The Newsletter of the Asia-Pacific Federation for Clinical Biochemistry andLaboratory Medicine for circulation among APFCB and IFCC members only

APFCB News 2023 Issue 1
Publication Team, 2023 Issue 1

APFCB Executive Board and Chairmenof Committees, Elected 2023

Chief Editor

Prof. Pradeep Kumar Dabla,
INDIA

Executive Board

Past Chief Editors

Dr. Raja Elina Raja Aziddin,
MALAYSIA

PresidentCEO, RCPAQAP

Prof. Praveen Sharma,
INDIA

Editorial Members

Dr. Tony Badrick
Faculty of Health Sciences andMedicine, Bond University, Australia

Dr. Joseph B Lopez,
MALAYSIA

Immediate Past

Dr. Endang Hoyaranda

President

Prodia Group, Jakarta, Indonesia

Dr. Leslie Lai, Kuala lumpur,
MALAYSIA

Vice-President

Dr. Samuel Vasikaran
Consultant Chemical Pathologist,

Prof. Damien Gruson,
BELGIUM
Prof. Ryunosuke Ohkawa,
JAPAN

PathWest-Laboratory Medicine,
Western Australia
Secretary

Former Professor and Head, Dean

Prof. Mingma Lhamu Sherpa,
INDIA

Research Biochemistry at AIIMS,
Jodhpur, India

Prof. Deepak Parchwani,
INDIA

APFCB MembershipCouncil Members

Prof. Praveen Sharma

Editor-in-chief, Indian Journal of
Clinical Biochemistry
Treasurer

Dr. Raja Elina Raja Aziddin
Senior Biochemist and Head of the
Drug and Research Laboratory,

Australasian Association of Clinical Biochemists (AACB)
Association of Clinical Biochemists of India (ACBI)
Association for Clinical Biochemistry, Sri Lanka (ACBSL)
Chinese Society of Laboratory Medicine (CSLM)
Chinese Association for Clinical Biochemistry, Taiwan (CACB)
Hong Kong Society of Clinical Chemistry (HKSCC)
Indonesian Association for Clinical Chemistry (IACC)
Iranian Association of Clinical Laboratory Doctors (IACLD)
Japan Society of Clinical Chemistry (JSCC)
Korean Society of Clinical Chemistry (KSCC)
Malaysian Association of Clinical Biochemistry (MACB)
Mongolian Association of Health Laboratories (MAHL)
Nepal Association for Medical Laboratory Sciences (NAMLS)
Pakistan Society of Chemical Pathologists (PSCP)
Philippine Association of Medical Technologists (PAMET)
Singapore Association of Clinical Biochemistry (SACB)
Thailand Association of Clinical Biochemists (TACB)

Chairmen of Committees

Vietnamese Association of Clinical Biochemistry (VACB)

Laboratory Management

Affiliate Members
Chinese Association of Clinical Laboratory Management (CACLM)
Association of Medical Biochemists of India (AMBI)
Macao Laboratory Medicine Association (MLMA)
Nepalese Association for Clinical Chemistry (NACC)
College of Chemical Pathologists of Sri Lanka (CCPSL)
Philippine Council for Quality Assurance in Clinical Laboratories(PCQACL)

Corporate Members
Abbott Laboratories (Singapore) Pte Ltd.
Beckman Coulter Hong Kong Ltd.
Becton Dickinson Holdings Pte. Ltd.
Bio-Rad Laboratories (Singapore) Pte Ltd.
DiaSys Diagnostic Systems GmbH
Roche Diagnostics Asia Pacific Pte Ltd.
Siemens Healthcare Pte Ltd.
Snibe Diagnostics
Sukraa Software Solution Pvt Ltd.
Sysmex Corporation
RCPA QAP
Thermo Fisher Scientific

Waters Pacific
Greiner Bio-One Singapore Pte. Ltd.
Quidel Ortho

Kuala Lumpur, Malaysia
Corporate Representative

Dr. Douglas W. Chung
Area Marketing Manager Asia
Pacific, Core Diagnostics at Abbott
Laboratories

Communications andPublications
Education

Prof. Pradeep Kumar Dabla,
INDIA
Dr. Cui Wei,
CHINA
Dr. Tjan Sian Hwa,
INDONESIA

ScientificDr. Tze Ping Loh,
SINGAPORE

Congress and Conference

Dr. Woei-horng Fang,
TAIWAN

Submissions
The APFCB News welcomes suitable contributions for
publication. These should be sent electronically to the Chief
Editor. Statements of opinions are those of the contributors
and are not to be construed as official statements, evaluations
or endorsements by the APFCB or its official bodies.
Contact email: afpcbofficial@apfcb.org
Cover page: A Bunch of Ripening Bananas with Flower Bud Still
Attached, in my Home Garden created during the first week ofthe lunar _Year of the Rabbit Contributed by Dr. Tan It Koo,
Founding and Past President APFCB

Address
The registered address of APFCB is as follows:
APFCB, c/o Solid Track Management Pte Ltd. 150 Cecil Street,#10-06, Singapore 069543

APFCB News 2023 Issue 1

Contents
From the desk of Chief Editor - Prof. Pradeep Kumar Dabla

01

Message from APFCB President - Dr. Tony Badrick

02

APFCB Activities 2023
Welcome APFCB Executive Board

03

Welcome APFCB Communication & Publications Committee (C-CP)

08

Welcome APFCB Congresses & Conferences Committee (C-CC)

10

Report APFCB Education & Laboratory Management Committee (C-ELM) -2022

12

Report APFCB Scientific Committee (SC) – 2022

14

Report APFCB Congress & Conferences Committee (C-CC) – 2022

16

Report APFCB Communications & Publications Committee (C-CP) -2022

18

Member Societies - Annual Activities Reports
Association of Clinical Biochemists of India (ACBI)

21

Chinese Association for Clinical Biochemistry (CACB)

34

Hong Kong Society of Clinical Chemistry (HKSCC)

37

Japan Society of Clinical Chemistry (JSCC)

39

Indonesian Association of Clinical Chemistry (IACC)

41

Malaysian Association of Clinical Biochemists (MACB)

43

Association of Medical Biochemists of India (AMBI)

46

Young Scientists Column
IFCC-Task Force Young Scientists (TFYS) at ACBICON 24th - 26th November - 2022 New Delhi, India

49

IFCC Global Medicine Week & IFCC TFYS

51

Young Scientist Interview

53

Industry Voice Section
Announcement on Corporate Appointments to the Committees and Working Groups

55

Sigma Metrics for Vitros Acute Care Assays from Asia-Pacific Region

57

Advancing Women’s Health Key Takeaways from AOGIN - 2022

64

APFCB News 2023 Issue 1

Expert Opinion Paper
Artificial Intelligence and Laboratory Medicine at the Crossroads of Value, ethics, and Liability

69

Comparative Analysis of COVID-19 Image Processing with X-ray and CT scan71

Accreditation of Medical Laboratories as per ISO 15189 - New the 4th Version Changes
From 2012 – 2022

81

Special Report
ACBICON, Assessing AI Technologies and Ethics in Healthcare Services – 2022

84

The Learning Lab for Laboratory Medicine

90

Newborn Screening Innovation Ramps up at Murdoch Children’s in Australia

92

In a Taiwan Clinical Lab, Molecular Consolidation offers key Benefits

96

Quiz Section

99

Quiz Answers

102

Painting Story

103

My Acrylic on Canvas Painting of a Bunch of Ripening Bananas with Flower Bud Still Attached, in
my Home Garden created during the first week of the lunar "Year of the Rabbit"

APFCB News 2023 Issue 1

From the desk of Chief Editor
My Dear Colleagues,
It is with my utmost pleasure to present you the 1st issue of APFCB eNews, 2023. APFCB being
one of the largest organisation of laboratorians in the south east region and as a prominentscientific organisation is always committed to promote science and education for the clinicalProf. Pradeep Kumar Dabla
Chief Editor, APFCB eNews

biochemists.
Thus, with the rise of year 2023, the new APFCB Executive Board (EB) took over the charge thatfurther led to giving me the baton of Chair APFCB C-Communication & Publications (C-CP) &Chief Editor APFCB eNews. Though, every position always comes with the greater responsibility.
So, we the Team C-CP, first faced the challenge to publish APFCB eNews in limited time which iscommittee’s one of the foremost responsibilities. Thus, we took the challenge and with the helpof APFCB members societies, EB & Industry partners, we are pleased to present this current
eNews.
is featuringtoMember
society’s Khosrow
Annual Reports,
new EB & Committees,
IThis
takeissue
this opportunity
thank Professor
Adeli andWelcoming
IFCC for contributing
a report on
AnnualReports
2022,
Industry support.
Voice, Technicalreports.
theactivities
of Committees
the IFCC andending
for their
continuous
A specialarticles
thank andyou Special
to Dr. Graham
No needmention that
contributions
and showcasing
work in education
& lab
White
fortocontributing
anthe
articleentitled “Hitchhikers
Guidetheto good
Measurement
Uncertainty
inmedicineLaboratories”
by APFCB member
Societiesof theprime
objectivesof APFCB
eNews. The same
Medicalwhich willserve isas onea veryusefulguide
to medical
lab professionals.
is complemented by the technical articles from industry partners and experts featuring Newborn
Also
includedin this issue
are reportson thevariousfor
activitiesof theAPFCB.
The committees
will
screening,
Molecular
consolidation,
Sigma
metrics
acute careassays,Artificial
Intelligenceinseeachangeinchairsandmembership
in
early
2023.
To
createawarenessandencouragealab medicine and Medical lab accreditation ISO 15189: 2012-2022.
culturesustainability
the medicallaboratories,
new GreenPatchsectionWe are ofalsothrilled to in
introduce
Young
Scientists acolumn
for thefirsttime hasby beengivingaddedthemtothis issue.
My thanks
to alltheircontributors
as wellasdoneto corporate
members
and those
who
have
exclusive
space,
to present
opinion andworkwith future
perspectives.
They
are
the
contributed
educational
articles.
My sincere
thank you also
to Dr Tan Koon who has
future leaders
and ready totake charge
with responsibility
and goesinnovation.
generously
histhatpainting
for the coverof the APFCB
these years.
In addition,shared
we hopethe modified
Quiz sectionin theNews
form allof ClinicalCase Discussion with
the investigations, graphs, pictures and relevant queries will be enjoyed by the readers.
As this is the last issue with me as Chief Editor, I would like to express my gratitude to everyone
At the end, no words would define the appreciations for the support rendered by the “TEAM
who had rendered their kind support and assistance towards making the publication of the APFCBAPFCB” to make this publication a reality.
news from 2020 to 2022 possible. I take this opportunity to also thank the editorial board and
C-CP team for their dedication and hard work throughout the whole three years.
Best Wishes
Thank you once again and may 2023 be a good year for everyone!
My vest wishes to all,Team APFCB C-CP
Prof. Pradeep Kumar Dabla
Chief Editor, APFCB eNews

1

APFCB News 2023 Issue 1

Message from APFCB President
President, APFCBThe APFCB is trusted organisation with a long history of service and distinguished leadership.
The new Executive Board will humbly strive to build on the legacy of previous Executive Boards
and leaders to build the reputation and capabilities of the APFCB.

Dr. Tony Badrick
President, APFCBOur goals are:


To engage with a member organisation to provide to the APFCB a cost effective secretariat that can provide resources
to manage key records and documents, assist with communication within the APFCB, and improve the efficiency of
the Executive Board, Committees and Council

To prudently manage and invest the financial resources of the APFCB

To develop succession plan for the Executive Board and Chairs of committeesTo increase the frequency and effectiveness of Council meetings

To implement the Strategic Plan and modify it as necessary to ensure it remains relevant and valuable to the APFCB
members

To focus the educational activities on webinars and our website to democratise this Knowledge

To provide opportunities for young scientists to present and learn

To work with Corporate members to develop educational programs and return value to this important groupTo focus the scientific and educational activities on regional priorities

To establish a greater international profile for the APFCB

To work closely with the IFCC and member organisations to improve laboratory practice in our Region

Best Wishes
President,
APFCB
President,
APFCB
Dr Tony
Badrick
Dr. Tony
Badrick

2

APFCB Activities

APFCB News 2023 Issue 1

Welcome APFCB Executive
Board
Welcome Note
I would formally like to welcome the member of the new APFCB Executive Board. As agroup we have worked together for many year as Committee Chairs so we share apassion for developing the APFCB. I would also like to welcome the new Committee
Chairs. The majority of the visible work and progress of the APFCB depends on this groupof people. I thank you for your support and hope you find the next few years rewarding
personally and for the laboratory professionals of this enormous Region we serve. I
would also like to thank the previous Executive Board for their leadership andcommitment to the APFCB through some very difficult years.

MEET OUR TEAM

Dr. Tony Badrick
President

B. App SC, BSc, BA, M Lit St (Math), MBA, PhD(QUT), PhD(UQ),FAIMS, FAACB, FACB, FAIM,
Member Aust Math’s Soc, FRCPA (Hon), FFSc(RCPA).
He was Associate Professor, Faculty of Health Sciences and Medicine at Bond University
for 4 years before becoming the CEO of the RCPAQAP in 2015. He is a visiting Fellow at
the John Curtin School of Medical Research at the Australian National University, also atAustralian Institute for Health Innovation Macquarie University and an honorary
Associate Professor in Biomedical Science at Bond University and an honorary Associate
Professor in Biomedical Science at Bond University.
He was President of the Australasian Association of Clinical Biochemists (2003- 2007), is
Chair of the Education and Laboratory Management Committee of the Asian PacificFederation of Clinical Biochemistry, Vice President of the Australian Institute of Medical
Scientists and currently the deputy Chief Examiner and Chair of the Faculty of Science of
the Royal College of Pathologists of Australasia

3

APFCB News 2023 Issue 1

APFCB Activities

Dr. Endang Hoyaranda
Vice-President
Prodia Group, Jakarta, Indonesia

Indonesian citizen, 65 years old, educated as Bachelor of Science in Pharmacy, andPharmacist at Bandung Institute of Technology, Indonesia
Appointed as the President Director of Prodia Group Holding Company in 2009, which
has currently 6 health operating business entities (Prodia Clinical Laboratory, Prodia theCRO, Prodia Occupational Health Institute, Prodia Stem cell, Prodia Diagnostic Line andProdia’sInnovasi Diagnostika
Previously she was the Operation Director of Prodia Clinical Laboratory in 1990 and
President Director of Prodia Clinical Laboratory for the period of 2002 to 2009
She actively engaged in various academic & associations’ activities such as lecturer inmanagement, entrepreneurship and ethics at Hasanuddin University and the Health
Polytechnic and Vice Chairman of the Indonesian Institute for Laboratory Technologists
Certification, serving at the Board of the Indonesia Clinical Chemistry Association, as
Advisor of the Indonesia Health Laboratory Technologists Association and Director of
the Asian Association for Medical Laboratory Sciences, as Vice President of the Asia
Pacific Federation for Clinical Biochemistry and Laboratory Medicine (2010-2016), andVice Chair of the Indonesian Institute for Corporate Directorship.

Dr. Samuel Vasikaran
Vice President

Consultant Chemical Pathologist at Path West – Laboratory Medicine, Western Australia.
Dr. Samuel Vasikaran is a Chemical Pathologist based in Path West-Laboratory Medicine,
Perth, Western Australia. He was Clinical Professor, Pathology and Laboratory Medicine,
University of Western Australia until 2016.
He was previously Chair of the APFCB Scientific Committee. He has extensive researchexperience in the use of bone turnover markers and a major interest in interpretative
commenting on laboratory reports, with over 140 publications in peer reviewed journals(H-index Google Scholar 42).

4

APFCB Activities

APFCB News 2023 Issue 1
Prof. Praveen Sharma
Secretary

Former Professor and Head, Dean Research Biochemistry at All India Institute of Medical
Sciences, Jodhpur, Editor-in-chief, Indian Journal of Clinical BiochemistryProf. Praveen Sharma (MSc (Med), PhD (Med), FACBI, FAMS, FAACC) has more than 44
years’ experience of teaching Clinical Biochemistry and Laboratory Medicine. Professor
Sharma is an eminent Indian Biochemists, served as Professor and Head of the
Department of Biochemistry and Dean Research at All India Institute of Medical Sciences,
Jodhpur, India. He has over 250 research publications in various prestigious journals.
And has an interest in Metabolic Syndrome, Atherosclerosis, Antioxidants, Metal
Toxicity, and Lab Management. He has delivered Invited Lectures at various National andInternational Meetings. He has been ranked among top 2% in worldwide scientist from
India,

statedby

Stanford

University

study(Updatedscience-wide

authordatabases, Plos Biology, 2020).
He is a recipient of the G S Seth Medical College Oration Award (2004), Pattabiram an
Oration Award (2010), Awadhesh saran memorial Oration Awards (2013), and A. J.
Thakur-ACBI award (2015) for distinguished service and significant contribution to thefield of Clinical Biochemistry. He has been awarded a merit award by Rajasthan
Government in 2002.
He has been twice President of ACBI and is Fellow of the Association of Clinical
Biochemists of India (FACBI), Fellow of National Academy of Medical Sciences (FAMS), andFellow of American Academy of Clinical Chemistry (FAACC).
He is Editor-in-Chief, Indian Journal of Clinical Biochemistry (IJCB) and Chairman,
Corporate Wing of ACBI. He has also served as a member of the Accreditation Committeeof the National Accreditation Board for Testing and Calibration Laboratories (NABL) anda NABL Assessor. Dr. Sharma is President of the Indian Society for Lead Awareness andResearch (Insular) and Director of the National Referral Center of Lead Project India,
Jodhpur.
He has served as member of IFCC-CCLM Committee (2016-2019) and is Chair of the IFCCCCLM Committee (2019-till date).
He is Director on WAS Palm board for South East Asia (2020-till date).

