N° 4 – May 2018

IFCC President
The African Federation of Clinical Chemistry (AFCC)
and the International Federation of Clinical Chemis­
try and Laboratory Medicine (IFCC) have formalised
a new partnership with the African Society for Lab­
oratory Medicine (ASLM). On 17 March 2018, Dr. Ali
Elbireer, Chief Executive Officer of ASLM, met with
Prof. Howard Morris, President of IFCC, and Prof. Rajiv
Erasmus, President of AFCC, at the ASLM headquar­ters office in Addis Ababa, Ethiopia, and subsequent­
ly signed a Memorandum of Understanding (MOU)
to work together on specific collaborative projects
aimed at strengthening and improving the quality oflaboratory medicine in Africa.
“The ASLM has developed and lead an excellent pro­gramme to assist clinical laboratories across Africa
work towards accreditation in an innovative step­
wise manner. At each step these laboratories improve
the quality of their procedures to improve healthoutcomes for their communities. The IFCC is proud
to work in collaboration with ASLM to extend thisimprovement in quality clinical laboratory practice”
Professor Howard Morris, President of IFCC stated on
the importance of this MOU. AFCC President Profes­
sor Rajiv Erasmus stated “This is a unique opportunity
for the 3 organizations to come together and use theirstrengths to further advance the practice of laborato­
ry medicine and strengthen the laboratory–clinical in­
terface on the African continent”. He emphasized theneed for collaboration between these organizations.
“Over the course of its history, the IFCC has made out­
standing contributions to the fields of clinical chem­
istry and laboratory medicine in Africa,” said Dr. El­
bireer after the meeting. “ASLM is delighted to workwith IFCC and AFCC to continue advancing the field oflaboratory medicine in Africa and worldwide.”­scientists and management training for laboratory
directors, as well as training and preparation of lab­
oratories for accreditation. This will be done, in part,through support of distance learning programmes
and clinical and scientific conferences in Africa, andthe development and promotion of national refer­ence laboratories. In addition, the organisations will
work together to promote the value of laboratory
medicine in Africa as a means to improve the recog­
nition of clinical laboratories improving clinical out­
comes across the continent.
One major focus will be on proficiency testing. ASLM,
IFCC and AFCC will further collaborate with the diag­nostics industry to establish proficiency testing pro­grammes and ensure the availability of quality labora­
tory medicine diagnostics in Africa.
“A first priority will be continuing and expanding theexternal quality assessment programmes for clini­
cal chemistry in Zambia, with the hope that successthere provides a format to be expanded across other
African nations,” said Prof. Morris. “Over the longer
term, the focus will be on ensuring the sustainabilityof proficiency testing and external quality assurance
programmes.”Our primary activity has been, from the start, to develop educational materials for:a) high­sensitivity, contemporary and point of care cardiac troponin assays; andb) natriuretic peptide assays used in clinical practice. We have been successful in distributing over 5000
posters and mouse pads based on the initial TF­CB educational documents.
OUR GOALS FOR 2018 ARE AS FOLLOWS:Firstly, to develop publishable laboratory medicine, interdisciplinary, expert opinion materials and papers, aswell as present global workshops in collaboration with industry, clinical societies and other IFCC committees.
Our recent collaborative ‘Special Report’ paper with the AACC Academy: Wu AHB, Christenson RH, Greene DN,
Jaffe AS, Kavsak PA, Ordonez­Llanos J, Apple FS. Clinical Laboratory Practice Recommendations for the Use of
Cardiac Troponin in Acute Coronary Syndrome: Expert Opinion from the Academy of the American Association
for Clinical Chemistry and the Task Force on Clinical Applications of Cardiac Bio­Markers of the International

tional tables on the IFCC website addressing cardiac
troponin assay and natriuretic peptide assays basedon manufacturer claims and peer‐reviewed literature.
Our most recent posting addresses interference ta‐
bles for biotin and haemoglobin on car diac troponinand natriuretic peptide assays.

markers’ workshop will be held at the Chicago AACC
meeting on August 1, 2018.

Thirdly, we have started organizing materials for de‐veloping an ‘APP’ for cardiac troponin and natriuretic
peptide assays and their role in clinical decision mak‐ing for both laboratorians and clinicians.

