistical internal QC and combining both techniques allows improved analytical quality assurance and a more (cost-) efficient QC plan. Challenges for laboratories are how to obtain proper laboratory specific settings and how to operate MA QC in routine practice. Recently tools and documentation that addresses these issues has become available for medical laboratories, amongst others via an IFCC working group. In what way can MA QC be of value for POCT testing especially because the quality control materials in current use are far from the nature of patient materials? Is here an opportunity available?
11:30 – 12:00 Industry view on POCT quality, John Y Pacheco, (BioRad, USA)
How does industry regard POCT, just another segment or the paved way to the future? QC on POCT is a new challenge! Patient outcomes depend on accurate test results that depend on operator proficiency. The calibration issue is addressed. BioRad lecture: Peter Deman, pending
12:00 – 12:30 Christian Schoenmakers
(Elkerlick hospital, The Netherlands)
And how about the patient?
POCT in a broader perspective; a patients’ view. The relationships between the various fields in medical care with regard to laboratory diagnostics are discussed. Christian is a registered clinical chemist but also chairman of the medical board of the hospital he is working. In the past he ran a program that patients allowed medical laboratory testing on their own initiative. So in a way he has personal experience in various lines of medical care. How does POCT fit in here? What is the minimal quality? What are the logistics needed? He will elaborate the paper “Point-of-Care vs Central Lab ‘Discrepancies”: Getting the message across” (Robert Moran, JALM, Febr. 2017), based upon his own experience. It is clear that the role of the clinical chemist has to change. Not only the commutable quality has to be accounted for but much more the quality of the laboratory test result is defined as how well it fits the context of the patient. POCT: curse or blessing for the treating physician and his / her patient?
12:30– 14:00 Lunch break
During the break the scientific advisory board as well as the board of recommendation will meet.
14:00 – 14:30 Gilbert Wieringa (NHS, UK)
NHS, Brexit and POCT quality supporting clinical decisions. Can POCT be performed within a network of healthcare services? Are there specific quality specifications to be fulfilled? Why is a good POCT creatinine not in use? Is that due to analytical quality, costs, medical diagnostic value or something else? How to qualify the employees and management involved in POCT? Does a register of medical specialists safe the profession or is this just a common requirement?
14:30 – 14:50 Oswald Sonntag (Technopath, DE)
Independent QC and POCT: a contradictio in terminis? Oswald will present his view on quality within the field of POCT, which quality supporting products (also from Technopath) are available and sensible.
14:50 – 15:15 Industrial and scientific snapshots
Technopath in cooperation with Oswald Sonntag will present on their quality supporting products.
Finbiosoft in cooperation with Tommi Hirvonen will present two subjects.
Validation Manager: From Excels towards a brighter future: How to ensure quality and save time in validation and verifications studies by using Validation Manager to collect your verification data, analyze the results with the latest CLSI protocols and create standardized reports automatically. Introduction to Validation Manager software service along with customer experiences from around the Europe.
EQA Manager: From Excels towards a brighter future: How to ensure quality and save time in quality assessment rounds by using EQA Manager to keep up with your EQA rounds with total visibility to the state of each round, required corrective actions and overall performance. Introduction to EQA Manager software service and how it can help your laboratory manage your EQA rounds effectively.
15:15– 15:45 Tea break
15:45 – 16:15 Snežana Jovičić (Center for Medical Biochemistry, Belgrade, Serbia)
Let’s get practical. The quality evaluation of smartphone applications for laboratory medicine was performed by an EFLM working group. Their conclusions were devastating: apps designed for patients, are of the poorest quality, considering the total quality of the content and information they provide, estimated using the MARS tool. This estimation needs to be validated for laboratory medicine apps, and eventually modified after consideration of specific quality benchmarks. However this trend is unstoppable …. so how to deal with these quality issues?
16:15 – 16:30
Let’s get practical once more, pending
The story of the APS chart enabling the calculation within the medical laboratory of APS (Analytical Performance Specifications, see the summary of the conference of 2018 for details). Ina Mathilde Kjaer is working on her PhD thesis under the supervision of Ivan Brandslund. At the 2018 edition of the Quality in the spotlight meeting in Antwerp she presented an energetic lecture on how the principle of biological variation and error budgeting was put into the practice of medical diagnostics. She showed us a flow chart that was introduced on the medical wards. Now, after two years we would like to now the status of this project. Did it die or did it survive? Can one use this cart also in POCT situations?
16:30 – 16:45 Conference statement
Based upon an historical overview of POCT developments especially with regard to quality. What are the analytical, logistical and financial desired specifications?
16:45 – 17:00 Closing remarks
17:00 – 17:30 Social gathering