5APFCB News 2023 Issue 1

APFCB Activities

He served as Chair Communication Committee of APFCB and Chief Editor of APFCB News(2010-2019) and Chair of the APFCB Committee on Congress and Conferences (20192022). Besides he has also organized the 15th APFCB Congress 2019 from 17th to 20th
November 2019 as Organizing Chairman at Jaipur.
Presently he is Secretary APFCB for the year 2023-2024.

Dr. Raja Elina Raja Aziddin
Treasurer

Dr. Elina is a senior Biochemist and Head of the Drug and Research Laboratory in Hospital
Kuala Lumpur. She received her Degree in Biochemistry and PhD from University of
Malaya. She has more than 30 years’ experience in Clinical Biochemistry and has special
interest in drugs of abuse testing and quality management.
Dr. Elina’s research studies include method development for toxicology and drugs ofabuse testing, drug pharmacology and toxicity studies, effect of genetic profile on drug
uptake and therapeutic levels, studies on reference values and quality improvement
studies.
Dr. Elina has held numerous representative roles at national and international level suchas being a member of the technical committee in the development of ‘Standards For the
Accreditation of Controlled Substances Forensic Science Testing Laboratories, Standards
Malaysia’, review committee for ‘MS ISO 15189 Specific Technical Requirements for
Chemical Pathology’, committee member on Programme Standards For Medical and
Health Sciences, Malaysian Qualifications’, member of the national committee on‘Method Standardization’ and member of the ‘Research Committee for Allied HealthProfessionals, Ministry of Health’.
She is the Technical Manager for Pathology Department Hospital Kuala Lumpur, Presidentof the Malaysian Association of Clinical Biochemists (MACB), national representative to
the Asia Pacific Federation of Clinical Biochemistry and Laboratory Medicine (APFCB),
national representative to the International Federation of Clinical Chemistry andLaboratory Medicine (IFCC) and member of the APFCB Scientific Committee.

6APFCB Activities

APFCB News 2023 Issue 1
Dr. Douglas W. Chung
Corporate Representative

Dr. Douglas W. Chung is Area Marketing Manager Asia Pacific, Core Diagnostics at Abbott
Laboratories. He received undergraduate training in molecular biology at the Universityof Pennsylvania, doctorate and public health degrees from University of Newcastle andChinese University of Hong Kong Faculty of Medicine, with a concentration in infectious
diseases.
His experience in laboratory medicine ranges from biochemistry to bacteriology,
immunohematology and molecular diagnostics; and across the spectrum from point-ofcare testing to the centralized core laboratory. Prior to joining the Executive Board of the
APFCB, he served on the IFCC-World Lab Congress Organising Committee from 2018 to
2022.

7

APFCB News 2023 Issue 1

APFCB Activities

Welcome APFCB Communication &Publications Committee (C-CP)
Contributed by:Prof. Pradeep Kumar Dabla
Chair: APFCB C-CP
The objectives of the Communication and Publications Committee (C-CP ) is tocommunicate and promote the activities of APFCB both at the national & regional level ofthe member countries and extending further to the international level. Though not limited
but extending further with the important task of bi-annual APFCB eNews publications andsupporting the APFCB website management for the APFCB council activities and initiatives.
Thus, the new Team C-CP resumed the task in the beginning of the year 2023 to meet theobjectives of the committee. The new APFCB website was launched in Feb 2023 and thatcame with the expected task of dynamic website updating & modifications. The committee
is open for suggestions to make better visibility for APFCB tasks and activities. Further,
the C-CP is planned to extend the readership of eNews and communication further byutilising mass mail activities and adding more interested readers. Though not limited but
to add flash news activities in future to compliment with the important announcements
informing the dynamic activities of APFCB EB & Committees in-between the bi-annual
eNews publications. We are also planned to extend the utilization of all social media
platforms for the promotion, education & networking of APFCB activities. Thus, leaving nostone unturned to unite every single member with the APFCB council. We congratulate theprevious C-CP team for handling the objectives efficiently during their tenure. Thus, theTeam C-CP is given an important task to bring the full Asia Pacific Clinical Biochemistrycommunity together on same front for the promotion of education & laboratory medicine
and C-CP is committed to the same.
I feel deeply honored and glad to receive the charge of APFCB Committee Communication& Publications (C-CP) to support the APFCB activities.

Meet Our Team
Chair APFCB Committee-CP

Prof. Pradeep Kumar Dabla (ACBI, India)

8

Professor
Department of Biochemistry
G.B.Pant Institute of Postgraduate Medical Education & Research (GIPMER)
Associated Maulana Azad Medical College, Delhi, India
Email: pradeep_dabla@yahoo.com

APFCB Activities

APFCB News 2023 Issue 1

Members APFCB Committee-CP

Dr. Ryunosuke Ohkawa (Japan)
Professor of Analytical Laboratory Chemistry
Graduate School of Medical and Dental Sciences
Tokyo Medical and Dental University, JAPANDr. Mingma Lhamu Sherpa (India)

Professor and Head
Department of Biochemistry
Sikkim Manipal Institute of Medical Sciences,
Sikkim Manipal University
5th Mile Tadong,
Gangtok, Sikkim, INDIA

Dr. Alireza Lotfi Kian (Iran)

Board member of the association doctorate
In Laboratory sciences of medical diagnosis,
IRAN

9APFCB News 2023 Issue 1

APFCB Activities

Welcome APFCB Congresses andConferences Committee (C-CC)

Chair: Dr. Woei-horng Fang

(Taiwan)Committee Members:

10

Dr. Ronaldo E. Puno

Dr. Rajiv Ranjan Sinha

Dr. Mehrdad Vanaki(Philippine)(India)(Iran)

APFCB Activities

APFCB News 2023 Issue 1

It is a great pleasure and honor to be newly appointed chair of APFCB Committee on
Congresses and Conferences. I am also very delighted to work with three C-CC members
appointed by APFCB EB. Briefly introduce the Committee members’ background
Dr. Woei-horng Fang is Associate Professor, Department of Clinical Laboratory Sciences
and Medical Biotechnology, National Taiwan University College of Medicine, Taiwan.
Mr. Ronaldo E. Puno RMT, MBA-H is the Chief Medical Technologist, PROLAB Diagnostics,
Philippine. It is his second term as APFCB C-CC member.
Dr. Rajiv Ranjan Sinha is Professor, Department of Biochemistry, and Nalanda Medical
College, India.
Dr. Mehrdad Vanaki is the lab director of FARVARDIN pathology genetic laboratorycomplex, Iran.
The APFCB C-CC is a standing committee of the APFCB. It was responsible to the APFCBEB and Council. The functions of the C-CC are as follows:
1) Role in APFCB Congresses- Oversee the organization of the APFCB Congress.
- Help raise sponsorship for meetings.
- Appoint members to be on the Scientific Committee of the APFCB Congress to ensure
the international nature of the scientific content.
The role of the Congress Committee shall follow APFCB Congress Guidelines. The current
Guidelines were approved by EB in early 2016 and then by the Council Meeting inNovember 2016. For the coming the 17th APFCB Congress, scheduled on 31 October - 3
November 2024 in ICC, Sydney, Australia, and the C-CC shall work closely with Congress
Organizing Committee (COC) of the 17th APFCB Congress. According to the APFCBCongress Guidelines, the COC shall furnish regular reports with budget and details of
the progress of preparation. Reports will also be submitted to the IFCC C-CC through Dr.
Woei-horng Fang who is a member of this committee as well. The Chair and APFCB
President shall plan to meet with the COC in Congress venue in November of this year
to discuss the progress of preparations. A report of the visit will be prepared by the Chair
C-CC and submitted to the Executive Board and the C-CC.
2) Auspices
One of the functions of the APFCB C-CC is the award of auspices of the APFCB for
scientific meetings. The provision of auspices is mutually beneficial: the APFCB lends its
prestige to a meeting which should help it attract greater participation and in return the
APFCB benefits from greater name recognition among the participating laboratory
scientists.
All applications for APFCB auspices are evaluated by the C-CC and treated on a case-bycase basis in an efficient and timely manner. The C-CC is careful to award auspices only
to scientific meetings that are organized by learned bodies and vendors such as APFCB
corporate members where the content is of educational value and non-commercial innature.

11

APFCB News 2023 Issue 1

APFCB Activities

Report APFCB Education and Laboratory
Management Committee (C-ELM) - 2022
The Education and Laboratory Management Committee (C-ELM) is chaired by
Dr. Tony Badrick (Australia) with the following members: Dr. Lia Gardenia
Partakusuma (Indonesia); Dr. Tze Ping Loh (Singapore); Dr. Ronda Greaves(Australia); Dr. Raja Elina (Malaysia); Dr. July Kumalawati (Indonesia); Dra Endang
Hoyaranda (Indonesia); Dr. Jozi Habijanic (Roche Corporate); Dr. Amit Manjure(Siemens Corporate); Dr. Rojeet Shrestha (Japan); Dr. Hong-yew Lim (Roche
Corporate).



The role of the C-ELM is to provide support for member organisations in education.
This usually involves the organisation of visiting lecturers, seminars, and training
activities.

Impact of COVID



Travel restrictions

Education and Laboratory Management Committee
1. APFCB Travelling Lecturer
The APFCB Visiting Lecturer for 2021/22 is Dr. Helen Martin from Australia. Whilst there
are travel restrictions on this key role, virtual lectures will continue.
2. APFCB - Roche – 12th Chemical Pathology Course – Vietnam
This is an ongoing annual event organised by Roche in collaboration with Rhonda
Greaves from Australia. In2020, the virtual event attracted approximately 400
participants and consisted of a mixture of invited and local speakers presenting on
routine chemical pathology topics.
The course is supported and endorsed by many prestigious local and international
medical organisations and associations, such as International Federation of Clinical
Chemistry and Laboratory Medicine (IFCC), Asia-Pacific Federation for Clinical
Biochemistry and Laboratory Medicine (APFCB), Australasian Association of Clinical
Biochemists (AACB), Vietnamese Association of Clinical Biochemists (VACB), Ho Chi Minh
City Association of Clinical Biochemists (HACB), Ho Chi Minh City Association of Medical
Laboratory Technologists (HAMLT), Bach Mai Hospital, Cho Ray Hospital and othermedical organizations and Associations
3. APFCB-AACC Workshops
The APFCB has been collaborating with the AACC with their Global Lab Quality Initiative(GLQI) as part of the Asia-Pacific Working Group (APWG). It was not possible to run any
workshop in 2020. However, it is planned to run the next program in Mongolia in 2022.

12

APFCB Activities

APFCB News 2023 Issue 1

4. Workshop on Laboratory Testing of COVID-19
As the information of laboratory diagnosis and monitoring of COVID-19 was rapidly
evolving with new information arising on a daily basis, laboratory professionals neededa constant update on the developments. Furthermore, many developing countries were
struggling to meet requirements of appropriate testing not only because of lack ofresources but also due to lack of well-trained laboratory professionals on the molecular
assays. To help lab professionals with appropriate guide in COVID-19 testing, the APFCB
committee for
Education and Laboratory Management organised a two-day virtual workshop that
contained a series of lectures from experts as a complete guide on Laboratory Testingof COVID-19.
5. APFCB Young Scientist Award
Objectives:
The APFCB Young Scientist Award Competition is a scientific paper competition
conducted by the APFCB through its Education and Laboratory Management Committeewith the following objectives: • Foster scientific potential of young scientists within the
Asia-Pacific region, • As a means of aiding and encouraging young scientists in written
and oral communication of their research results • There are 12 recipients at thismeeting.

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APFCB News 2023 Issue 1

APFCB Activities

Report APFCB Scientific Committee (SC)2022
Chair: Dr. Samuel Vasikaran
Members:
1.

Tze Ping Loh, Chair of Harmonization of Reference Intervals WG

2.

Ronda Greaves, Chair of Mass Spectrometry Harmonisation WG

3.

Mohamed Saleem, Chair of Laboratory Data for Improving Diagnostics WG

4.

Mithu Banerjee, Chair of Diabetes Testing Harmonisation WG

5.

Pavai Sthaneswar, Chair of APFCB / WAS Palm Task Force on CKD

1. Reference Intervals WG
The Harmonization of Reference Intervals WG has examined and compared indirect
methods for the derivation of reference intervals using data from laboratories within the
Asia-Pacific region. The results of these studies have resulted in three publications
Publications:Comparison of two (data mining) indirect approaches for between-subject biologicalvariation determination. Tan RZ, Markus C, Vasikaran S, Loh TP; APFCB Harmonizationof Reference Intervals Working Group. Clin Brioche 2022; 105-106:57-63.
Comparison of 8 methods for univariate statistical exclusion of pathologicalsubpopulations for indirect reference intervals and biological variation studies. Tan RZ,
Markus C, Vasikaran S, Loh TP; APFCB Harmonization of Reference Intervals Working
Group. Clin Brioche 2022; 103:16-24
Comparison of four indirect (data mining) approaches to derive within-subject biologicalvariation. Tan RZ, Markus C, Vasikaran S, Loh TP; APFCB Harmonization of Reference
Intervals Working Group. Clin Chem Lab Med 2022; 60(4):636-44.
2. Mass Spectrometry Harmonisation WG
A multicenter study of the influence of internal standard on the analysis of 17hydroxyprogesterone by LCMSMS was completed in association with RCPAQAP – AACB
and IFCC ETD Pediatric Harmonics Working Group.
A study of patients presenting to the National Children’s Hospital in Vietnam with 5αreductase type 2 deficiency detected by GC-MS analysis of the urinary steroid
metabolome was conducted. The additional aim of this study was to determine thesensitivity and specificity of urinary steroid metabolite ratios in the diagnosis of 5αreductase type 2 deficiency

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Publications:
Validation of steroid ratios for random urine by mass spectrometry to detect 5αreductase deficiency in Vietnamese children. Tran TCM, Tran TNA, Le HBN, Nguyen VH,
Tran MD, Vu CD, Greaves RF. Clin Chem Lab Med 2022;60(8):1225-33.
3. Laboratory Data for Improving Diagnostics WG
The WG has Analysed Laboratory Data for Improving Diagnostics and produced data on
the reporting of critical results in Asian laboratories and Quality indicators in ChineseLaboratories. These survey reports will be used to support healthcare goals for improved
disease management in the region. The support of Roche Diagnostics for this activity is
acknowledged.
4. Diabetes Testing Harmonisation WG
The WG has expanded its survey of diabetes testing and reporting practices in the region.
Results of surveys conducted in the Philippines, Sri Lanka and Singapore have been
analysed and was presented as a poster at the AACB Annual Scientific Conference in
Perth, Australia in October 2022. Results confirm that whilst most laboratories follow
recommended practices, there is some lag in laboratory practices in some areas which
could benefit from activities to harmonize and update practice. The data are being
written up for publication in eJIFCC.
5. APFCB-WAS Palm TF-CKD
The WG has undertaken a survey of testing and reporting practices for CKD related
laboratory indices in India in order to ascertain concordance of reporting practices withcurrent guidelines and industry standards. The results have been analysed and were
presented as a poster at the AACB Annual Scientific Conference in Perth, Australia in
October 2022. It is hoped that the findings would lead to activities to harmonize testing
and reporting practices according to current recommendations throughout the region.
6. Masterclass webinars: Interpretative commenting on clinical chemistry reports.
Webinars to discuss and analyses interpretative comments and to educate laboratory
professionals on the addition of interpretative commenting have continued through therest of 2022 with wide participation from the region. The resource material and therecordings

of

these

webinarsareavailable

on

the

APFCB

website:https://apfcb.org/webinar
The support and the excellent organisation of the webinars by Dr. Pearline Teo, Siemens
Healthcare Pte Ltd is acknowledged.

Samuel Vasikaran
Chair 2022

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Report APFCB Congresses andConferences Committee (C-CC) - 2022
Chair: Prof. Praveen Sharma
APFCB Congress Committee
1. Praveen Sharma (India) - Chair
2. Woei Horng Fang (Taiwan) - Member
3. Ronaldo Puno (Philippines) - Member
4. Prasenjit Mitra (India) - Member
5. Will Greene (Roche) - Corporate Member
6. Ai Tin Lim (Siemens) - Corporate Member
The mandate of the committee is to streamline the process of granting APFCB auspices
to various scientific events like conferences, congresses, events organized by regionalsociety members, and corporate member events. With the COVID-19 situation affecting
the global scientific community, there were no applications for physical conferences.
Rather, there was a surge in the events based on virtual platforms. The committee
received a number of applications for grant of APFCB auspices. During2021 - 2022, thecommittee members evaluated and granted APFCB auspices to the following scientificevents.
Conferences and Courses

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The committee is also working on updating the Congresses and Conferences webpageof APFCB to include the details of all the scientific events, which have been granted APFCB
auspices.

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Report APFCB Communications andPublications Committee (C-CP) - 2022

Prepared by:
Dr. Raja Elina Binti Raja Aziddin,
Past Chair-CCP and Past Chief Editor, APFCB NewsThe C-CCP committee in 2022 comprised of the following members:
1.

Dr. Raja Elina Raja Aziddin – Chair and Chief Editor of APFCB News

2.

Dr. Purvi Purohit (Web Editor)

3.

Dr. Rojeet Shrestha (Media Coordinator)

4.

Prof. Pradeep Kumar Dabla (Full Member)

5.

Will Greene (Corporate -Roche) replaced by Yvonn Ong (Roche) in June 2022

6.