Fred Apple, PhD, Chair C­CB
Hennepin County Medical Center
Professor, Laboratory Medicine and Pathology
University of Minnesota
School of Medicine Clinical Labs P4
Minneapolis MN, US

Fourthly, we have designed a ‘Clinical Scorecard Study’pertaining to hs‐cTn assays based on optimizing ruling

On behalf of the C‐CB, I thank the IFCC office for their
ongoing support as well as the generous financial sup‐port of our corporate partners.

IFCC welcomes a new corporate member: Timedico AS

Timedico A/S is a leading global developer of safe and reliable transportation systems for small clinical sam‐ples. Timedico is committed to the development, manufacturing and marketing of the patented invention TEM‐
PUS600® ‐ the internal transportation system designed for transferring small clinical samples in hospitals andrelated businesses. The system is fast, safe and dedicated. By enabling one‐touch handling and point‐to‐pointdelivery it provides a crucial reduction of the total turn‐around time and improves the treatment of the patientsand the efficiency of the hospitals.

News from the IFCC Website
JCTLM Newsletter for 2018 is now available
JCTLM is pleased to announce the publication of its 2018
Newsletter. Accompanying the distribution of the Newsletter
is a special report on the Commutability of Certified Reference
Materials, written by Greg Miller and Neil Greenberg.

by Andrew St John
Chair, IFCC C­VPLM
ARC Consulting, Australia
For many years laboratory professionals proudly made the claim that thevalue of laboratory medicine was demonstrated by the fact that 70% of
clinical decisions depended upon the lab. In recent years we have realisedthat this claim has very little foundation and we need to generate and pro­
mote more substantive measures of value. The case for a need to movefrom a focus on the costs of testing to one which is more value based was
documented by the IFCC Task Force on the Impact of Laboratory Medicine
on Clinical Management and Outcomes and is now widely acknowledged
throughout the profession and industry.
­

A third and somewhat different approach to determine value has just been formalised into the IFCC­WASPaLM
Committee for the Value Proposition in Laboratory Medicine (VPLM). It aims to address the problem that evenwhen we have tests accompanied by a substantial evidence base to support their effectiveness, experience
shows that this evidence often does not always translate into routine practice. In other words there are serious
problems with the implementation of new tests, a problem which exists in healthcare generally.
The value proposition concept has been borrowed from business and can be defined simply as a “statement that
describes the benefits of a service, to whom, and how the benefits can be delivered”. Translating that to laboratory
medicine and the use of a particular test, means that we must define the care pathway where the test will be used,
document the evidence, and measure the impact and outcomes on all the stakeholders including patients. In work
completed to date we have described a theoretical framework which lists all the key components of the value prop­
osition that need to be determined for a test to be clinical and economically effective. The most recent publication
describes the application of the value proposition to the implementation of high sensitive troponin testing.
The VPLM Committee will be working on extending the value proposition to several different tests and evaluating
the concept in laboratory sites. Another key task will be to assess the relevance and applicability of the conceptINTRODUCTION
The Malawi Association of Medical Laboratory Scien­tists (MAMLS) became a Full Member of IFCC during
2015. Shortly after joining IFCC, MAMLS expressed awish for support from IFCC to help develop the quali­
ty of laboratory medicine in Malawi.
A scoping visit by Graham Beastall took place in 2016,
in which particular needs were identified and speci­
fied in a detailed report.
In November 2017, after additional discussions at
the occasion of the IFCC WORLDLAB Conference in
Durban in October 2017 with the people concerned,
MAMLS issued a request for an IFCC DQCML work­
shop in Malawi.
Two major topics were listed in this application:
Training of Medical laboratory professionals
on quality process and practice.
Helping the society plan and strategize on
how to execute an EQA pilot project in Malawi.
The application was approved by the EMD Executive
Committee and DQCML started to prepare the visit
and assessed how best IFCC may assist MAMLS.

The programme for the visit was discussed in ad­vance with the following MAMLS’ members, whowere our hosts and extremely helpful and open in
the preparation and execution of this visit: Victor
Makwinja, MAMLS Interim President, Elias Chipofya,
National Representative, Humphries Malata, Training
and Education Technical Advisor to MAMLS council,
and Wakisa Kipandula, MAMLS project coordinator.
THE WORKSHOPS
The visit to Malawi took place from 26 February to
1 March 2018. The visiting team consisted of Egon
Amann, Graham Beastall, and Annette Thomas,
each of whom covered special topics for two (iden­
tical) workshops held in Blantyre at the College ofMedicine (Day 1) and Lilongwe, Malawi’s capital, at
the Kamazu College of Nursing, part of the Medical
Department (Day 3).
Day 1 and Day 3 were devoted for presentations andworkshops, divided into three sessions, including lec­tures on QC and EQA and a “Lessons Learnt” pres­entation given by Ronald Khunga who completed an
IFCC­funded PMEP at the EQA scheme run by neigh­boring Zimbabwe (ZINQAP).

Quality monitoringinadequate

management

Too intensive
Governmental control oflabsInternal quality control
not always correctly
appliedKnowledge gap frompolicy makers to labs
workers

EQA materials supply
document control

Missing freedom to act

Equipment maintenancenot done properly

being accredited

trustworthy

personnel­

For the interactive workshop “What is the best strategy to achieve compliance with QMS and QC requirements in the clinical laboratory?” the participants(38 in Blantyre and 16 in Lilongwe) were divided into
groups to discuss and articulate the most burning is­sues of clinical laboratories in Malawi.
THE LABORATORY VISIT TOUROn Day 2, five public sector District Hospitals (Zomba,
Machinga, Balaka, Ntcheu, and Dedza) were visitedalong the way from Blantyre to Lilongwe (The “Laboratory Visit Tour”), which allowed the visitors a deep
and detailed insight into daily routines, practices andissues of these rural, hospital­associated clinical lab­
oratories.
We were welcomed in all laboratories and shownaround. Questions were openly answered. Insteadof describing the impressions of each laboratory
separately, a selection of common themes (exam­ples) and situations are summarized:
Laboratories are very small in size, variety andnumber of assays and endowment.

reagents and QC
workload and must do
everything

government body plans –reality miss

No CAPA system in place

No real interest and pushfor EQA from government

Missing instrument
maintenance & servicing

Bad commitment fromsystemin­patients, and also (in smaller percentages)out­patients.
Phlebotomy areas were very small and not al­ways in good shape and hygienic standards.
No laboratory displayed a fully developed LIMS
system.
Some labs used a four­digit system to assign
and identify patients’ samples.
Most labs just used the patient’s name as ID.
Instrument maintenance and servicing is poor:
we saw often signs reading “Out of order since…”
Blood­group matching (in transfusion med­
icine) could often not be done, because fridges
and freezers were not in operation.
The labs often experience power outages.
Few have generators, and in case they have, diesel
may not be available.
Some labs have large battery packs, which al­
low to bridge power outages for instruments af­
fected for approximately four hours.

No glomerular filtration rates are measured.
Often QC/EQA could not be done since QC
materials did not arrive on time.
VISIT SUMMARY
This visit of IFCC officers by request of MAMLS was
extremely useful. MAMLS expressed their thanks andexplained that the two workshops have raised theirattention towards improved IQC and, even more im­portantly, towards implementing EQA schemes for all
tests being performed in Malawi.
So far, EQA is done by the National EQA instituteonly for Malaria, HIV and TB. MAMLS should inten­
sify their activities to the Ministry of Health towards
country­wide, general EQA schemes. In brief, such ac­
tivities should include, but are not limited to the fol­lowing strategic plan:
Develop an EQA establishment work place.

Raise attention to the EQA schemes by work­
shops or seminars.
MAMLS must influence the education curricu­
lum by highlighting the meaning of IQC and EQA.
MAMLS should influence the education cur­riculum by raising attention to risk management
tool, e.g. FMEA.
MAMLS should develop programs to enablelabs to “move up the Quality ladder” by applying
SLIPTA, SLMTA schemes.
The final goal must be to achieve accreditationaccording to ISO 15189.
The IFCC visitors would like to express their thanks
to MAMLS for this invitation to come to Malawi. We
wish you all the best in working towards (and reach­ing) these ambitious goals in the medium term.