Lim Ai Tin (Corporate -Siemens)

In 2022, the C-CCP published 2 copies of the APFCB News which are available on the
APFCB website as e-book and pdf copy. A new feature that was added to APFCB News
2022 issue 1 is the quiz section. Questions in this section are based on the APFCB
webinars which were organized in 2020-2021 and which are still available on the APFCB
website.

APFCB News 2022 Issue 1

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APFCB News 2023 Issue 1

The focus of the C-CCP in 2022 was to work on the new APFCB website. In total, thecommittee met more than 10 times in 2022 to discuss the features, to work on thedevelopment and to review the content migration from the old to the new website.

C-CP meeting to discuss new APFCB website development

In 2023, the committee again met 3 times for final review and to endorse the content of
the new website. The new website finally went live on 30 January, 2023. Features of the
new website include: mobile friendly browsing, improved hosting environment, searchfunction, tracking and analytics, website hit counter, password protected pages andsecurity features.

Home page of the new APFCB website
In addition to migrating existing content, new sections such as educational articles,
continuing education, awards and competitions have been added. To facilitate
networking the APFCB website provides direct links to national society’s website and tocorporate member’s website pages.
The website also allows easy access to past webinars which have been arranged
according to year. Just go to the webinars page and search under Archives.

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Recordings and power point presentations of past APFCB webinars

A 60 second video on the APFCB in the APFCB website
The committee also worked on creating a 60 second introduction video on APFCB andthis video is now available on the About us page on the APFCB website.

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Association of Clinical Biochemists of India(ACBI)
ACBICON 2022 New Delhi Report

The Registration Counters and the entrance of the Convention Center
The 48th annual conference of the Association of Clinical Biochemists of India,
ACBICON 2022, was held at the ICAR Convention Center in New Delhi, India from 24th
to 26th November, 2022, on the theme “Harnessing Basic and Molecular Research to
Enhance Patient Care”. The clinically oriented state-of-the-art preconference workshops
were held on the 22nd and 23rd of November, 2022. With the whole-hearted support
from our two international academic partners (International Federation of Clinical
Chemistry and Laboratory Medicine, and Asia Pacific Federation of Clinical
Biochemistry), National and International advisors, 26 Corporate partners and theorganizing Secretariat – Department of Biochemistry, Sir Ganga Ram Hospital (SGRH),
ACBICON 2022, was very fruitful and successful, under the able guidance andleadership of Prof. L. M. Srivastava as Organizing Chairman, and Prof. Seema Bhargava
as Organizing Secretary.
This was the first totally in-person conference of ACBI since the beginning of the COVID
pandemic. The Delhi Medical Council granted 6.5 credit hours for the preconference
workshops and 16 credit hours for the main conference.

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At the Inauguration. From L to R: Dr. Parul Singla (Member, Core Organizing Committee,
ACBICON 2022), Dr. Anjali Manocha (Treasurer and It Secretary, ACBICON 2022), Dr.
Rajiv Ranjan Sinha (General Secretary, ACBI), Dr. Harshvardhan Singh (It Secretary.
ACBICON 2022), Dr.Subir K Das (Immediate Past-President, ACBI), Dr. S.P.Byotra(Patron, ACBICON 2022 and Director, Clinical Laboratory Services, Sir Ganga Ram
Hospital, New Delhi), Dr.D.S. Rana (Patron, ACBICON 2022 and Chairman, Sir Ganga
Ram Trust Society), Dr.V.K.Paul (Chief Guest, Hon’ble Member, Niti Aayog, Govt ofIndia), Dr. Ajay Swaroop (Chairman, Board of Management, Sir Ganga Ram Hospital,
New Delhi), Prof. L. M. Srivastava (Organizing Chairman, ACBICON 2022), Dr. Seema
Bhargava(Organizing

Secretary,

ACBICON

2022

and

Chairperson,

Dept.

of

Biochemistry, Sir Ganga Ram Hospital, New Delhi), Dr. Mamta Kankra (IT Secretary,
ACBICON 2022).

Traditional lighting of the ‘Lamp of Knowledge’ by the dignitaries on the dais
The theme, preconference workshops and symposia generated a lot of enthusiasm andthere were over 800 delegates who attended the conference. In the inaugural function,
Master of Ceremonies, Dr. Mamta Kankra, Joint Organizing Secretary, ACBICON 2022,
introduced the dignitaries and invited them to the dais. The Chief Guest for theinauguration was Dr. V. K. Paul, Hon’ble Member, NITI Aayog, and Government of India.
The theme, preconference workshops and symposia generated a lot of enthusiasm andthere were over 800 delegates who attended the conference. In the inaugural function,
Master of Ceremonies, Dr. Mamta Kankra, Joint Organizing Secretary, ACBICON 2022,
introduced the dignitaries and invited them to the dais. The Chief Guest for theinauguration was Dr. V. K. Paul, Hon’ble Member, NITI Aayog, and Government of India.

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Dr. V. K. Paul was also awarded the Awadhesh Saran Oration for which he gave his
inaugural-cum-oration address on ‘The COVID Journey of India’. it was a concise
narrative of an exhaustive journey, highlighting how our country has not only managed
to design and produce effective vaccines for COVID, but also how we have helped overa hundred countries across the globe to fight this virus. The oration carried a cash prize
too which he graciously donated to the association. The Guest of Honor was Dr. Ajay
Swaroop, Chairman, Board of Management, and SGRH. The meeting was also presided
over by the patrons of the conference, Dr. D.S. Rana, Chairman, Sir Ganga Ram Trust
Society, and Dr. S. P. Byotra, Director, Clinical Laboratory Services, SGRH, President,
ACBI, Dr. Subir Das, General Secretary, ACBI, Dr. Rajiv Ranjan Sinha, and Organizing
Chairman, Prof. L.M.Srivastava. ACBICON 2022. The patrons, Dr. Rana and Dr. Byotra,
appreciated the efforts of the organizing committee. The President, Dr. Das, talked
about ACBI and its role in promotion of clinical biochemistry. Dr. Sinha presented theannual report of ACBI activities of the preceding year. The guest of honor, Dr. Swaroop,
encouraged the fraternity to continue its good work. The Souvenir and the Proceedingsof the conference were released during the inauguration. Organizing Secretary, Dr.
Seema Bhargava, ACBICON 2022, was handed over the reins of the President ship of
ACBI from Prof. Subir Kr. Das.

During the inaugural function, ACBI Fellowship was awarded to Prof. Abbas Ali Mahdi
and Prof. Pradeep K Dabla. The ACBI-A J Thakur award, an award of appreciation andproficiency in Clinical Biochemistry, was given to Prof Jayashree Bhattacharjee in
absentia. Several other awards were also presented to their respective awardees. The
Vote of Thanks was delivered by Dr. Anjali Manocha, Treasurer and Joint Organizing
Secretary, ACBICON 2022.

Scientific Programmer
The scientific Committee was chaired by Prof. Shyam S Chauhan. His team of eminent
biochemists form various premier institutes of Delhi and the Northern Capital Region(NCR) included Dr. S. B. Sharma and Prof. Vijay Kutala as the Chair and Co-Chair of the
Symposia Committee, and Dr. Ritu Singh as chair of the Pre-Conference Workshops’
Committee. They put together an educative scientific programme oriented to current
policies and guidelines pertinent to patient care.

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Pre-conference workshops: Nine preconference workshops (PCW) were organized.
They were:
Genetics in Medical Diagnostics and Prognostics, Statistical Analysis of Research Data
including Meta-analysis –Hands on Workshop, Hands-on-training: In vitro mammaliancell culture techniques and its application, Newborn Screening - From Text to Test, Endto-end Integrated Total Laboratory Automation, Applied Artificial Intelligence Research
Genome editing via CRISPR-Cas9, Roadmap to Laboratory Accreditation as per ISO
15189 and Molecular Advances in Cardiovascular Research
These were highly appreciated by all the participants for their newer topics andtechniques, and their highly sophisticated methodologies and content.
ORATIONS: Seven Orations were delivered by eminent members of the national andinternational faculty of the fraternity as given below: 1. Awadhesh Saran Memorial
Oration: Dr. V.K.Paul Hon’ble Member, Niti Aayog Govt. of India 2. Dr. K.P Sinha Oration:
Dr. Maurizio Ferrari (Past President IFCC) Director of Research Institute for Photonics
and Nanotechnologies, CNR Trento, Italy 3. Seth GS Medical College & . King Edward
Memorial Hospital Oration: Dr. Khusrow Adeli, President, IFCC 4. Dr. Praveen Sharma
Oration: Prof. Sedef Yenice Professor of Biochemistry and Clinical Chemistry Group
Florence Nightingale Hastaneleri Istanbul, Turkey 5. K.L.Gupta Memorial Oration:
Dr.Rahul Purwar Associate Professor Department of Biosciences and Bioengineering
Indian Institute of Technology, Powai Mumbai 6. Dr. T.N. Patabhiraman Oration: Dr
Vijay Kutala Dept. of Clinical Pharmacology & Therapeutics Nizam’s Institute of Medical
Sciences Chairman, Hyderabad 7. Mrs. & Dr. G.P. Talwar Oration: Prof. Arnab Pal
Professor, Department of Biochemistry PGIMER, Chandigarh
SYMPOSIA There were 33 symposia which addressed varied areas of clinical chemistry
and involved clinicians in each session so as to establish a cohesive workflow between
laboratorians and clinicians towards better patient care. These symposia were
distributed over 2.5 days in 5 parallel sessions. Special emphasis was laid on artificial
intelligence, ethics in laboratory medicine and epidemiology, including special
programmes set up by the Government of India. The scientific community was very
appreciative of the scientific program and the venue. The symposia generated lots ofdiscussions.
Other highlights
The International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) had
granted 3 Visiting Lecturers for this conference –1. Prof Sedef Yenice Professor of Biochemistry and Clinical Chemistry Chair, EFLM
Working Group on Laboratory Medicine Credit Points
2. Prof Bernard Gouget Chair, IFCC Committee on Mobile Health andBioengineeringinLaboratory

Medicine

President-Healthcare

Division

Committee Comate François d’accréditation (Cofrac) Paris, France
3. Dr. Ramy SH Assad Khalil, SCE Endocrinology & Diabetes- Royal College ofPhysicians (UK)In addition, we had several other international faculty from across the borders and seas:
1. Prof. Alexander Haliossos (Greece)
2. Egon Peter Amann (Germany)24

3. Prof. Ken.

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APFCB News 2023 Issue 1

Sikaris (Melbourne, Australia) [Online] 4. Dr. Qing Meng (Texas, USA) 5. Prof. Jay Kalra(Saskatchewan, Canada) 6. Prof. Sergio Bernardini (Italy) 7. Dr. Pierre-Jean Lamy (France)
8. Prof. Shabbir Syed Abdul (Taiwan) 9. Prof. Tahir Pillay (South Africa) 10. Mr. Anil
Srivastava (Maryland, USA) 11. Dr. Rajesh Sharma (California, USA) 12. Dr. Madhab
Lamsal (Nepal) 13. Dr. Nirmal Baral (Nepal)
The AFMC Quiz is an integral feature of our Annual Conferences of ACBI. It is meant
especially for postgraduate students of Biochemistry to encourage and inspire them. It
was conducted by the faculty of Armed Forces Medical College (AFMC), Pune, Dr. Col.
Anurodh Gupta and Dr. Vivek Ambade. The participants performed very well and,hence, to further encourage them, the Organizing Committee gave several Prizes ofAppreciation over and above the regularly instituted first 3 prizes.
A special innovative feature of this ACBICON 2022 was the ‘Vigyan Chaupal’ – aprogram convened by Prof. Tapasya Srivastava, Department of Genetics at Universityof Delhi, South Campus. This was a hands-on session for senior school children in thescience stream. There were 60 participants from two schools. They were taken through3-4 experiments like DNA extraction, to pique their interest in Biochemistry. They were
extremely excited and enthusiastic and their accompanying school teachers also
appreciated the program.
There were several symposia conducted under the aegis of different committees of
IFCC and AACC, namely IFCC Evidence Based Laboratory Medicine Committee, IFCC
Global Lab Quality Committee, and AACC India section. Prof. Bernard Gouget kindly
submitted a report on the IFCC EBLM symposium. The young scientists’ presentations
and posters were also appreciated. In addition to the regular awards for young
researchers, we, the organizing committee, had instituted the “Sir Ganga Ram HospitalAward for Translation Research in Clinical Biochemistry” in the form of first and second
prizes each for posters and oral presentations. The conference culminated with the
Valedictory Function where all the awards were given to the participants who had been
selected by the judges of the respective sessions.

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Prof Sedef Yenice delivering her oration (Left) and receiving the Dr. Praveen
Sharma Oration Award. (right)

Dr. Vijay Kutala Receiving the Pattabiraman Oration Award

Prof Sedef Yenice receiving the Seth GS Medical College & KEM Hospital Oration
Award on behalf of Prof Khusrow Adeli.

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APFCB News 2023 Issue 1

Prof Maurizio Ferrari delivering the oration (left) and receiving the Dr K.P. Sinha
Oration Award (right)

Prof Sedef Yenice being felicitated (Left) & The audience as IFCC VLP (right)

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International and National faculty in the audience

Faculty of the IFCC GLQ-C symposium: (Above from L to R) – Prof Qing Meng, Prof
Egon Amann, Prof Alexander Haliossos, Prof Seema Bhargava, Dr. Mamta Kankra,
Prof Venkatesh Thuppil, Prof Pradeep K Dabla, Prof Bernard Gouget.
(Below from L to R) – Prof Alexander Haliossos delivering a lecture and being
felicitated; Prof Qing Meng being felicitated and delivering a lecture in the IFCC
GLQ-C symposium

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The Faculty of the IFCC EBLM-C symposium: From L to R – Dr. Arvind Kumar Mehta(AIIMS, New Delhi, India), Dr. S Arulselvi (AIIMS, New Delhi, India), Prof Arif Ali(Chairperson, India)), Prof Seema Bhargava (Convenor), Prof Bernard Gouget(Chairperson, France), Dr. Tahir Pillay (South Africa), Dr. Ramy SH Assad Khalil (VLP
of IFCC EBLM-C from Egypt).
Below: Speakers being felicitated30

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APFCB News 2023 Issue 1

Dr. Praveen Sharma and Prof D. K. Srivastava felicitating the faculty of thesymposium titled “Heavy Metals in Health and Disease”, L to R Dr. Rachna Agarwal(New Delhi), Dr. Prasenjit Mitra (Chandigarh), Dr. Shailja Sharma (New Delhi).

Posters31

APFCB News 2023 Issue 1

Corporate Exhibition

32

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Corporate Exhibition

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Chinese Association for Clinical
Biochemistry (CACB-Taiwan)
National Society Report for APFCB News
NAME OF SOCIETY

Chinese Association for Clinical Biochemistry(CACB-Taiwan)

OFFICIAL SOCIETY EMAIL

office@cacb.org.tw

ADDRESSNAME OF PRESIDENT &Sandy Huey-Jen Hsu

EMAIL ADDRESS

sandyhsu@ntu.edu.tw

NAME OF NATIONAL

Woei-horng Fang

REPRESENTATIVE TO APFCB &whfang@ntu.edu.tw

EMAIL ADDRESS

Report on Society Activities

To Celebrate IFCC 70th Anniversary, CACB president Dr. Sandy Huey-Jen Hsu and her
staff contribute a photo to congratulate IFCC 70 years Global Leadership in Laboratory
Medicine (photo 1).
CACB Executive Director and National Representative Dr. Woei-horng Fang attended
2022 IFCC General Conference in Brussels. Dr. Fang reunited with old friends in IFCC
and had a fruitful discussion on education and regulation (Photo 2).
In the 2022 IFCC General Conference in Brussels, an agreement was achieved between
Prof. Nader Rifai (AACC) and Dr. Woei-horng Fang (CACB) (Photo 3). In order to increase
utility and eliminate language barriers, Dr. Fang would join the Chinese version
initiative of AACC Learning Lab for Laboratory Medicine on NEJM Knowledge+ program.
Dr. Fang proposed the Traditional Chinese version initiative and was accepted. The
translation was started in December 2022 and the Chinese site was schedule to belaunched in April 2023.

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APFCB News 2023 Issue 1

Photo 1 CACB congratulates IFCC 70th Anniversary

Photo 2. At 2022 IFCC General Conference in Brussels, CACB Executive Director Dr.
Fang presented CACB 40th Anniversary Celebration book of “The chronicle andcommemorative photographs of Chinese Association for Clinical Biochemistry
1982-2022 to APFCB President Dr. Endang Horyanda, IFCC President Prof Khosrow
Adeli, Past President Prof Maurizio Ferrari and President-elect Prof Tomris Ozben,
and IFCC Secretariats staff.

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Photo 3 At 2022 IFCC General Conference in Brussels, Prof. Nader Rifai (AACC) and
Dr. Woei-horng Fang (CACB) agreed on the AACC Learning Lab for Laboratory
Medicine traditional Chinese version initiative

Upcoming events for 2023
CACB annual conference and scientific symposium in conjunction with the 37th Joint
Annual Conference of Biomedical Science (JACBS). The main theme for JACBS this year
is “Metabolism in Human Health”. Four speakers will be invited to present the progress
on metabolomics and its clinical applications. Professor Andrew Hoofnagle, Director of
Division of Chemistry, Department of Laboratory Medicine and Pathology University ofWashington, is going to deliver a keynote speech on “Clinical Metabolomics: Current
state and future directions”. Professor Ming-Shi Shiao, Consultant and CRO, Geneon
Link, and adjunct Professor, Graduate Institute of Traditional Medicine, National Yang
Ming Chau Ton University, will present “Metabolomics Enables Precision Medicine”.
Professor Jentaie Shiea from National Sun Yat-sen University will talk about “Rapid
Characterization and Imaging of Drugs and Potential Metabolic Disease Biomarkers on
Human Skin with Ambient Ionization Tandem Mass Spectrometry”. Professor Tjin-Shing
Jap, Physician, Division of Endocrinology and Metabolism, Taipei-Veterans General
Hospital will present” The laboratory evaluation of glucose and lipid metabolism fromBiochemical perspectives”.