SFBC, International Committee
Chair, Human Health Care Committee on Accreditation ­ COFRAC
Chair, IFCC Nominations Committee (2016­2017)
General Secretary of the International Francophone Federationof Clinical Biology and Laboratory Medicine (FIFBCML)
It was an adventure to reach India to attend the ACBI­
CON 2017 meeting after a long journey stopping in
Delhi airport in­between, currently the world’s num­ber 2 airport of the highest category. It is a gateway
with a mini­smart city.
I rested in a comfortable hotel for one night before
reaching the final destination. India has always beenhome to a wealth of cultural, social, and ethnic diver­sity across its 1.350 billion people. Its 29 states andseven union territories – many of which have popu­
lations larger than countries – vary widely in termsof their ecology, economy, and demography, all ofwhich impact health outcomes. Uttar Pradesh, India’s
largest state, with a population of more than 204 mil­lions, has among the lowest per­capita incomes in the
country. Infant and child mortality rates are especial­
ly high. Uttar Pradesh is also known as UP and it is
the most densely populated state in India. The state­es and was later renamed as Uttar Pradesh in 1950.
Lucknow is the capital city and home to the largest
number of Hindu and Muslim people.
For the first time in the history of its existence, thenational conference of the Association of Clinical Bi­
ochemists in India (ACBI) was organized by the de­partment of biochemistry, King George’s Medical
University, in Lucknow. A three­day conference wasattended by more than 150 very well­known scien­tists from India and abroad and by 800 delegatesfrom all around India to learn more about “Emerging
trends in Clinical Biochemistry: from Evidence based

Prof. Abbas Ali Mahdi and Dr. Bernard Gouget

Prof. MLB Bhatt, Honorable Vice Chancellor, King
George’s Medical University. Prof. M. Ferrari, IFCC
President, Prof. H. Morris, IFCC President elect, Dr.
G. Zubieta­Calleja (BO) together with Prof. Poormi­
na A. Manjrekar, KMC, Mangalore, President ACBI,
Prof. Rajeev R Sinha, General Secretary ACBI, Prof.
A.A. Mahdi, Organizing secretary ACBICON 2017, Dr.
Shivani PANDEY and Dr. Dilutpal SHARMA, joint or­
ganizing secretaries ACBICON 2017 took part in the
opening ceremony.
As in each year, with pleasure I met Indian friends
thousands of kilometres away from my home. Special

Arriving one day in advance, I had the privilege to be
invited to join the ACBI­EB members at the private
home of Prof. Abbas Ali Mahdi who took over as new
ACBI President during the inaugural function as suc­cessor of Dr. Poormina A Manjrekar. The dinner re­flected the lip­smacking royal cuisine, a real foodies’
paradise influenced by the Mughal touch!
The scientific program reflected several current
and emerging topics on: Vitamin D, neurological,
cardiovascular, respiratory, kidney diseases; role ofnutritional factor in health and disease, reproduc­tive biology, natural products and nutraceuticals,
life style diseases, molecular medicine, metabolic
disorders, biomarkers, environmental health/metal
toxicity, epigenetics, chrono­medicine, nanomedi­cine, cancer biology.
According to Prof. Praveen Sharma the conference
was graced by luminaries in the field of Laboratory
medicine that would provide enormous opportu­
nities for interaction among faculties, researchers,
students and clinicians. The first IFCC session washeld on Monday where Prof. H Morris described therole of Vitamin D and molecular actions across a va­
riety of biological systems; followed by Prof. T Ozben
who delivered her talk on Potential risk Predictors
for cardiovascular diseases and Dr. B. Gouget dis­cussing emerging trends in quality management. It
is clear that the laboratory services are currently at
the centre of attention regarding quality due to thewide ranging impact on patient care.
The second IFCC session on Tuesday started with
Prof. H Morris speaking on standardization and har­monization, Prof. T Ozben on Liquid biopsy as nov­el diagnostic and prognostic biomarker and myself
with a presentation focusing on the investigationof the cyber security paradigm and e­health. Indian
government is encouraging a pluralistic approach in­

me to visit the university, the IVD exhibition and to
discover the city of Nawabs along the bank of river
Gomti. We visited the Bara Imambara built in 1784,
the mysterious maze called Bhul Bhulaiya and we had
a glimpse on the Husainabad Clock tower, the Rumi
Gate and the Residency.
The conference was also an opportunity for the ex­changing of points of view and experiences between
ACBI, APFCB and IFCC in a friendly and professional
atmosphere. The IFCC delegation was invited to the
APFCB 2019 COC meeting. Prof. M. Ferrari, IFCC Pres­
ident, Prof. Abbas Ali Mahdi, ACBI President and Prof.
Praveen Sharma, APFCB 2019 President have pledged
to work together for the next Asian pacific federation
congress.” The participation of IFCC at APFCB 2019 is
aimed to strengthening the bilateral scientific dimen­sion of our engagement inside the international fed­
eration” said Prof. Praveen Sharma.
Prof. Abbas Ali Madhi, ACBI President, expressed also
his desire to make his country “the best partner in the
IFCC world”. Prof. Howard Morris said “I think we havea very good chemistry, we want to see India as one of
the foremost partners in IFCC”.
The two great federations have a historic relation­
ship, reinforced by the presence of the APFCB rep­resentative at the IFCC EB 2018­2020. Both sides willcontinue to enhance and to cooperate on issues ofconcern such as education, science and technology
cooperation, innovation in lab medicine related sec­
tors and youth exchanges. “Deepening the partner­
ship between India and IFCC is one of the most im­
portant and comprehensive bilateral engagements
marked by intense and frequent high­level exchanges
and deep cultural and scientific understanding” Prof.
Praveen Sharma commented, before formally inviting
all IFCC members to the 2019 APFCB Congress (17­20

This is the third in a series of articles regarding theefiting from this program. Approximately 40% of CCTC users are from emerging and developing countries.
As we presented earlier, the CCTC website contains a wealth of educational materials including a Question
Bank. The CCTC Question Bank is a compilation of multiple choice and Royal College of Pathology­United
Kingdom (RCPath) type of questions; the latter is in an essay format with multiple probing questions.
The questions were derived from multiple sources including:American Association for Clinical Chemistry
College of American Pathologists
American Society for Clinical Pathology
Association of Clinical Biochemists­UK
Personal collections [Carey­Ann Burnham and Christopher Doern (microbiology), Ronald Jackups andWilliam Lane (transfusion medicine), Allan Deacon (biochemical calculations), and Roy Peake (RCPath)]
Internally developed by more than 100 laboratory medicine professionals
All contributed questions were evaluated for correct­
ness and relevance by various groups of specialists
and peer­reviewed.
At the present time there are ~2500 questions in use
and we anticipate the addition of ~600 molecular di­agnostic questions by the end of 2018 (Table 1).
The Question Bank can be accessed via the CCTC web­site on a desktop computer or a mobile device.
Questions are grouped into courses and each course
is ranked in the order of difficulty as easy, intermedi­
ate or advanced (Figure 1).
Upon completion of a course, a certificate can be sent
to the user and/or mentor; it is an effective means
for individuals to assess their level of competence andTable 1

Types and Numbers of Questionsin the Various Disciplines

Clinical Chemistry & Immunology

740
370

Microbiology

390

Transfusion Medicine

190(available at the end of 2018)
Other

600
180

­

We encourage all trainees
in laboratory medicine andtheir mentors to take advan­
tage of this free resource andto register to gain access tothese materials by going toChair, Human Health Care Committee ­ COFRAC
Chair, IFCC Nominations Committee (2016­2017)
General Secretary of the International Francophone Federationof Clinical Biology and Laboratory Medicine (FIFBCML)
Currently 415 million people in the world are affected by diabetes. This
figure will increase to 642 million people by 2040 if nothing changes.
Type 2 diabetes represents 90% of the diabetes encountered worldwide,or around 372 million people. 12% of global health costs concern diabe­tes. While these figures are impressive, many pre­diabetics are not evennecessarily screened. Among the chronic diseases that are currently at
the heart of health concerns, diabetes is at the head of the list.
Mobile Health, defined by WHO as “medical and public health practice sup­ported by mobile devices, such as mobile phones, patient monitoring de­Bernard Gouget
vices, personal digital assistants (PDAs), and other wireless devices” offers
such as the graphene and gold patch, a very strong
new possibilities to improve monitoring of chronic dis­and flexible sensor that is positioned on the skin foreases and permit patients to take a more active role incontinuous monitoring of blood glucose levels. Google
their management. It can also contribute to the devel­
and Novartis are working on contact lenses using tears
opment of the predictive and preventative dimension
to measure blood glucose.
of medicine via patients who are experts in their dis­ease and ultra­connected.
We can also mention the artificial pancreas, com­
As shown by a study of the Fédération Francaise desDiabétiques (French Federation of Diabetics), 80% of
diabetics are currently equipped with smartphones
and tablets. While 25­34­year olds own most of them(63%), those above age 80 are not left behind. Twen­ty percent of them have both a tablet and a smart­phone. Among this 80%, half of patients have alreadydownloaded a mobile health application. This is animpressive result if it is compared to that for all chron­ic diseases, which drops to 15%. Diabetics do not justdownload these applications. They use them! Morethan half of diabetics estimate today that these appli­
cations are vital for managing their disease.
Efforts by clinicians and laboratory medicine specialists
are still ongoing to better understand the applications