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Hong Kong Society of Clinical Chemistry(HKSCC)
National Society Report for APFCB News
NAME OF SOCIETY

Hong Kong Society of Clinical Chemistry

OFFICIAL EMAIL

hkscc@hos.com.hk

PRESIDENT

Name: Dr. Iris HS Chan
Email: chs483@ha.org.hk

APFCB NATIONALREPRESENTATIVE

Name: Dr. Iris HS Chan
Email: chs483@ha.org.hk

Report on Society Activities
The Hong Kong Society of Clinical Chemistry (HKSCC) hold 2 online scientific webinars
via Zoom platform in 2022. The 1st one was on 23rd July 2022. There were threepresentations from invited local speakers: ‘Iron Profile Made Easy’ by Dr Jenny CHENG,
Prince of Wales Hospital, ‘Porphyria: Topic Review and Case Presentation’ by Dr
Jeremiah TSEUNG, Princess Margaret Hospital, ‘Review on the Biomarker in Liver
Fibrosis’ by Dr. Kelvin YIP of Pamela Youde Nethersole Eastern Hospital.
Another online seminar was hold on 19th November 2022. There were threepresentations by invited local speakers: ‘Cushing's syndrome: Diagnostic workup andchallenges’ by Dr. Hoi Shan LEUNG, Princess Margaret Hospital; ‘Vitamin D Metabolism:
A Review’ by Dr. Shreenidhi R SUBRAMANIAM, Prince of Wales Hospital; ‘Abnormal
thyroid function tests in a 9-month-old boy’ by Dr. Rachel SW YIU of Queen Mary
Hospital.
The year 2023 was started with the Annual Scientific Meeting (ASM) held on 7 January
2023. It was the first physical ASM of the society since the COVID-19 pandemic. The
theme of the ASM was “Current Advances in Clinical Investigation and Management”.
There were two presentations by invited speakers: (1) " Development of Robotic
Surgical System for Clinical Application - from Laparoscopic to Endoscopic Surgery" byProfessor Philip WY CHIU, Head of Division of Upper GI & Metabolic Surgery,
Department of Surgery; Associate Dean (External Affairs), Faculty of Medicine, The
Chinese University of Hong Kong; and (2) " Therapeutic Drug Monitoring of 5fluorouracil to improve Patient Safety and Drug Efficacy" by Dr Felix CK WONG,
Consultant, Division of Chemical Pathology, Department of Pathology, Queen Mary
Hospital. These were followed by five industrial presentations by Beckman Coulter
Hong Kong Limited, Bio-Rad Pacific Limited, Ortho Clinical Diagnostics and Roche
Diagnostics (Hong Kong) Limited, Waters Corporation. The ASM was well attended by
139 HKSCC members and guests. There were also fifteen industrial partners
participating in the industrial exhibition.

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Group photo of HKSCC Council Members (Term 2022 – 2023) with Industrial
Partners
HKSCC celebrated its 40th Anniversary in 2023. One of the events was photo contest
with a theme of “Wonderful Moments in the Clinical Chemistry” for members to share
their career lives, stories, precious moments and others in the past 40 years in the fieldof Clinical Chemistry. A total of 28 photos was received. Below is the winner from Ms.
Judy Po Shan LAI sharing her happy moments at the Neonatal Screening Laboratory
during Christmas in 1985.

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Japan Society of Clinical Chemistry (JSCC)APFCB NewsThe 62nd Annual Meeting of the Japan Society of Clinical Chemistry (JSCC), chaired byProfessor Isao Kitajima (University of Toyama), was held in Toyama from September 30
to October 2 in 2022. The theme of the meeting was “Development of clinical chemistry
through interdisciplinary collaboration” reflecting the origin of the Society of Clinical
Chemistry, "Creating Clinical Laboratory”. Conference participants were anticipated tojoin the meeting on site. However, for those participants who could not make it to thevenue, lectures were made available on demand after the conference. A total 669 ofregistration were obtained.

Photo1: Poster for the 62nd Annual Meeting of the Japan Society of Clinical
ChemistrySpecial lectures and symposiums were held to raise awareness of interdisciplinary
collaboration. Special Lecture 2 was "Functions of the Idle Brain" by Kaoru Inokuchi(Distinguished Professor, University of Toyama), and Special Lecture 3 was"Mathematical Modeling of Complex Systems and its Application to Research on Un
wellness" by Kazuyuki Aihara (Professor Emeritus, University of Tokyo). They showed
us that new research can be opened up through collaboration between different fieldsof brain research and mathematical science.

Photo 2: Dialogue between Kaoru Inoguchi (Distinguished Professor, University of
Toyama) on and Kazuyuki Aihara (Professor Emeritus, University of Tokyo)

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Photo 3: The international symposium. (From left) Dr. Subehan Lallo, Hasanuddin
University (Indonesia), Dr. Pornang Aramwit, Chulangkorn University (Thailand),Dr. Isao Kitajima (Meeting chair). Dr. Yoshihiro Hayakawa (Symposium chair)
The international symposium was held under the theme of Current status and future
perspective of traditional medicines. Dr. Pornang Aramwit, Dean of Faculty of
Pharmacy, Chulangkorn University (Thailand), and Dr. Subehan Lallo, Faculty of
Pharmacy, Hasanuddin University (Indonesia), spoke on the current status of traditional
medicines in ASEAN countries and their regulation for clinical use. In ASEAN countries,
including Japan, medical treatment using traditional medicines and natural drug
resources is widely used even today. Collaboration between traditional medicine andWestern medicine is becoming increasingly important. In particular, there is a strong
demand for scientific evidence and clinical trials of the efficacy and safety of traditional
medicine.
The next 63rd meeting is be held by Dr. Hiroshi Yoshida (Tokyo Jikei University) inTokyo from October 27 to 29 in 2023.

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Indonesian Association of Clinical
Chemistry (IACC)

Arwin Prasasto
hkki.secretariat@gmail.com or arwin.prasasto@yahoo.com
16th IACC NATIONAL CONGRESS
The 16th IACC National Congress was held in Jakarta on 22nd-24th July 2022. This
Congress elected Dr. Tjan Sian Hwa, Sp.PK, and MSc for the President of IACC for the
2nd period. During her time as President of IACC, IACC enjoyed rapid growth from 12
branches to 14 branches (with Lampung and North Sumatra as new branches) andachieved the highest number of members (more than 800 IACC registered members).
IACC branches were also growing with more members and more educational activities(webinars, educational videos, and public seminars). This Congress also set the tone
for IACC’s direction in the future by targeting more educational seminars and webinars,
public webinars, green lab development in Indonesia, and promoting quality assurancein Indonesian clinical laboratories.
During the Congress, IACC also held an offline seminar with “The Future of ClinicalLaboratory: Precision Medicine Perspective” as the seminar’s theme. We had keynote
speakers from the Indonesia Ministry of Health, Prof. Damien Grison, Prof. Aw Thar
Chon, and many more. The target audiences of this seminar were clinical pathologists,
laboratory technicians, and all laboratory practitioners. We had more than 500
participants across Indonesia.
IACC’s Lampung Branch Inauguration
Lampung Branch Inauguration was held in Lampung on the 16th of September 2022.
Attended by IACC President (Dr. Tjan Sian Hwa), IACC board member (Dr. Lia
Partakusuma), and IACC Lampung Branch members. Along with this inauguration, anoffline seminar was held. The topic of the seminar was “Update of Autoimmune
Diseases: Early Diagnosis, Management and Laboratory Aspect of Systemic Lupus
Erythematosus”.

41

APFCB News 2023 Issue 1

Member Societies

Westgard Series: From A to Z Laboratory Risk Management (Quality and Laboratory
Management Webinar by IACC)
This webinar was held on the 19th of November 2022 and 1155 participants attended.
The participants are not only from Indonesia, but from Asia Pacific countries (including
Malaysia, Australia, Philippines, Singapore, India, Pakistan, and Sri Lanka). Stem
Westgard was the keynote speaker in this webinar.
IACC-GLEAM (Green Laboratory for Environment and Mankind) Initiative Webinar
IACC, in collaboration with Abbott, will hold a webinar on the 4th of March 2023. This
webinar will have a representative from the Indonesia Ministry of Health, Prof. Tomris
Ozben, and Dra. Endang Horyanda, and Dr. Lia Partakusuma, Sp.PK (K) as speakers.
IACC aims to promote green laboratories in Indonesia with this webinar.
Visiting Lecture by Prof. Khosrow Adeli
Prof. Khosrow Adeli will visit Indonesia on the 23rd-25th of March 2023 and IACC will
have him as a lecturer on his short visit to Indonesia. The aim of this visiting lecture isto promote newborn screening programs in Indonesia. This is also aligned withIndonesia’s national programs.

42

Member Societies

APFCB News 2023 Issue 1

MALAYSIAN ASSOCIATION OF CLINICAL
BIOCHEMISTS (MACB)
1. MACB Annual Conference
The 32nd Annual MACB Conference under the auspices of the APFCB was held via a
virtual platform from 11-13 September, 2022.

A pre-conference which focused on

Point of Care Testing (POCT) was held on 11 September 2022 followed by a 2-day
conference. The theme of the virtual conference was “Integrated Approach in Medical
Laboratory: Challenges and Opportunities”. Various topics of interest such as
integrated diagnostics, updates on eGFR reporting, personalised medicine and quality
management were presented by local and international experts. The conference wasattended by 245 participants with 3 oral and 30 e-poster presentations.

Attendees at the 32nd MACB Conference 2023
In conjunction with the conference, a Young Scientist Award Competition 2022 washeld for the first time. The main objective of the MACB YSA Competition 2022 was torecognize the achievements of young scientists under 40 years in the field of Clinical
Biochemistry. The Awards was conferred to the recipients during the 32nd MACB
Annual Conference 2022. The competition received applications from 10 candidates
which included locals as well as from India and Sri Lanka. The five (5) deserving
scientists under the age of 40 years old who were selected as award winners comprised
on 4 locals and one from India.
Winners were given free registration and a token sum. They were given the opportunity
to present their papers in a special oral presentation session during the conference.
The following were the recipients of the MACB YSA Competition 2022

43

APFCB News 2023 Issue 1

Member Societies

1.

Dr. Prasad Mundllamudi Iman

2.

Nabilah Abd Rahim

3.

Mohd Firdaus Abdul Aziz

4.

Raja Hasyidah Raja Bongsu

5.

Siti Suhana BT Abdullah Soheimi

3. Forum on “eGFR reporting in Malaysia”
A pre-MACB AGM Forum entitled “eGFR reporting in Malaysia” was held on Saturday,
24th Sept 2022 via Microsoft Teams. One nephrologist and 2 chemical pathologists
make up the 3 panelists. The objective of the forum was:
1. To discuss the current practice of eGFR reporting in Malaysia
2. To discuss the impact of the implementation of the new CKD-EPI 2021 equation that
does not include a race coefficient.
The forum began with a presentation of the report of surveys that were carried out on
the practice of eGFR reporting in Malaysia. Lively discussion followed the presentation
and a decision was made not the make any changes to the current MACB guideline on
eGFR reporting.
4. MACB Annual General Meeting
The 32nd Annual General Meeting (AGM) of the Malaysian Association of Clinical
Biochemists (MACB) was held on Saturday, 24th September, 2022. The nomination for
MACB Council for the term 2022-2024 was closed on 31st August 2022 and electionof MACB Council was carried out during the AGM by electronic voting.
The new elected MACB council members for the term 2022-2024 are as follows:
President

Dr. Raja Elina binti Raja Aziddin

Vice-President

Tunku Marinah Ashraf binti Tunku Abdullah

Secretary

Chuo Peck Ham

Assistant Secretary

Sivasangkari a/p Supremaniam

Treasurer

Chen Bee Chin

Council Members

44

1.

Chew Yee Yean

2.

Vani a/p Munusamy

3.

Roziela binti Abu Bakar

4.

Dr. Nurulamin Abu Bakar

Member Societies

APFCB News 2023 Issue 1

Lucky draw at the MACB AGM
5. Membership to the EFLM Academy
The MACB has been a member of the EFLM Academy since 2021. In November 2023,
the MACB again made a block enrolment to the EFLC Academy for its active members.
The active MACB members who enrolled into the academy has been steadily increasing
since the first enrolment in 2021.
6. MACB Participation at the 17th APFCB Council meeting
The MACB was represented by Tunku Marinah, Vice President of MACB at the meetingas the MACB president attended the meeting as chair of the APFCB Communications
and Publications Committee.

45

APFCB News 2023 Issue 1

Member Societies

Association of Medical Biochemists of India(AMBI)The Executive Council:
Members of the Executive Council for Association of Medical Biochemists of India (AMBI)
was appointed in the Annual General Body Meeting held at Bangalore, on 22nd July 2022 at
29th Annual National conference of the AMBI. The office bearers were:
Head Office

Dr V Govindaraju

Secretary General

Dr Shanthi Naidu

President

Dr Prashant Vishwanath

Honorary Secretary

Dr Jasbinder Kaur

Joint Secretary
National Coordinator

Dr Anitha Devanath
Dr A Pullaiah
Dr Shivani Jaiswal

Treasurer

Dr Anila Sushma Challa

Editor in Chief

Dr Anju Jain

Dr V Govindaraju
Head Office

Dr Prashant V
President 2022-23

Dr Jasbinder Kaur
Honorary Secretary Bangalore

Bangalore
drgovindaraju@gmail.com

JSSMC Mysuru
prashantv@jssuni.edu.in

GMCH, Chandigarh
jasbinderkaurambi@yahoo.com
jasbinderkaur@yahoo.co.in

Secretary General

Dr Shanthi Naidu K Care Hospital, Hyderabad

President Elect 2021

Dr Prashant V JSS Medical College, Mysuru Immediate

Past President

Dr Navjot Kaur DMC, Ludhiana

Joint Secretary

Dr Anitha Devanath St Johns Medical College, Bangalore

Joint Secretary

Dr A Pullaiah GMC, Nalgonda

National Coordinator

Dr Shivani Jaswal GMCH, Chandigarh

Treasurer

Dr Anila Sushma Continental Hospital, Hyderabad

Editor in Chief- IJMBDr Anju Jain LHMC, New Delhi

AMBI NATIONAL CONFERENCE-AMBICON 2022
The 29th Annual conference of AMBI was held for three days (21st to 23rd July 2022) and thetheme this year was “Building tomorrow's leaders by the young generation”. It wasorganized by Dr V Govindraju and Dr Shanthi Naidu at Moongate Resort, Bengaluru. The
conference was inaugurated by Dr Srinath Reddy, President of Public Health Foundation ofIndia and Former Head of Department of Cardiology, All India Institute of Medical Sciences,
New Delhi along with Dr K S Ravindranath, Former Vice-Chancelor, Rajiv Gandhi university
of Health Sciences, Bengaluru and Chief Cardiologist, Jayadeva Institute of Cardiac
Sciences, Bengaluru. It was attended and appreciated by about 450 academicians fromprestigious institutions across the country. Young scientists and Experts all over India

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Member Societies

APFCB News 2023 Issue 1

were invited to deliver orations and lectures. In addition to scientific sessions, there
were platform/poster presentations, and postgraduate Quiz program.

A 3-day preconference workshop (18th to 19th July 2022) was organized and the theme
for this year was “Advanced Techniques in Biochemistry”. The workshops were
designed to cover both theoretical and hands-on training in certain niche areas like PCR(Polymerase Chain Reaction), HPLC, LCMS/MS, Cell culture, prenatal workup, genetic
testing, cytogenetics, and Next generation sequencing. Nine workshops wereconducted parallely during this 3-day period. Target audience were postgraduates andresidents who had completed master's degree.
State Chapter Academic Activities
Various state chapters of the association held conferences , CMEs, workshops and likeacademic activities during the year.
6th March 2022, AMBI State Chapter Odisha held at MKCG Medical College,
Odisha.India Organizing Secretary- Dr Madhusmita Acharya.
26th March 2022,AMBI State Chapter Telangana, CME and workshop held on Advances
in molecular biology7 and primer designing’ at AIIMS Bibi agar, Hyderabad. Organizing
Secretary- Dr Anand Tyati. 23rd April 2022, AMBI Bihar State Chapter, Indira Gandhi
Institute of Medical Sciences, Patna held a Webinar on Essence of POCT in emergency.
Organizing Secretary-Dr RaviShekhar.

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APFCB News 2023 Issue 1

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22nd -23rd April 22 , 5th Annual State Conference of AMBI Telangana held at Kamineni
Academy of Medical Sciences and Research Centre, Hyderabad, India. The theme of theconference was ‘Biochemistry of Aging’ and workshop was held on ‘Therapeutic Drug
Monitoring’. Organizing Secretary_ Dr.Archana Dharwadkar.
28th-29th April 22, Tamil nadu State chapter CME: ‘Integrated biochemistry-basics totherapy’. Conducted for postgraduates based on clinical scenarios. Scientific online
and hybrid sessions on hemoglobinopathies, quality assurance, inborn error of
metabolism, metabolomics and instrumentation were conducted. Organizing SecretaryDr. M P Sarvanan.
7th Dec 2022 AMBI Panjab State Chapter. CME on ‘Newborn Screening –The Road Ahead’
held at AIIMS, Bathida. Punjab. India. Organizing Secretary-Dr Monica.