prised of a blood glucose sensor that sends data toa terminal that contains a complex algorithm in or­
der to determine the best insulin dose to send to theconnected pump. Data are sent at the same time toa monitoring service in order to improve long­term
treatment.
Many applications can be found in the Apple or
Google Play Store. There are solutions to connect
the blood glucose meter to your smartphone to send
blood glucose values to the cloud. The data are thenorganized, prioritized and interpreted by healthcare
professionals or patients themselves. Electronic
blood glucose logbooks and rapid decision support
systems are available to adjust the insulin dose. Con­nected digital scales, tensiometers, physical activi­
ty sensors, and nutritional programs complete theits members via the Internet, especially the web ap­
plied to health, and all the new cutting­edge technol­ogies, including telemedicine. In diabetes, m­Healthdoes not substitute for the human relationship be­
tween the healthcare professional and the patient,
but improves and simplifies the management ofdiabetic patients, allowing them to live in an opti­
mal and independent manner. The more reliable,
more systemic monitoring of diabetes parameters
through m­Health is essential for more appropriate
interventions by the healthcare professional.
Large companies, such as Novo Nordisk and Eli Lilly,
are making investments for rapid innovation. Google,
an expert in Big Data, and Sanofi, which has the kno­
whow in the field of medical treatment and devices,of the disease. Only a few sizeable pharmaceuticalcompanies have not yet integrated Alphabet (Google)
into their strategy.
Laboratory Medicine has become systemic, whileconventional technology and the digital world havecombined to generate interdisciplinary progressthat revolutionizes healthcare. Faced with these
trajectories, active reflection on m­Health and bio­engineering becomes indispensable within the IFCC
to anticipate the scientific, technical, and humandisruption. New collaborations need to be estab­lished, not only with the GAFAM Big 5 giants, butalso with the pharmaceutical, biomedical device,and IT industries, to address the new challenges
and possibilities of digital health.

NEWS FROM REGIONAL FEDERATIONS AND MEMBER SOCIETIESNews from the Spanish Society of Laboratory Medicine
New Strategic Planof the Spanish Society of Laboratory Medicine
In its new Strategic Plan (2018­2020) the SEQCML proposes technological innovation and quality in thelaboratory as keys to improving clinical decisions
The SEQCML Strategic Plan 2018­2020 seeks to improve the visibility of Laboratory Medicine
The Society will enhance the scientific quality of its publications, with the goal of having its
Magazine indexedFree membership fees for new members will be introduced during their period of medical residency
to encourage generational change
Madrid, 15 March 2018 ­ The Spanish Society of Laboratory Medicine (SEQC ML) has prepared a new Stra­­ment of the National Health System (NHS), promoting excellence in scientific­technical activities, improving theperception by its members of Society activities, making the SEQCML visible in society in general and promoting
generational change.
QUALITY AND INNOVATION
In order to strengthen the value of Laboratory Medi­cine, the Strategic Plan focuses on quality and innova­
tion. “The best way to improve our scientific standards
is to open ourselves to the clinical aspects of the spe­cialty, participating in congresses of other specialties,
and collaborating with international societies for Labo­ratory Medicine, such as The International Federation ofClinical Chemistry and Laboratory Medicine (IFCC), The
European Federation of Clinical Chemistry and Labora­
tory Medicine (ELFM) and The International Council forStandardization in Haematology (ICSH)”, explains Dr. Ca­ballé. In this sense, one aim is to strengthen the ClinicalLaboratory Journal´s role in dissemination, as it includes
original articles as well as reviews and clinical guides
produced by the Society. The goal of this initiative is forthe magazine to be indexed; i.e. included in the Integrat­
ed Classification of Scientific Journals.