28th Jan 2023 AMBI State held a CME at JIPMER, Pondicherry “LABMEDIX: Focus onModern Concepts” held at JIPMER, Pondicherry ,India. Organizing Secretary - Dr Ramesh
Ramasamy.
5th Feb 2023 AMBI State Chapter Odisha held at Veer Surendra Sai Institute of Medical
Science & Research, Burla, Odisha. Organizing Secretary- Dr Madhusmita Acharya.
AMBI -Academic Webinars
25.01.23

Topic: Understanding automation in a diagnostic lab
Speaker; Dr G.Jayachandran16.02.23

Topic: ABC of molecular visualization
Speaker: Dr Shailesh Patel

National Academic Activities Planned in 2023:
11th-13th March 2023. Planned National PG Update by AMBI Chandigarh State Chapter,
in Chandigarh
Dec 2023 Annual National Conference of AMBI, in Mumbai. India
JOURNAL - IJMBJournal of the Association-IJMB is bringing out two issues per year.
Contributed by:
Dr. Jasbinder Kaur
Hon. sec-AMBI

48

Young Scientists Column

APFCB News 2023 Issue 1

IFCC-Task Force Young Scientists (TFYS)
at ACBICON - 24th-26th November - 2022
New Delhi, India
The 48th Annual Conference of Association of Clinical Biochemists of India (ACBI), washeld in ICAR Convention Center, New Delhi, from 24th to 26th November 2022. IFCC Task
Force Young Scientists symposium was successfully organized with the support of theorganizing committee of 48th ACBICON on 24th November 2022. The theme of the IFCCTFYS symposium was “Shifting Paradigms in Clinical Dialectology, reflecting recent
trends in the management of Diabetes Mellitus. The symposium was chaired by Dr.
Krishnajyoti Goswami and Dr. Jitender Sharma (Corresponding Member, IFCC TFYS, andIndia).
Diabetes mellitus affects people at the most productive age, slows economic growth,
reduces life-expectancy in older population, causes rise in healthcare expenditure.
Diabetes is a more complex disease than initially expected and its management should
target multiple defects that contribute to hyperglycemia. Evidence emerging over the
decade showed that intensive glycemic control does not seem to lower all-cause
mortality in Diabetes. Technological advances opened the route to the connected carehelping to shape new approaches to diabetes care.

L to R: Dr. Brijesh, Dr. Susruta Sen, Prof Kannan Vaidyanathan, Dr. Jitender
Sharma and Dr. Krishnajyoti Goswami

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APFCB News 2023 Issue 1

Young Scientists Column

The topics covered were, 1) Redefining Diabetes Care: Shift from Glossocentric to Organprotective approach- Dr. Anand Chellappan, Asst. Prof, Nephrology, AIIMS Nagpur. 2)
Emerging technologies for Diabetes Management: Application and Challenges-Prof
Kannan Vaidyanathan, IFCC TF-NBS, Vice President ACBI, 3) Unravelling the mysteries of
Hormonal Assays-Dr. Susruta Sen, Director Lab Medicine, CMRI Kolkata, 4) Incidence of
new onset diabetes in post COVID-19 patients-Dr. Brijesh, Era’s Medical College,
Lucknow.
The symposium concluded with an interactive discussion between speakers and young
scientists and the participating delegates.
We are thankful to the organizing committee ACBICON 2022, senior members IFCC and
ACBI; especially Prof Pradeep K Dabla, Consultant IFCC TFYS and our young delegatesfrom India.
By: Dr. Jitender Sharma, Assistant Professor Biochemistry, GIPMER, New Delhi andCorresponding Member, IFCC TFYS, India.

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Young Scientists Column

APFCB News 2023 Issue 1

IFCC Global Medicine Week & IFCC TFYSMaria Schroeder
Castagno
Contributed By: Maria Schroeder-Castagno (C-PR / TF-YS / WG-FC)
Acknowledgments: C-PR, Prof. Erasmus (Chair: C-PR), TF-YS; Santiago Fares Taie
(Chair: TF-YS)

From 2022, IFCC has launched a new initiative entitled “IFCC Global Medicine Week”
which will be carried out in April each year. However, many of this week programmes
will be carried out throughout the year. The idea behind this initiative is to createawareness of the fundamental role our profession plays in patient care and public health.
While

our

profession

is

vital

to

healthcare, healthsystemsandthegeneral public are not always aware of its crucial role in healthcare delivery. COVID
pandemic has greatly contributed to increase the visibility of our profession. We must
keep it alive over time with “Global Lab week” (GLW). In an era of social medias,with Public Relations Committee (C-PR) and Task Force Young Scientists (TF-YS) haveworked together and created a worldwide young scientists’ network to adapt our C-PR
programmes to current channels of communication. In this line, at the end of 2022, CPR have made liaison with Task Force young scientists (TF-YS) and at the beginning of2023 additionally with Committee on Internet and Digital Communications (C-IDC).
Thus, from 2023 young scientists (YS) around the globe have been invited to work
together with C-PR, C-IDC in collaboration with National IFCC Champions andAssociation Representatives to develop plans for promoting Laboratory Medicine to the
public in their respective countries during GLW mainly and throughout the year.
Among those plans are worldwide competitions for the tasks mentioned below to be
carried out in Spanish/English/French/Chinese-mandarin. We expect to expand ouractivities into additional languages in the future.

51

APFCB News 2023 Issue 1
1.

Young Scientists Column

Creation of videos in several languages as part of a project entitled “Live My Lab”,
where young scientists explain to the general population our daily work

2.

Creation of Audios (to be transformed in Spotify and Apple Podcasts) highlighting
the fundamental role of lab professionals in public healthcare. Clinicians andpatients’ opinion about the value of lab tests and lab professionals in the
improvement of patient care and diagnosis.

3.

Invite lab professionals to share their expert opinion on clinical diagnostics

4.

Organization of Open Days in clinical diagnostic labs in IFCC-member societies

5.

Organization of conferences/public lectures focused on emphasizing the role oflab professionals and laboratory tests in diagnosis and disease management

6.

Creation of brochures and video clips related to the impact of lab diagnostics inhealthcare.

Together we “develop programs to raise the awareness the fundamental contributionof lab medicine in patient care and public health”.



We believe that this Campaign to create awareness of the fundamental role our
profession plays in patient care and public health will impact positively in thevision of general public of our profession resulting in the support of our
profession in our respective countries.



We additionally expect a positive impact that health care providers, different
than lab-professionals, have of our professions.

52Young Scientists Column

APFCB News 2023 Issue 1

Young Scientist Interview

Kohki Okada
Junior associate professor
Department of Medical Technology and Sciences,
Faculty of Health Sciences, Kyoto Tachibana University, Kyoto, Japan
Corresponding member of Task Force for Young Scientists,
International Federation of Clinical Chemistry and Laboratory Medicine (IFCC)
1.

Please introduce yourself

My name is Kohki Okada, from Japan. I used to work as a biomedical laboratory scientist
in a general hospital and as a research assistant in a university. Currently, I am a juniorassociate professor at Kyoto Tachibana University, mainly teaching clinical chemistry to
students. I am actively engaged in both education and research in the university.
2.

What is your main focus?

I especially focus on research activities. My research theme is to develop laboratory
methods for detecting natural toxins derived from mushrooms, pufferfish, potatoes, etc.
Food poisoning by natural toxins even currently occurs worldwide, but most medical
facilities are unable to measure them in biological samples such as serum and urine. Then,
I am trying to establish laboratory methods based on high-performance liquid
chromatography(HPLC),

enzyme-linked

immunosorbent

assay(ELISA),and

immunochromatography.New HPLC and ELISA methods for α-amanitin, a mushroom toxin,
and tetrodotoxin, a pufferfish toxin, have already been developed and reported in research
papers. At present, I am in the process of constructing easy and rapid laboratory methods
for detecting α-selinene and α-chaconne, which are natural toxins of potatoes. Throughthese results, I would like to contribute to the improvement of diagnostics regarding foodpoisoning in medical facilities.
3.

What else is important to you?

I feel that international exchange is important. To date, I have attended and given
presentations at international academic meetings in France, China, and Korea. Furthermore,
I have been a corresponding member of the International Federation of Clinical Chemistry
and Laboratory Medicine Task Force for Young Scientists (IFCC TF-YS) since 2020.In recent
years, although the activities of the international academic society were restricted due tothe global COVID-19 pandemic, I have made efforts to continue them. IN collaboration withother members of the IFCC TF-YS, we created a video to encourage medical staffs striving
to suppress the COVID-19 pandemic.

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APFCB News 2023 Issue 1

Young Scientists Column

This video is now available on YouTube, in which I also make an appearance as arepresentative of young scientists in Japan. In addition, to providing useful informationon the pathology of COVID-19, I gave a presentation entitled “S100 proteins as
potentially therapeutic targets of the cytokine storm in COVID-19” at the IFCC Global
Conference on COVID-19; Critical Role of Clinical Laboratories in the COVID-19
Pandemic (virtual conference). Owing to these achievements, I have also been assigned
as a member of the Japan Association for Clinical Laboratory Science Committee on
International Activities. In 2023, under the project of this committee, we will organize
a symposium together with young scientists in Southeast Asia. I would like to be more
active in gaining experience in international exchange, and to promote the importanceof these experience to young scientists.
4.

What are your interests in biomedical laboratory medicine?

I predict that artificial intelligence (AI) will dramatically advance biomedical laboratory
medicine in the future. In recent years, there has been concern that AI may take away
the jobs of biomedical laboratory scientists. In my opinion, we do not have to competewith AI. AI certainly performs some tasks mechanically with given knowledge and canlearn from the results. However, AI can’t flexibly work compared with humans and isn’t
good at multi-tasking beyond their programs. I think that AI will probably come to
conduct some screening examination in the future, but biomedical laboratory scientists
will have to carry out highly specialized and complex examination and theinterpretation of the examined results. We need to develop our knowledge andexpertise to keep up with AI. I strongly recommend that young scientists try to obtainprofessional certifications and engage in research activities. In order to improve myEnglish skills and develop my expertise, I have previously taken and passed the Medical
Laboratory Scientist of American Society for Clinical Pathology certification. In addition,
I have two professional certifications in clinical chemistry and quality control in Japan.
I believe that such efforts are necessary to prevent our work from being. Substituted
by convenient tools such as AI and automatic analyzers.
5.

What are your future goals?

As a researcher, I would like to introduce new laboratory methods into the medical fieldin the future. For this purpose, I would like to continue to acquire specialized
knowledge and polish experimental skills. As a faculty member, I would like to promote
the growth of students so that they will become internationally active young biomedicallaboratory scientists. For this purpose, we would like to not only teach students a lotof specialized knowledge but also provide them with opportunities to participate inacademic conferences and make presentations.
Interviewer:
Dr. Ryunosuke Ohkawa, PhD
Professor of Analytical Laboratory Chemistry, Graduate School of Medical and Dental
Sciences, Tokyo Medical and Dental University. Committee member of Communication& Publications Committee.

54

Industry Voice Section

APFCB News 2023 Issue 1

Announcement on Corporate Appointments
to the Committees and Working Groups
Contributed by:
Dr. Douglas Chung FRSPHAPFCB Corporate Representative

The APFCB recognises the immense amount of knowledge and passion in laboratory
medicine amongst our industry partners. As such, we have encouraged interested andqualified individuals from our Corporate Member companies to join our various
committees and working groups. Their inclusion enables more direct hands-on
involvement and close collaboration with experts around the Asia-Pacific region, andensures that important industry viewpoints and expertise are not overlooked acrossour various programs and initiatives.
I am pleased to announce the appointment of the following individuals from our
supportive Corporate Members to the various committees and working groups. Pleasejoin me in congratulating them on their appointments, I am sure we will be seeing
many fruitful and win-win collaborations moving forward.
Publications and Communications
Committee

Dr Tze Wei Poh(Beckman Coulter)

Congress and Conferences Committee

Ms Sasha Duan
(Mindray)Congress and Conferences Committee

Mr Fionn Quinlan(Waters)

Scientific Committee - Working Groupon Harmonisation of Mass
Spectrometry

Mr Hong-Yew Lim(Roche)Scientific Committee - Working Groupon Harmonisation of Reference
Intervals

Dr Claire Chen
(Abbott)

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APFCB News 2023 Issue 1

56

Industry Voice Section

Scientific Committee - Working
Group on Patient-Based Quality
Control

Dr Shane Brown(Abbott)

Education Committee

Mr Sum Li(Greiner Bio-One)

Education Committee

Dr Pearline Teo(BD)

Laboratory Management
Committee

Dr Douglas Chung(Abbott)

Laboratory Management
Committee

Mr Anup Shamsher
Budhathoki(SNIBE)

Industry Voice Section

APFCB News 2023 Issue 1

Sigma Metrics for Vitros Acute Care Assays
from Asia-Pacific Region
Author: Johanna Miller, Ajita Kondalkar, Dr. Mayank Upadhyay
Conflict of interest: The authors are employees of Quidel Ortho
Content Owner: Quidel Ortho
Source of funding: Quidel Ortho
Corresponding Author:
Dr. Mayank Upadhyay
Regional Marketing Manager, Quidel Ortho Corporation
Email – Mayank.upadhyay@orthoclinicaldiagnostics.com
Introduction
Acute care assays are essential in providing timely and accurate information to healthcare
providers, enabling them to make informed decisions about the patient's treatment andmanagement. These assays which include a variety of biomarkers can help to identify
underlying conditions that may be contributing to a patient’s critical illness. This allows
healthcare providers to have a more complete understanding of a patient’s condition, andto implement more targeted and effective treatments. Critical care assays play a crucialrole in the management of critically ill patients with conditions such as acute myocardial
infarction, heart failure, acute kidney injury, and sepsis. Early diagnosis and treatment ofsepsis, which is a severe and often a life-threatening condition, is critical as the risk ofdeath increases with each hour that passes without appropriate intervention.
Our goal at Quidel Ortho is to provide hospital and diagnostic labs with easy to use
innovative technologies and systems that have the menu to support their clinical andoperational needs. The assays we provide need to be clinically precise, to support their
medical decisions in order to provide accurate and timely diagnosis for improved patientcare. Especially in a critical care setting like the Emergency Department or Intensive Care
Unit, getting the right result the first time in a timely manner is extremely important.
Laboratories are required by regulatory and accreditation agencies to assess and monitor
assay performance relative to acceptability criteria determined by CLIA (Clinical Laboratory
Improvement Amendments) or other apex bodies as part of their quality systems. The ongoing quality assurance program includes external QC (e.g. proficiency material, inter-lab
testing, etc. tested at various intervals throughout the year) and internal QC (assayed or
un-assayed quality control materials tested at least once per day).Internal QC utilizes
various tools like Westgard Rules, Sigma Metrics etc. to monitor assay. Precision andaccuracy. Labs can use results from internal or external QC to calculate Sigma Metrics aspart of a quality management system that can be used for process improvement. 1 Sigma
Metrics are important because they provide a measure of both the precision and accuracyof the test results. This is particularly vital in a critical care setting, where accurate test
results are essential for effective patient care and for ensuring optimal patient outcomes.
Sigma Metrics can be used to measure process performance on the “Sigma Scale” which
typically runs from 0 to 6, although a process can exceed Six Sigma if variability is
sufficiently

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APFCB News 2023 Issue 1

Industry Voice Section

Low as to decrease the defect rate. Within the context of clinical laboratories, thefollowing calculation is used to derive the Sigma metric for an assay: 2

𝜎𝑚𝑒𝑡𝑟𝑖𝑐 =(𝑇𝐸𝑎 − %𝐵𝑖𝑎𝑠)
%𝐶𝑉

Where
Tea= Total Error Allowed. Typically use proficiency limits%Bias = % error of a sample relative to a reference method or peer mean
%CV = 100 %*( Standard Deviation)/ (Mean) for QC fluids
CLIA proficiency limits are targeted to be adopted in 2024 and have been used in thispaper as the total allowable error when available 3. If unavailable, other published Teavalues were used such as the RCPA (Royal College of Pathologists of Australasia) 4,5 andRicco’s Desirable Limits. 6
This paper examines the Sigma metric values for critical care assays running on Vitros
analyzers. A control fluid was selected for each assay to be the most popular fluid forthe control level in the study time range with a medically relevant concentration. In
order to report a single value for each assay, the Sigma metric is taken as the medianvalue across all Vitros analyzers in the study that ran the control fluid of interest. Thus,
when this paper reports an assay as a particular sigma level, it means that at least halfof E-Connected® analyzers achieved that level of quality in a real-world setting.
Methods
The Quidel Ortho E-Connectivity® system connects Vitros analyzers to a cloud data
where results are collated. All results are pseudonym zed at source so result datacannot be attributed to any patient information. However, the information on control
fluids used for quality control (QC) measurements is retained. The E-Connectivity®
database.
Contains QC measurements for Vitros instruments for every assay from labs around theworld. In addition, several months of results are available, leading to the hypothesisthat it could be possible to assess the Sigma metric performance for the population of
Vitros analyzers.
This study specifically examined critical care assays running on Vitros analyzers in thefollowing countries: Australia, Bangladesh, India, Malaysia, Maldives, Myanmar, Nepal,
New Zealand, Philippines, South Korea, Sri Lanka, Thailand, and Vietnam.

Thesecountries represent a diverse range of healthcare markets, providing a good overview
of how the Vitros assays perform in varied settings. An algorithm was developed using
Python to extract QC data for a time span ranging from January 2022 to August 2022
(inclusive). This was done for each set of QC data that originates from a single assay,
control fluid lot, analyzer, reagent lot, and calibration curve – which will be referred toas a “combination” below. This analysis incorporated serum and plasma body fluids. In
the laboratory if the high and low QC levels are wrongly labelled, they can be manuallyamended or deleted. However, in the E-Connectivity® database, all results will bepresent which leaves the analysis susceptible to outliers if not mitigated. To assess foroutlier QC results within a combination, an interquartile range outlier detection

58

method7 was employed, and spurious replicates were removed if detected.

Industry Voice Section

APFCB News 2023 Issue 1

The average concentration for each combination was then calculated, requiring there to beat least 15 control data points in the combination.
For each control fluid for an assay, the peer mean and peer standard deviation were
calculated using all the relevant combination averages. To objectively assess whether
mislabeled fluids were present, a z-score was then calculated for each combination using
the following equation8:
𝑚𝑒𝑎𝑛𝑖 − 𝑝𝑒𝑒𝑟𝑚𝑒𝑎𝑛𝑧 − 𝑠𝑐𝑜𝑟𝑒𝑖 = ||𝑝𝑒𝑒𝑟𝑆𝐷

Where mean is the average concentration for a combination, peer mean is the average
concentration for a QC fluid lot across the means of all combinations, and peer SD is thestandard deviation of the combination means for a QC fluid lot. Any combination with a zscore > 1.96 was considered to be mislabeled and was excluded. Any fluid that did nothave at least 5 different analyzers used in the peer mean calculation was excluded. For
each combination, calculate the Sigma Metric as% 𝐵𝑖𝑎𝑠𝑖 = 100% ∗ |𝑚𝑒𝑎𝑛𝑖 − 𝑝𝑒𝑒𝑟𝑚𝑒𝑎𝑛|
𝑝𝑒𝑒𝑟𝑚𝑒𝑎𝑛%𝐶𝑉𝑖 = 100% ∗ |𝑆𝑖𝑔𝑚𝑎𝑀𝑒𝑡𝑟𝑖𝑐𝑖 =

𝑆𝐷𝑖
|
𝑚𝑒𝑎𝑛𝑖

𝑇𝐸𝑎 − % 𝐵𝑖𝑎𝑠𝑖%𝐶𝑉𝑖

Where mean is the average concentration for a combination, SD is the standard deviation
for points within a combination, peer mean is the average concentration for a QC fluid lot
across the means of all combinations, and Tea is the “total allowable error”. Note that peergroup mean is an acceptable method for determining bias for Sigma Metric calculations
when standard reference materials are not available9. The value of the Teased for eachassay is included in Table 1. For assays with a Tea expressed as a fixed limit, the peer
mean was used to convert the fixed limit to a percent as opposed to the combination mean.
Where the Tea value was available in the 2024 CLIA published data 3, it was used to calculate
the Sigma values. If 2024 CLIA data was unavailable, the following other sources were used:
Royal College of Pathologists of Australasia (RCPA) 4,5, and Ricco’s Desirable Limits6.Once a
Sigma metric is calculated for each combination for every assay, the median value acrossall combinations is taken as the Sigma metric for the assay.

59

APFCB News 2023 Issue 1

Industry Voice Section

Results
The Sigma metric results for each assay are shown in Table 1. In the table below, “TV” stands
for True Value.
Table 1: Sigma Metric Results for Vitros Critical/Acute Care Assays

60Industry Voice Section

APFCB News 2023 Issue 1

A summary of Vitros assays within each calculated median Sigma level is shown in Table 2
Table 2: Summary of Vitros Acute Care Assays for Each Sigma Level

4

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Industry Voice Section

Discussion
Conventionally, Sigma metrics are calculated within a single laboratory using reagentsand QC material stored and managed in the same way. In this study, the Sigma metricfor Vitros assays were calculated using QC results collected from Vitros analyzers
across different laboratories and countries. Although the systems were running thesame QC material, unknown variation in material handling could not be eliminated in
our analysis. It is also noted that this study included results from as many analyzers as
were available in the E-Connectivity® database, for some assays numbering in thehundreds. At a minimum, there were 5 different analyzers assessed for every control
fluid and assay. Thus, this study includes variability sources such as lab-to-lab, testing
on different days, and multiple reagent lots. It is noted that assays that demonstrated
high Sigma levels did so despite this variation.
In this analysis, 28 out of 35 of the assays assessed achieved 4 Sigma or better. Since
the reported metric is taken as the median value across all Vitros analyzers in the study,
it means that at least half of E-Connected analyzers achieved that level of quality in areal-world setting. Several assays that are key in managing critically ill patients achieved
Sigma metrics of six or better such as Troponin, NTproBNP, Creatinine(both single and
XT formats), C-Reactive Protein (both standard and high sensitivity), and PCT.
Potassium nearly achieved Six Sigma performance with a Sigma level of 5.6. Anotherimportant assay, high sensitivity troponin, achieved a Sigma metric of4.6 which can be
described as having between “Good” and “Excellent” performance.10
A key assay that appears to have low Sigma metrics is Sodium. Interestingly, it has
lower Sigma metric results compared to Potassium despite comparable %CV and %Bias
levels. However, the Tea limits are very different: the Tea is near 3% for Sodium whileit’s over 7% for Potassium. An examination of available literature suggests that therelatively tight Tea values result in low Sigma metrics for Sodium assays from othermanufacturers. When the same CLIA 2024 Tea limits are used to derive Sigma metrics
for Abbott’s ICT Sodium assay, 11 Siemen’s Sodium assay,12 or a cross-method
assessment of Bio-Rad Unity Inter laboratory Program data,13 Sigma metrics
consistently measure less than 4 for Sodium. This consistency is seen across studies is
despite differences in the type of reference method used, number of labs included in
the studies and assay reagent manufacturer. These lower Sigma values suggest thatlaboratories would benefit from running more Levels of QC more frequently14 thanPotassium, regardless of manufacturer. It was observed during the analysis that the
selection of control fluid for each assay sometimes had a significant impact on the
Sigma metric reported. For example, with high sensitivity troponin we report a Sigmalevel of 4.6 in this study based on a fluid with a peer mean of 9.8 ng/L. Had the analysis
instead used a higher level control fluid with a peer mean of 5,998 ng/L, the reported
Sigma metric could have been 8.14.However, it was determined that the performanceof high sensitivity troponin at an often an assay does not have a single “Sigma level”
for its performance. Rather, Sigma metrics can vary depending on the fluid selection
plus factors such as Tea. This is an inherent limitation of the study and it is encouraged
that the reader examine the Sigma metric results in the context of their patient
population.

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Industry Voice Section

APFCB News 2023 Issue 1

This study also suggests that further investigation is required to understand the reason
behind lower performing assays such as CKMB micro slide. An initial assessment of theraw data indicates that imprecision as opposed to inaccuracy is the main driver of the

APFCB News 2022 Issue 2

High Vitros
Sigmabutmetrics
correspondwith Thea significantly
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measured across the same reagent lot and same laboratory. Thus, the %CV would besuch6.high-levelinsightsthat otherwise
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provideinsights on
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Quidel Ortho aims to provide easy-to-use and innovative systems and technologies toin a variety of2278-1021
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support ISSN:
clinical and operational needs.critical care assays are essential in providing
acuteassays canhelpclinicalandlaboratories
ensurehighofthemaccuracyandhealthcare
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thatlevels
allowsto make
8. careE. Kreyszig(1979).
AdvancedEngineering
Mathematics(Fourthed.).
Wiley.
p.
informed
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andillmanagement.
In criticalcarehighlights
settings,
reliability880,
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eq. 5. ISBNand
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Sigma Metrics are an important tool for measuring the precision and accuracy of test
the 9.
importanceand Quality:
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assaysin criticalcare settingsfor ensuring
WestgardofS,accurate
Quantitating
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optimaloutcomes.
This
study
demonstrates that quality assay
results are being achieved by Vitros2016.
labs
AbbottLaboratories,
across multiple countries in the Asia-Pacific region. High sigma scores are particularly
https://static.secure.website/wscfus/4091441/uploads/MS_10_38704_Six_Sig
References for assays like potassium, creatinine, urea, high sensitivity Troponin,
importantma_Whitepaper_032111_8pgs_POSTED.pdf
NTproBNP,
and Procalcitonin
as theseare T.
useddiagnoseand monitor
criticallyill
1. Coskun
A, Unsal I, Serteser
M, InalSix toSigma
as a Quality
Management
Tool:patients.
10. Westgard S, Bayat H, Westgard JO. Analytical Sigma Metrics: A review of Six
Evaluation of Performance in Laboratory Medicine Quality Management and Six
Sigma implementation tools for medical laboratories. Biochem Med (Zagreb).
Sigma. InTechOpen: Rijeka, Croatia. 2010:248–61. [Google Scholar]
2.

2018 Jun 15;28(2):020502. doi: 10.11613/BM.2018.020502. PMID: 30022879;
J.O. Westgard, Six Sigma QC Design and Control, 2nd edition, Westgard QC,
PMCID: PMC6039161.
Madison WI, 2008 (First edition published in 2001).

11. Taher J, Cosme J, Renley BA, Daghfal DJ, Yip PM. A Novel Sigma Metric
3. Westgard QC. New CLIA Proposed Rules for Acceptance Limits for Proficiency
Encompasses Global Multi-Site Performance of 18 Assays on the Abbott Alinity
Testing.
https://www.westgard.com/2019-clia-changes.htm(Accessed
System.
Clin
November 2, 2021).
4.

Biochem.

2019;

63:106-112.

doi:

10.1016/j.clinbiochem.2018.10.003
Royal College of Pathologists of Australasia. “Chemical Pathology Analytical

12. Pierson-Perry J. Sigma Metrics for Atellica Solution Assays. (Order No. 30-18Performance
Specifications
RCPAQAP:RCPAQAP.”RCPAQAP,
12850-02-76). Tarrytown (NY): Siemens Healthineers; 2018https://rcpaqap.com.au/resources/chemical-pathology-analytical13. Computing a Patient-Based Sigma Metric” Kuchipudi, L., Yundt-Pacheco, J.,
performance-specifications/. Accessed 16 Nov. 2022.
Parvin, C.A., Clinical Chemistry. 2010, 56(6), Supplement:A35
14. Westgard JO, Westgard SA. Chapter 12 Designing SQC procedures. In: Basic
Quality Management Systems. Madison (WI): Westgard QC, Inc.; 2014.

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Industry Voice
Section

Advancing Women’s Health Key
Takeaways from AOGIN - 2022

Samantha Yeoh
By Samantha Yeoh
Digital Content Specialist, Roche Diagnostics Asia PacificWith face-to-face conferences and scientific symposiums back on, the Lab Insights teamrecently attended the 14th meeting of the Asia-Oceania Research Organisation in
Genital Infection and Neoplasia (AOGIN 2022). Distinguished speakers from around theworld gathered to talk about human papillomavirus (HPV) and the several cancers it
can cause, the most notable among them being cervical cancer. Here are somehighlights from the 3-day conference.
Asia Pacific’s vaccination and screening challenges
To tackle cervical cancer, one of the most dominant cancers in young women
worldwide, the World Health Organization (WHO) recommends a ‘90-70-90’ approachthat involves three key pillars: vaccination, screening and treatment. Yet coverage ofvaccination or screening is lacking in many parts of the world, including much of the
Asia Pacific region.
“With a vaccination programme rate that covers only 40%, Asia is lagging badly behind
the Americas and Europe,” noted Professor Suresh Kumar asamy, clinician and adjunctclinical professor at the Royal College of Surgeons in Ireland (UCD, Malaysia campus).
This is especially severe as low vaccination coverage means approximately 345 million
women are at risk. A lagging vaccine rollout and implementation was further hinderedby the low supply of vaccines during the COVID-19 pandemic.
To address these challenges, speakers at AOGIN 2022 brought up recommendations
that can be summarised into the following categories:
More funding to improve vaccine and screening access

Increased public education and trust in health institutions to address vaccine
hesitancy

64

•



Gender-neutral vaccination approach and herd immunity

School-based delivery of vaccines

Destigmatisation of cervical cancer and HPV infection

Industry Voice Section

APFCB News 2023 Issue 1

AOGIN 2022 speakers also discussed how various countries in the Asia Pacific region
have implemented policies in line with these recommendations, from vaccination
leadership in Australia to screening policy in Malaysia.
Vaccination leadership in Australia
The first pillar of the WHO’s 90-70-90 target is to ensure that 90% of girls are fully
vaccinated against HPV by 15 years old. Vaccination programmes are critical because
they help interrupt transmission risk, according to Dr Suzanne Garland, Director of the
Women’s Centre for Infectious Diseases in Australia.
Widely regarded as a pioneer in cervical cancer vaccination, Australia has had manysuccesses in its elimination efforts. Since the introduction of a vaccination programmein 2007, very little high-risk HPV strains are circulating in the community, a fact thatcan be attributed to the very high vaccination coverage in girls.
In 2018, Australia moved to vaccinate all eligible children, with coverage rates
reaching about 70% in adolescent males. “There is no one size fits all approach,” said
Dr Garland. “In our messaging, we must be sure not to stigmatise those with infection.”
Projection data provides further evidence of vaccine efficacy [1]. Dr Karen Canfell,
Director at The Daffodil Centre in Australia, shared data showing that an estimated
4.9 – 6.0 million cases of cervical cancer can be averted with ramped up HPV 16/18
specific vaccination, and an even larger estimate of 6.7 – 7.7 million cases of cervicalcancer with broad-spectrum vaccination.
When public trust in the efficacy and safety of vaccines is undermined, however, theimpact is far-reaching. In 2013, safety concerns raised by the public and media
reporting in Japan resulted in the ministry of health pausing HPV vaccine programmes.
Dr Ryo Konno of the Department of Obstetrics and Gynaecology at Jichi Medical
University said that surveys and research will soon reveal the ramifications of the 9year suspension. Even if and when vaccination rates recover and escalate, there is alimit to what this can do for women (and men) who are vaccinated in their post-teenyears [2].

The critical importance of screening
The second pillar of the WHO’s 90-70-90 target is to ensure 70% of women would bescreened with a high performance test by age 35 and again by 45. Screening has theability to achieve the targeted 4 or less cases per 100,000 women much earlier [2].
Despite the advantages of high-performance approaches like the HPV DNA test,
however, most experts would agree that screening with any test is better than none atall. There are a number of clinically validated assays that are approved for primary
screening, which you can find here.

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APFCB News 2023 Issue 1

Industry Voice Section“We have a long way to reaching 70% coverage of screening with a high performance
test,” noted Dr Neerja Bhatla, Professor of Obstetrics & Gynaecology at the All India
Institute of Medical Sciences in India. “Eventually, [implementing] screening
programmes will be even more important than the test itself.” Only 4 out of 10 ASEAN
countries have launched a population-based screening, with most women screened
opportunistically or not at all. This lack of access to screening can be due to manyfactors, ranging from the lack of financial resources to pay for a test to the low qualityof testing infrastructure within a country.
Effective cervical cancer screening programmes are worth the investment as they can
improve outcomes and reduce costs to health systems and women. The benefits canalso extend to the broader economy, with an estimated USD $3.20 return for every
dollar spent on intervention measures, and up to USD $26 when this support isextended to broader aspects of a woman’s life [3].
To reap all the benefits from screening programmes, having good follow-up services
is important. For Professor JautpolSrisomboon of Chiang Mai University, the practice in
his region for follow-up is predominantly colposcopy due to the low cost. Yet thispractice comes with its own set of challenges, such as 20-40% loss to follow-up, theemotional stress of waiting, and women incurring more expenses due to these multiple
visits. Srisomboon said that introducing HPV DNA testing for primary screening in
Thailand across all 77 provinces in 2023 would reduce the expected workload from
colposcopies to an estimated 2% of all screened women.
Screening is especially important in some minority populations, such as those livingwith HIV. In APAC, there are about 6 million adults and children living with HIV, second
only to the highly burdened regions of East and Southern Africa. With a compromised
immune system, HIV-infected women are 6 times more likely to develop cervical cancer
due to their inability to clear what should be a transient HPV infection [4].
Dr Annette H Sohn, paediatrician and Vice President and Director of TREAT Asia at
amfAR, argued that women living with HIV should be screened earlier, and screened
with HPV DNA tests more frequently. She highlighted that there is no one set of
guidelines for the management of HPV in this population, and called for efforts to close
the research gap.
The power of self-sampling
Many countries are also exploring self-sampling approaches to make it easier for more
women to get tested. These approaches are beneficial in places where women’s healthissues are culturally sensitive and for women who may hesitate before visiting a doctor
for sample collection. Being easily transportable, they are also beneficial for remoteand low-resource settings where access to testing services is limited.
Professor Woo Yin Ling, Consultant Gynaecological Oncologist at the University of
Malaya Medical Centre and Founder of Program ROSE (a community-based

screening

programme in Malaysia) spoke about the use of self-sampling as a possible for66Industry Voice Section

APFCB News 2023 Issue 1

conventional methods. Allaying concerns regarding the validity of the, she shared alist of papers (see below under additional resources) that show good concordance of
results between self-sampled and healthcare worker collected ones.
While not yet part of any national guidelines, urine-based HPV tests are anotherapproach to self-sampling that may have advantages in settings where vaginal swabs
are not as readily accepted. Studies run in the past few years have shown goodconcordance between first void urine samples and vaginal swab samples, but current
research is limited to small subject groups and most experts agree that more evidenceis needed to evaluate this method [5].
Additional Resources:
Arbyn, M. et al. (2018) “Detecting cervical preconcert and reaching under screened
women by using HPV testing on self-samples: Updated meta-analyses,” BMJ [Preprint].
Available at: https://doi.org/10.1136/bmj.k4823.
Polman, N.J. et al. (2019) “Performance of human papillomavirus testing on selfcollected versus clinician-collected samples for the detection of cervical intraepithelial
neoplasia of grade 2 or worse: A randomised, paired screen-positive, non-inferiority
trial,”

The

LancetOncology,20(2),

pp.