SEQCML at the National Congress

Another axis of the new Strategic Plan is to reinforce theprominence of its members. In the words of Dr. Francis­
co Antonio Bernabeu, vice president of the SEQCML, theaim is to “open up new options for improving their sci­
entific­technical training” and also the perception that
this would have of the excellence of the Society’s activ­
ities. Direct communication with members will also be
strengthened, with publications every two weeks on thewebsite and a biennial survey.

In addition, as an innovative element, the Strategic
ML
Plan emphasizes the importance of giving the SEQC
visibility in society in general. To this end, a seriesof actions are proposed that will begin with an update of the Society’s website and greater participation insocial networks. In addition, the SEQCML will be provided with “unambiguous signs of identity” via a seriesof documents, such as a Style Manual, Partner’s Manual, and training guides.
ML­“The SEQCML will use this free access as a means to encourage the training of residents. We must ensurethat there is a balance between the know­how provided by senior members and the freshness provided by
the new additions to the Society. Everything that favors these new additions will be welcome,” he concludes.

THE SEQC ML
ML) – founded in 1976 – currently includes more than 2,500­

by Sibtain Ahmed
Consultant Chemical Pathologist
Aga Khan University Hospital, Karachi, Pakistan

ruary 2018 with a collective participation of patients,
family members, health care providers and the gen­eral public.

and solidarity for the rare disease community. All theattendees and speakers actively participated in thiscampaign.

As the theme of this year’s event was ‘research’ acontinuing medical education (CME) programme wasconducted by the Department of Pathology and Labo­The seminar was moderated by Dr. Lena Jafri and theproceedings were officially initiated by a welcome
note by the service line chief of the department of

The next two presentations were by Dr. Sibtain
Ahmed and Dr. Hafsa Majid and were focused on Hy­
perphenylalaninaemia and Methylmalonic Acidurias
respectively explaining the spectrum of the disease,pathogenesis, aetiologies, diagnostic algorithm andappropriate treatments.
Dr. Sibtain emphasized the importance of differenti­
ating aetiologies of Hyperphenylalaninaemia to attainbetter patient outcomes.
Dr. Hafsa elaborated that Methylmalonic Aciduria
was a common biochemical finding in high risk pa­
tients suspected of having IMDs in Pakistan. She
discussed the utility of analyzing serum vitamin
B12, folic acid and plasma homocysteine in thesepatients.

access to various diagnostic tests and high cost oftreatment that are encountered as potential con­founders adding to the miseries of patients.
The evening was concluded with a fruitful panel
discussion headed by Dr. Salman Kirmani with thepresence of eminent paediatricians from leading
hospitals of the country and representative of Paki­
stan Paediatric association (Karachi chapter).
The discussion revolved around the need for advo­
cacy by all stake holders of the health of the chil­dren of Pakistan including physicians and the Gov­
ernment of Pakistan.
A formal refreshment programme followed whereparticipants had a chance to mingle with the experts
and share their views.

of the Pakistan Society of Chemical Pathologists
by Sara Reza
Quaid­e­Azam Medical College, Bahawalpur, Pakistan
The 9th Annual course of the Pakistan Society of Chemical Pathologists, CHEMCON
2018, was held between 23­24 February 2018, at Quaid­e­Azam Medical College,
Bahawalpur, Pakistan.
The conference was well attended by consultants and trainees of Chemical Pathology
from all over Pakistan. The conference started with the pre­conference workshop on“Blood gas analysis” conducted by Brig (R) Aamir Ijaz. The opening ceremony had a
special welcome from president PSCP, Prof. Asim Mumtaz. With a focus on patient’s
The new Centurion logo
health, the theme of conference was “From diagnosis to Patient’s care” and was pre­sented by the Head of Pathology Department, Prof. Asma Shaukat in her state of the art lecture.
After the inaugural session the honorable guests were entertained with a variety of recreational activities in­cluding the local Cholistani cultural show and visit to the majestic Palaces of Nawab of Bahawalpur, which is why
it is often known as the “Princely State”. Shields were distributed at the Gala dinner. These activities promoted
conference venue.
The conference addressed a variety of topics relevant to the main theme: diabetes mellitus, diagnosis & monitor­
ing update, enjoy your breakfast, evaluation of short stature­the right way, role of supervisors: FCPS training, pro­fessionalism and emotional intelligence. The sessions also provided a reflection on the role of supervisory skills inthis specialty. After the plenary session there was oral and poster presentations by the trainees.

ants exceeded one hundred.