229–238.

Availableat:https://doi.org/10.1016/s1470-2045 (18)30763-0.
Saville, M. et al. (2020) “Analytical performance of HPV assays on vaginal self-collected
vs practitioner-collected cervical samples: The scope study,” Journal of Clinical
Virology, 127, p. 104375. Available at: https://doi.org/10.1016/j.jcv.2020.104375.
References:[1] Slims, K.T. et al. (2019) “Impact of scaled up human papillomavirus vaccination andcervical screening and the potential for global elimination of cervical cancer in 181
countries, 2020–99: A modelling study,” The Lancet Oncology, 20(3), pp. 394–407.
Avalable at: https://doi.org/10.1016/s1470-2045(18)30836-2.
[2] Burger, E.A. et al. (2020) “Projected time to elimination of cervical cancer in the
USA: A comparative modelling study,” The Lancet Public Health, 5(4). Available at:https://doi.org/10.1016/s2468-2667 (20)30006-2.
[3] A cervical cancer-free future: First-ever global commitment to eliminate a cancer.
World

HealthOrganization.

World

HealthOrganization.

Availableat:https://www.who.int/news/item/17-11-2020-a-cervical-cancer-free-future-first-everglobal-commitment-to-eliminate-a-cancer (Accessed: December 8, 2022).
[4] Stelzle, D. et al. (2021) “Estimates of the global burden of cervical cancer associated
with

HIV,”

The

LancetGlobalHealth,9(2).

https://doi.org/10.1016/s2214-109x (20)30459-9.

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Availableat:APFCB News 2023 Issue 1

Industry Voice Section[5] Ørnskov, D. et al. (2021) “Clinical performance and acceptability of self-collectedvaginal and urine samples compared with clinician-taken cervical samples for HPV
testing among women referred for colposcopy. A cross-sectional study,” BMJ Open,
11(3). Available at: https://doi.org/10.1136/bmjopen-2020-041512.

Expert Opinion Paper

APFCB News 2023 Issue 1

Artificial intelligence and laboratory
medicine: at the crossroads of value
ethics and liability
Damien Gruson, Pradeep Kumar Dabla
Pôle de recherché an Endocrinology, Diabetes et Nutrition, Institute de Recherché

1

Experimental et Clinique, Clinique’s Universities St-Luc and University Catholique deLouvain, Brussels, Belgium.
Department of Clinical Biochemistry, Clinique’s Universities St-Luc and University

2

Catholique de Louvain, Brussels, Belgium
3

Department of Biochemistry, G.B. Pant Institute of Postgraduate Medical Education &Research, Associated Maulana Azad Medical College, New Delhi, India

Corresponding Author
Prof. Damien Gruson, damien.gruson@saintluc.uclouvain.beLaboratory medicine plays a pivotal role in healthcare and provides essential
diagnostic information to guide clinical decision-making. Emerging technologies suchas next-generation sequencing, liquid biopsies, and omics have transformed
diagnostic testing on the way of a more personalized medicine. These technologies
enable healthcare professionals to obtain more precise and accurate diagnostic
information, which can lead to more targeted therapies. Artificial intelligence (AI) isalso revolutionizing laboratory medicine with the potential to leverage value atdifferent levels such as improving patient outcomes, clinical laboratories efficiencies
and allocation of resources.
AI has the potential to transform laboratory medicine by enabling better decisionmaking, faster diagnosis, and more personalized treatment. AI can analyze andintegrate vast amounts of data, identify patterns, and make predictions that can assist
healthcare professionals in making accurate diagnoses. AI can also optimize
laboratory workflows, reducing turnaround.

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APFCB News 2023 Issue 1

Expert Opinion Paper

Time and improving patient outcomes. AI is also at the basis of a next generation ofclinical decision support systems (CDSS) that can assist healthcare professionals inmaking clinical decisions. CDSS can integrate patient-specific data, imaging, andclinical guidelines to provide personalized treatment recommendations. However,
CDSS must be carefully designed and evaluated to ensure that they are accurate andreliable and laboratory specialists are playing a fundamental role for that.
However, these advancements also raise ethical concerns and questions of liability.
The use of emerging technologies and AI in laboratory medicine raises ethicalconcerns such as patient privacy, informed consent, and the potential for biases. AI
algorithms must be transparent, explainable, and accountable to ensure that they
are not perpetuating biases or making decisions that are not in the best interest of
the patient. Patient privacy must also be protected when using AI, as patient data
can be vulnerable to hacking and misuse.
Another important concern for the use of AI is liability. Who is responsible if an AI
algorithm makes an incorrect diagnosis or recommendation? Is it the healthcare
professional who uses the tool, the manufacturer of the tool, or the AI algorithm
itself? Liability must be carefully considered and addressed to ensure that patientsare protected, and healthcare professionals are not held responsible for errors that
may be beyond their control.
Specialists in laboratory medicine are central players in the transition of emerging
technologies as well as in the application of AI. They should be engaged, collectively
and in multidisciplinary teams to achieve it. They must also carefully evaluate andimplement these technologies to ensure that they are accurate, reliable, and ethical.
It is crucial to strike a balance between the benefits and potential risks of using
emerging technologies and AI in laboratory medicine to ensure the best possible
outcomes for patients.
References:1.

Jiang F, Jiang Y, Zhi H, et al. Artificial intelligence in healthcare: past, present andfutureStroke and Vascular Neurology 2017; 2: doi: 10.1136/svn-2017-000101

2.

Wiens J, Saria S, Sendak M, et al. Do no harm: a roadmap for responsible machinelearning for health care. Nat Med. 2019; 25:1337–1340.

3.

Waechter, S., Mittelstadt, B., Russell, C.: Bias preservation in machine learning: thelegality of fairness metrics under EU non-discrimination law. W. Va. L. Rev. 123, 735(2020)

4.

Irene Y. Chen, Emma Pierson, Sherri Rose, Shalmali Joshi, Kadija Ferryman, Marzyeh
Ghassemi. Annual Review of Biomedical Data Science 2021 4:1, 123-144

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Expert Opinion Paper

APFCB News 2023 Issue 1

Comparative Analysis of COVID - 19 Image
Processing With X-Ray And CT Scan
Amit Kumar Arora, 2Jyoti Parashar, 3Kamal Upreti, 4Balram Rao
Department of Computer Science and Engineering, IIT Madras, India
2,3
Department of Computer Science & Engineering, ADGITM, Delhi, India
4
Asia Pacific Institute of Management, New Delhi, India
11manshguide@gmail.com, jyoti.parashar123@gmail.com,
kamalupreti1989@gmail.com, balram.rao@asiapacific.edu

Corresponding Mail Id: kamalupreti1989@gmail.com
ABSTRACT- the SARS-COV2 (COVID-19) virus continues to spread over the world in theform of various mutant strains that are responsible for epidemic conditions. As aresult, the clinical prognosis cannot be relied upon. Chest x-rays, computed
tomography, and ultrasound imaging models supplement the analytical methods (forexample, RT-PCR) to a certain degree, despite the fact that different clinical diagnostic
approaches have been developed and used up to this point. The purpose of this work
is to carry out the diagnosis of COVID-19 individuals utilizing the image padding
technique, as well as to develop a Deep Covix-Net model for the identification of
COVID-19, Pneumonia, and healthy individuals utilizing X-ray and CT scan images.
Both of these objectives will be accomplished through this work. Using ultrasoundpictures, create a model called Ultra Covix-Net for early diagnosis of COVID-19,
pneumonia, and healthy persons; then, using CT scan images, estimate the severityof the COVID-19 infection. In order to complete the categorization process, machinelearning and deep learning strategies are used.
KEYWORDS: COVID-19, World Health Organization (WHO), Computed Tomography,
SARS-CoV-2, diarrhea,
General introduction
AI and its applications are among the most explored research regions. Over recent
years, we have seen AI upsetting a wide range of clinical imaging, including chest XRay, ultrasound.

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Expert Opinion Paper

CT, fMRI, PET, as well as SPECT. Different AI-situated devices have to modernize clinicalpicture assessment and further create robotized picture interpretation. Modern
medical imaging methods allow doctors to access data from a wide range of different
sorts of research, including artificial intelligence. Deep learning, fuzzy sets, roughsets, doubtful analysis, multi-target development, swarm knowledge improvement,
and machine learning are only few of the many areas of study that often make use of
these elements. Patients are surveyed according to clinical groups using the delayed
findings of these commonly used tests as a data point. By taking use of AI models'capacity to understand patterns and connections in clinical images, this newexperiment in computer intelligence-driven configurations enhances tools forindividualized infection evaluation. To do this, clinical images are used as the training
data.
Prevalence of covid-19 disease
In the latter half of 2019, the SARS-COV2 (COVID-19) outbreak began in Wuhan Cityin China, and it eventually became a pandemic over the whole world. The pandemic
caused by the COVID-19 virus has spread to more than 220 countries and territories
throughout the world and has had an effect on every aspect of our day-to-day life. The
quantities of contaminated cases passing despite everything increment significantly,
which does not indicate a very well controlled circumstance; as of the 22nd of January
in the year 2022, a total aggregate of 34,64,64,304 (55,85,224) contaminated(deceased) COVID-19 cases were accounted for all over the world [1]. The World HealthOrganization (WHO) has classified this illness as a global epidemic and has
recommended a number of preventative actions in response to the growing severityof the pandemic. In the 21st century, Human COVIDS like as SARS-CoV and MERS-CoV
have emerged out of the animal supplies-induced global pandemic, bringing withthem a distressingly high mortality rate as well as morbidity. Infections caused by the
COVID-19 virus seen in humans are classified under the Corona vitrine subgroup,
which is part of the larger Corona viridae group. It was given the name COVID-19
owing to the presence of spikes in the pattern on the outside surface of the infection
when seen under an electron microscope. Its RNA is a lone abandoned molecule witha diameter ranging from 80 to 120 nm, and the length of the nucleic material reaches
varies between 26 and 32 Nucleotides [2]. In its most basic form, they may be broken
down into four different genera known as, whereas -Cove and -Cove are mostly
responsible for infecting vertebrates, -Cove and -Cove are primarily responsible for
infecting avian species. HCoV-229E, in addition to HCoV-NL63 of -Coves, as well as
HCoV-HKU1 and HCoV-OC43 of -Coves, demonstrates modest pathogenicity as well
as mild respiratory side effects as a normal virus. This makes them one of the six
defenseless human illnesses.

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Figure 1 exhibits the total number of reported cases. Figure 2 represents the daily
number of deaths reported up to 22nd January, 2022.

Figure 1- Number of active cases up to 22nd January, 2022 [1]Figure 2- Number of deceased cases up to 22nd January, 2022 [1]Characteristics of COVID-19
While the profoundly pathogenic infection predominantly influences individuals
through respiratory droplets, disseminated via ecological contact [5, 6]. Unlike thevarious respiratory infections, other studies [7, 8] recommended that the SARS-CoV-2
communicated through the oral-fecal course. An ongoing investigation was done inref. [9] on stool specimens of seventy-one individuals with COVID-19, 39 individuals+ve for fecal COVID-19 RNA, which supports the speculation that fecal-oral
contamination could be an extra course for the extent of the infection. Generally,
COVID- 19 manifestations are cough, fever, as well as fatigue [10–12].Various
gastrointestinal indications showed in contaminated individuals like diarrhea, nausea,
as well as deficiency of appetite [13, 14]. It is also important to note that the infection
contamination could happen with no manifestation; asymptomatic people are apossible wellspring of infection transmission.

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Consequently, stringent adherence to the climate, hand cleanliness, as well as contact
segregation is needed to guarantee viral control. The ACE2 is the cell receptor for
COVID-19 as well as various respiratory asperity condition viruses [15]. It acts a real
job in the guideline of intestinal aggravation as well as the management of heart
physiology. In any case, it has been accounted for that ACE2 is a cell-surface receptor
for the infection, which works with the viral RNA section in the lung [16, 17].
Aspects of medical imaging modalities in the prognosis of COVID-19
The RT-PCR is usually employed being the determination of COVID-19. Thisbiochemical response utilizes RNA rather than DNA as an initial step [8]. The reverse
transcriptase chemical utilizes the RNA to generate a corresponding single-abandoned
DNA in the reverse transcription measure. Then, at that point, the new integral single
DNA is changed over into twofold abandoned DNA since it is utilized as a format fora PCR reaction [1, 2]. Even though numerous endeavors have been led to augment the
number of PCR tests each day, this method experiences a few limits. The remarkablepace of false-negative recognized in individuals identifying COVID-19, the nonaccessibility of PCR reagent kits, and the generally lengthy timespan interaction ofthis technique [2]. Various more precise procedures or practices are expected to help
determine COVID-19 infected individuals in such a setting. In this circumstance, clinicalimaging methods assume a significant part in separating patients chosen from a frontline medical emergency and in the portrayal of pulmonary inclusion of COVID-19. The
role of clinical imaging in battling the epidemic of COVID-19 and achieved outcomesof each imaging approach are explained.
COVID-19 exists in the form of various mutants, making epidemic circumstances
around the globe. Thus, the clinical prognosis is not precise. However, different
medical predictive techniques are in practice, viz. CXR, Computed Tomography, afurthermore non-radiation technique like ultrasound diagnostic method to augment
the analytical techniques (for example, RT-PCR) to a definite restraint.
Chest X-Ray
Description: A typical X-ray utilizes an immovable tube that transmits X-rays in a single
direction.
Working Principle: An electromagnetic wave of immense energy as well as shortened
wavelength, which can send over the body.
Wavelength range: 10-9 to 10-12 meters and Energy range: 124 eV to 124 Kev.
Usage: To detect dislocations and fractures of bones as well as to detect cancers andPneumonia.
Given the large number of medical infectious of COVID-19, the Chest X-ray method is
possibly a convenient tool for identifying the infection because its vacancy correlated
to CT tools. In a few nations like Spain, X-ray is the primary imaging procedure utilized
for the prognosis of COVID-19 infected individuals [2].

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The significant characteristics noticed in X-ray image individuals with COVID -19 were
GGO as shown in figure 3, pulmonary nodules as well as interstitial variations [3, 4].
The Ground Glass Opacities were described as hazy regions by expanded lungthickness without obscuration of bronchial designs as well as vessels [18, 19].
Likely the rise of infected cases, the adoption of X-rays could perform a significant
aspect. It may inhibit CT analysis, especially in the nations with restricted availabilityof the RT-PCR method. Nonetheless, in extremely medically infected, an RT- PCR test /Computed Tomographic films should be carried out [20, 21].

Figure 3- A sample of COVID-19 infected Chest X-ray image shows peripheral opacities
in all pulmonary lobes.
Chest Computed Tomography
Description: Computed Tomographic films are associated with abundant X-ray
measurements, collected from various angles to yield cross-sectional pictures of aparticular region of a scanned bodyWorking Principle: A mechanized X-ray source that explodes narrow beams of X-rays
as it pivots around the individual.
Usage: Particularized images of abundant structures inside the body, containing thebones, internal organs, as well as blood vessels.
Under current medical involvement, Chest CT is contemplated as the best accurate
tool for identifying COVID-19 disease [5]. Albeit various early prognosis tests of viral
infectious like RT-PCR as well as biomarkers [6, 7]. The CT pictures give more signs ofinfection movement; furthermore, it is endorsed for asymptomatic individuals with ve nucleic acid testing [8].

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Indeed, affectability of chest Computed Tomography is better than RT-PCR in
recognition of COVID-19 disease as exhibited in Fang et al. [9], as well as was
illustrated in the analysis that enclosed 1014 individuals amidst +ve RT-PCR test thatrevealed an affectability of 97 percent of chest Computed Tomography in theidentification of COVID-19 [3]. In general, CT identification is the crazy-paving patternthat resides in linear patterns overlapped on circumstances of Ground Glass Opacities[1, 2], as indicated as shown in figure 4. Various abnormal features were accomplishedin CT pictures like pleural effusion, lung fibrosis, and airway transitions [3, 4].

Figure 4- A sample of COVID-19 infected CT scan image shows the crazy-paving
pattern
Chest UltrasoundDescription A piezoelectric crystal vibrates when an electric signal is enforced
creating high-recurrence sound waves.
Working Principle Transducer transmits sound waves inside the body, gathers thereverberations that are reflected, and transfers them to PC, which makes the pictures.
Sound wave range 2 to 18 MHz
Usage To detect the organs damage, tissues, and other structures inside the body.
Figure 5- A sample of COVID-19 infected Ultrasound image
Researchers concentrated on X-ray and CT results for COVID-19 diagnosis to thegreatest extent possible. Ultrasound images and their potential inputs were used to
do some analysis that helped diagnose the illness. Ultrasound artefacts from thepleural surface and the chest wall are important to analyse for diagnosing lunginfections. As shown in figure 5, the B lines artefacts, in their varying manifestations,are characteristic of COVID-19 in LUS images [5]. This is particularly true for thesituation of intermediate asperity. The focus on this artefact as a specific lunginfection lineage is growing. Broad bands of tissue in the lungs emerge at the pleuralline and move forward in a coordinated manner through lung sliding, as described in[6,25].