Group photo of participants at CHEMCON 2018

was quite busy, with an extensive
programme. The Pakistan Societyof Chemical Pathologists has always
provided a good platform for dis­cussion of new ideas and exchange
of information.

Belgrade (SRB) – 23­25 May 2018
The Society of Medical Biochemists of Serbia takes pleasure in inviting you to the 14th EFLM Symposium for Balkan
Region being held under the title Neighbouring Countries: The Same Professional Aim.
The 14th EFLM Symposium for Balkan Region will be organized on 23­25 May 2018, during the XXI Serbian CongressChair of the EFLM Communication Committee
The use of error and uncertainty methods in the medical laboratory
Oosterhuis WP, Bayat H, Armbruster D, Coskun A, Freeman KP, Kallner A, Koch D, Mackenzie F,
Migliarino G, Orth M, Sandberg S, Sylte MS, Westgard S, Theodorsson E.
All authors are members of the Task and Finish Group on Total Error of the EFLM.
Clin Chem Lab Med 2018; 56: 209–9
This paper presents the consensus reached within the EFLM task group established after the 1st Strategic EFLM
Conference (Milan, 2014). The task of the group was to elaborate a proposal on how to use the Total Error concept
and how to possibly combine measures of bias and imprecision in performance specifications. The conclusionof the paper is that error methods are at the moment the most widely used methods for quality assurance andanalytical performance specifications in laboratory medicine and that error and uncertainty methods are comple­
mentary when evaluating measurement results in medical laboratories.
The EFLM Working Group on pre­analytical phase (WG­PRE) issued two more papers related to the manage­
ment of samples with haemolyis, icterus and lipaemia—continuing their effort towards the harmonization of thepre­analytical phase.
Practical recommendations for managing haemolyzed samples in clinical chemistry testing
Lippi G, Cadamuro J, von Meyer A, Simundic AM, on behalf of the EFLM Working Groupfor Preanalytical Phase (WG­PRE)
Clin Chem Lab Med 2018 doi 10.1515/cclm­2017­1104
The aim of this paper is to suggest a pragmatic approach for managing results of clinical chemistry testing in haemo­
lyzed samples, attempting to balance the need to produce quality laboratory data with clinical need to release thetest results. You can find here below a short summary of the main recommendations; however, a careful readingof the paper is highly advisable. 1. Always check the sample quality before testing; 2. Preferably use the automatic
assessment of the H­index; 3. If it is not available, visual assessment is allowed; 4. The H­index results should betransferred to the lab information system; 5. Define a standardized procedure to manage the test results in hemo­
lyzed samples; 6. Always use control materials to check the analytical performance of the H­index.
Local quality assurance of serum or plasma (HIL) indicesLippi G, Cadamuro J, von Meyer A, Simundic AM, on behalf of the EFLM Working Groupfor Preanalytical Phase (WG­PRE)
Clin biochem 2018 doi 10.1016/j.clinbiochem­2018­02­018
This article is aimed to provide an expert opinion about management of internal quality control (IQC) assessmentfor HIL indices. The Authors support the use of in­house prepared IQC materials with at least two different levels

Jun 20 ­ Jun 22

Istanbul, TR

Jul 2 ­ 4, 2018

Rome, ITMay 19 ­ 23, 2019

Barcelona, ES

Sep 11 ­ 13, 2019Panama, PA

Nov 17 ­ 20, 2019

Jaipur, IN

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Seoul, KR

May 16 ­ 20, 2021

XXIV IFCC ­ EFLM EuroMedLab ­Munich 2021

Munich, DEBelgrade, SRB
Madrid, ES
Erice, IT

Jun 5 ­6, 2018

Belgrade, SRB
Manchester, UK
Helsinki, FIMannheim, DE

Naxos, GR
Shanghai, CN
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Sep 26 ­Mannheim, DE
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Oct 30, 2018

Padova, IT
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La Paz, BO

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Division (CPD) of the IFCC
Starting in 2018, the Communications
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per year,ten editions of the
including two double issues.

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