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Additional indicators of COVID-19 in LUS images include pleural line abnormalities.
The average range separates the horizontal lines below the pleural lines in normallungs. These pleural lines seem broken, uneven, and thickened to the person livingwith COVID-19 [22, 23].
The LUS method may be useful in determining the presence or absence of an active
infection, and it certainly has the advantage of being less expensive [24]. Chest
ultrasounds have limited use in medicine, being limited to detecting abnormalities in
the lungs' periphery [7].
Medical Imaging Positioned on AI on the Prognosis of COVID-19
In the face of widespread worries over the COVID-19 pandemic, the majority ofcountries have adopted the policy of home isolation for infected persons who movethrough moderate or advanced phases of the disease. Nevertheless, using thisstrategy results in an extremely high mortality rate, which is proportional to thenumber of patients that are infected. The rapid worsening in patients' health broughton by COVID-19 at the emergency stage of the disease in the presence of very severe
circumstances [8] may help to explain the rise in the mortality rate. In severe cases of
respiratory failure, heart attack, or severe pneumonia, hospitalization is required as
one of the next stages in the treatment process.
It is possible that clinical imaging technologies that include AI techniques will be vitalin the future since they will provide patients with a quick and early diagnostic
mechanism during times of severe illnesses. In addition, AI would be able to determine
the major vulnerability instances that are associated with the quick progression ofserious consequences for people who have COVID-19, which would make it possible
to expand the treatment plan.
Conclusion
The findings that were presented and reported in the dissertation were the result
analysis of radiological pictures to locate people who were infected with COVID-19. At
the preliminary phase of the pandemic, simulation was carried out on a small numberof the samples that were available in the repository. As time goes on, more
photographs are added to the repositories as a result of the rising number of incidents
that occur each day. An early detection of COVID-19 using Ultrasound pictures may

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There by minimize the severity level and prevent the infection from spreading to otherpeople. The approaches that were exhibited produced superior performance accuracy
with big and balanced picture datasets in comparison to previous published studies.
Neither overfitting nor under fitting will have any effect on the suggested models while
they are being trained or tested. After receiving this first diagnosis, these processes
could be of use to the doctors and radiologists in caring for COVID-19 infectedpatients.
References[1]

GoogleNews:

https://news.google.com/covid19/map?hl=en-IN&gl=IN&ceid=

IN%3Aen. Accessed on 22nd January 2022.
[2] Zhu, N., Zhang, D., Wang, W., Li, X., Yang, B., Song, J., Zhao, X., Huang, B., Shi, W.,
Lu, R. and Niu, P., 2020, “A novel coronavirus from patients with pneumonia in China,
2019”, New England journal of medicine, 382, pp. 727-733.
[3] Yin, Y. and Wondering, R.G., 2018, “MERS, SARS and other coronaviruses as causesof pneumonia”, Respirology, 23(2), pp. 130-137[4] 3D medical animation corona virus.jpg- Wikimedia Commons. Wikimedia
Commonsn.d.https://commons.wikimedia.org/wiki/File:3D_medical_animation
corona_viru.jpg. Accessed on 8th August, 2021.
[5] Liu, J., Liao, X., Qian, S., Yuan, J., Wang, F., Liu, Y., Wang, Z., Wang, F.S., Liu, L. andZhang, Z., 2020, “Community transmission of severe acute respiratory syndrome
coronavirus 2, Shenzhen, China, 2020”, Emerging infectious diseases, 26(6), pp.
1320.
[6] Jiang F, Deng L, Zhang L, Cai Y, Cheung CW, and Xia Z, 2020, “Review of the clinicalcharacteristics of coronavirus disease 2019 (COVID-19)”, Journal of General Internal
Medicine, 35, pp. 1545-1549[7] Yeo, C., Kaushal, S. and Yeo, D., 2020, “Enteric involvement of coronaviruses: isfaucal–oral transmission of SARS-CoV-2 possible?” The lancet Gastroenterology &hepatology, 5(4), pp. 335-337.
[8] GU, J., Han, B. and Wang, J., 2020, “COVID-19: gastrointestinal manifestations andpotential fecal–oral transmission”, Gastroenterology, 158(6), pp. 1518-1519.
[9] Xu, Y., Li, X., Zhu, B., Liang, H., Fang, C., Gong, Y., Guo, Q., Sun, X., Zhao, D., Shen,
J. and Zhang, H., 2020, “Characteristics of pediatric SARS-CoV-2 infection andpotential evidence for persistent fecal viral shedding”, Nature medicine, 26(4), pp.
502-505[10] Fu, L., Wang, B., Yuan, T., Chen, X., Ao, Y., Fitzpatrick, T., Li, P., Zhou, Y., Lin, Y.F.,
Duan, Q. and Luo, G., 2020, “Clinical characteristics of coronavirus disease 2019
(COVID-19) in China: a systematic review and meta-analysis”, Journal of Infection, 80(6), pp. 656-665.

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APFCB News 2023 Issue 1[11] Pernazza, A., Mancini, M., Rullo, E., Bassi, M., De Giacomo, T., Della Rocca, C. andd’Amati, G., 2020, “Early histologic findings of pulmonary SARS-CoV-2 infection
detected in a surgical specimen”, Virchows Archive, 477(5), pp. 743-748[12] Zhang, R., Ouyang, H., Fu, L., Wang, S., Han, J., Huang, K., Jia, M., Song, Q. andFu, Z., 2020, “CT features of SARS-CoV-2 pneumonia according toclinicalpresentation: a retrospective analysis of 120 consecutive patients from Wuhan city”,
European radiology, 30(8), pp. 4417-4426[13] Cholankeril, G., Podboy, A., Aivaliotis, V.I., Tarlow, B., Pham, E.A., Spencer, S.,
Kim, D., Hsing, A. and Ahmed, A., 2020, “High Prevalence of Concurrent
Gastrointestinal Manifestations in Patients with SARS-CoV-2: Early Experience from
California”, Gastroenterology, 159(2), pp. 775-777[14] Xiao, F., Tang, M., Zheng, X., Liu, Y., Li, X. and Shan, H., 2020, “Evidence forgastrointestinal infection of SARS-COV-2” Gastroenterology, 158(6), pp. 1831-1833.
[15] Zhang, H., Penninger, J.M., Li, Y., Zhong, N. and Slutsky, A.S., 2020, “Angiotensinconverting enzyme 2 (ACE2) as a SARS-CoV-2 receptor: molecular mechanisms andpotential therapeutic target”, Intensive care medicine, 46(4), pp. 586-590.
[16] Jia, H.P., Look, D.C., Shi, L., Hickey, M., Pewe, L., Netland, J., Farzan, M., WohlfordLenane, C., Perlman, S. and McCray Jr, P.B., 2005, “ACE2 receptor expression andsevere acute respiratory syndrome coronavirus infection depend on differentiation ofhuman airway epithelia”, Journal of virology, 79(23), pp. 14614-14621.
[17] Misra, D.P., Agarwal, V., Gasparyan, A.Y. and Zimba, O., 2020, “Rheumatologists’perspective on coronavirus disease 19 (COVID-19) and potential therapeutic targets”,
Clinical rheumatology, 39(7), pp. 2055-2062.
[18] Shreshth Tuli, Shikhar Tuli, Gurleen Wander, Praneet Wander, SukhpalSingh Gill,
Schahram Dustdar, Rizos Sakellariou, Omer Rana, Nextgeneration technologies
for smart healthcare: challenges, vision, model,trends and future directions, Internet
Technol. Lett. 3 (2) (2020) e145.
[19] Maxwell W. Libbrecht, William Stafford Noble, Machine learning appli-cations in
genetics and genomics, Nat. Rev. Genet. 16 (6) (2015)321–332.
[20] Mohammad Jamshidi, Lalbakhsh Ali, Jakub Talla, Zdenˇek Peroutka,Farimah
Hadjilooei,

PedramLalbakhsh,

MortezaJamshidi,

Luigi

LaSpada,Mirhamed

Mirmozafari, Mojgan Dehghani, et al., Artificialintelligence and covid- 19: deeplearning approaches for diagnosis andtreatment, IEEE Access 8 (2020) 109581–
109595.
[21] A. Singh, D. Singh, K. Upreti, V. Sharma, B. Singh Rathore, and J. Raikwal,“Investigating New Patterns in Symptoms of COVID-19 Patients by Association Rule
Mining (ARM),” Aug. 25, 2022. https://doi.org/10.13052/jmm1550-4646.1911(accessed Mar. 05, 2023).

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Expert Opinion Paper[22] Pradeep Kumar Dabla, Kamal Upreti, Divakar Singh, Anju Singh, Jitender Sharma,
Aashima Dabas, Damien Gruson, Bernard Gouget, Sergio Bernardini, Evgenija Homsak& Sanja Stankovic (2022) Target association rule mining to explore novel paediatricillness patterns in emergency settings, Scandinavian Journal of Clinical and Laboratory
Investigation, 82:7-8, 595-600, DOI: 10.1080/00365513.2022.2148121.
[23] Upreti, K. et al. (2023). IoT-Based Control System to Measure, Analyze, and Track
Basic Vital Indicators in Patient Healthcare Monitoring System. In: Shaw, R.N.,
Paprzycki, M., Ghosh, A. (eds) Advanced Communication and Intelligent Systems.
ICACIS 2022. Communications in Computer and Information Science, vol 1749.
Springer, Cham. https://doi.org/10.1007/978-3-031-25088-0_63.
[24] Upreti, K. et al. (2023). A Deep Convolution Network-Based Pneumonia
Identification from Thoracic X-Ray Imagery Scans. In: Nagar, A.K., Singh Jat, D., Mishra,
D.K., Joshi, A. (eds) Intelligent Sustainable Systems. Lecture Notes in Networks andSystems, vol 578. Springer, Singapore. https:/ /doi.org/10.1007/978-981-19-76605_64[25] Syed MH, Upreti K, Nasir MS, Alam MS, Kumar Sharma A. Addressing image andPoisson noise deconvolution problem using deep learning approaches. Computational
Intelligence. 2022;1-15. DOI: 10.1111/coin.12510

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Accreditation of Medical Laboratories as
per ISO 15189 - New the 4th Version
Changes from 2012 – 2022

Tomáš Zima
Institute of Medical Biochemistry and Laboratory Diagnostics, 1st Faculty of Medicine,Charles University and General University Hospital, Prague, Czech Republic phone:+420-22496 2841, e-mail: zimatom@cesnet.cz
One and key of the priorities in laboratory medicine is improvement of quality
management system for patient safety. Quality in the health care is tightly connectedto the level of excellence of the health care provided in relation to the current level ofknowledge and technical development.
Accreditation is an effective way to demonstrate competence of the laboratory, is atool to recognize laboratories world-wide, is linked to periodical audits stimulating tokeep and improve the quality, leads to high standard of services for clients (patients,
health care providers, etc.). Accreditation is a procedure by which an authoritative
body gives formal recognition that a body or person is competent to carry out specifictasks, it is an independent process and there is only one recognized national
accreditation body in each country.
The history of quality systems in labs has started many decades ago. The first steps
are implementation of internal (IQA) and external quality control (EQA) systems andtheir basic principles in daily laboratory practice.
An importance set of criteria was done in EN 45 001 (European Standard), specifying
general criteria for the operation of a testing laboratory. Next step for accreditation
was documented in ISO 17025 (General Requirements for the Competence of Testing
and Calibration Laboratories). This standard is widely used for testing laboratories inwhole world in industry and also in medicine. This standard requires a management
system and how the laboratory be found competent to perform specifictests/calibrations or types of tests/calibration.

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The strategic plans of IFCC and EFLM include focusing on accreditation of labs basedon ISO standards and cooperation with regional accreditation bodies and national
accreditation bodies. IFCC and EFLM recognised that ISO 15189 Medical laboratories– Requirements for quality and competence is precisely describing standard for labs
and has been widely accepted. The first issue of standard was in 2003, 2007 next
2012 and in December 2022 was issued the last the 4th version.
Main principles for the revision of ISO 15189 and new ISO 15189:2022 version


ISO/IEC 17025 is the normative reference to ISO 15189 and the 2017
revision of ISO/IEC 17025 informs the revision of ISO 15189 (restructured
according ISO 17025); therefore, the common structure of ISO CASCO
standards (ISO CASCOPROC 33) has been implemented in the new draft of ISO
15189. Mandatory language coming from PROC 33 was integrated into the
document and will continue to be highlighted throughout the relevant partsof the document.

The revised ISO 15189 will consider other relevant published ISO
documents with the aim of avoiding redundant repetitions, as well assynchronizing relevant clauses in the following: ISO 15190, ISO 22367, ISO
TS 20658, ISO 17511, ISO TS 20914, and the suite of molecular diagnostic
standards developed by ISO TC 212 WG 4.



The revised ISO 15189 should be less prescriptive risk based and linked
to patient care.

The revised ISO 15189 will include relevant aspects of POCT performed
under the control of the laboratory.

Main changes in ISO 15189: 2022
New part of ISO/IEC includes part – impartiality (Laboratory activities shall be
undertaken impartially and structured and managed so as to safeguard
impartiality) Confidentiality (The laboratory shall be responsible, throughlegally enforceable commitments, for the management of all patient
information obtained or created during the performance of laboratory
activities) and ethical conduct.

More ethical issues - timely satisfaction of the needs of patients and medical
staff



Complexity of services from preparation of patient to interpretation of results

Better communication between labs and other health care providres –harmonization of processesManagement system – in accordance with the principles of ISO 9001:2015.
The laboratory shall establish, document, implement and maintain amanagement system. The laboratory shall implement a management system
in accordance with Option A or Option B.

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Emphasis on risk management (aligned with the principles of ISO 22367
Medical laboratories–

Application of risk management to medicallaboratories) and evaluation of effectiveness of processesThe requirements for laboratory safety are aligned with the principles of ISO
15190 Medical laboratories – Requirements for Safety.

Implementation of POCT requirements - additional requirements for Point of Care
Testing (POCT) - Annex C (normative)
We cannot forget that the most critical parameter for improving the quality of labs iseducational activities inside and outside the labs, which are the key points inaccreditation and quality management systems.
Accreditation is mandatory in some countries or will be mandatory in the future (e.g.
France, Hungary, Lithuania) or some specific parameters should be accredited (e.g.
Germany, Belgium, Czech Republic, Serbia, Greece – molecular biology, new born
screening, blood transfusion, etc.) or accredited labs have better reimbursement orcontract with health insurance companies (e.g. Sweden, Belgium, Czech Republic).
The accreditation of labs improves laboratory medicine and all processes inlaboratories, which include – reduction of errors in the pre-analytical, analytical andpost analytical processes, facilitation of accurate and rapid diagnostics, participationin acceleration and efficiency of treatment, facilitation of personalised medicine
development, and stimulates continuous improvement.
Accreditation is more an instrument than the aim that increases the quality of services
for clients – patients, physicians. Accreditation is not about who the best is, but who
has a system of standard procedures. Improvement of quality system in labs isambitious and never ending story. Don’t forget that quality system is about people,
with people and for people.
References1.

Zima T. Accreditation in clinical laboratories. Biochemical Medical 2010; 20/2:
215-220.

2.

EN ISO 17025:2017 - General Requirements for the Competence of Testing
and Calibration Laboratories.

3.

EN ISO 15189:2012 - Medical laboratories – Requirements for quality andcompetence.

4.

EN ISO 15189:2022 - Medical laboratories – Requirements for quality andcompetence.

Acknowledgment Supported by MH CZ DRO VFN 64165 and Cooperation Program,
research area DIAG.

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Special Report

ACBICON, Assessing AI Technologies
and Ethics in Healthcare Services – 2022

Bernard GOUGET, Chair IFCC-CMHBLM, IFCC Abbott VLPWith the participation at the preconference workshop of IFCC ETD EC and IFCCC MHBLM:
Pradeep Kumar DABLA, Department of Biochemistry, G.B.Pant Institute of
Postgraduate Medical Education & Research (GIPMER), Member IFCC C-MHBLM
Damien GRUSON, IFCC- ETD member, IFCC-C MHBLM liaison
Sergio BERNARDINI, Chair IFCC ETD
On the occasion of the 48th annual conference ACBICON 2022 (New Delhi, Nov 2426th 2022) organized by the Association of Clinical Biochemists of India, the topic
Artificial Intelligence and its ethical challenges in Lab Medicine was the subject ofseveral presentations. As disruptive technology advances, that interact more directlywith the digital sphere, the healthcare and lab medicine sectors are transforming
themselves on a daily basis, characterized by better clinical diagnosis. Across thehealthcare sector, technological and product advances are supporting patient
diagnosis and care. Lab Medicine is affected significantly by 4.0 technologies, which
include machine learning and artificial intelligence, Internet of Things andautomation, data mining as well as multiomics and POCT devices improving healthy
lifestyle. The integration of these new technologies is perhaps one of the mostessential developments in the Indian context.
A preconference workshop dedicated to: “Assessing AI technologies in healthcare
services “was organized by Prof Pradeep Dabla and IFCCC-MHBLM on November 23th
at the Delhi Govind Ballah Pant Institute of Post Graduate Medical Education andResearch (GIPMER). In his opening speech, he recalled that the primary duty of thespecialist in Lab Medicine is to the patient, placing the welfare of the patient above
their own needs and desires and ensuring that each one receives the highest qualityof care according to current standards of medical practice. Laboratory medicine has
always been one of the medical disciplines with the highest degree of digitalization.
Since its emergence, automation, electronic transmission of results, and electronic
Reporting have becoming increasingly prevalent. High quality lab medicine services
must be safe, effective, efficient, timely, equitable, and patient-centered. Specificknowledge of AI in the lab medical community is still poor and AI education is muchneeded. This was the challenge of the workshop. Education on the value of AI andresearch to prove its clinical utility are needed to integrate AI into laboratory

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AI in healthcare is the use of complex algorithms and software to mimic humancognition in the analysis of complex medical data. AI algorithms can only work
properly with reliable and accurate laboratory data. As laboratory medicine enters into
the era of big data and artificial intelligence (AI), the ability to provide accurate, readily
available and contextualized data is crucial.

AI has the potential to improve

diagnostics through more accurate pathology detection, better laboratory workflows,
better decision support, leading to greater efficiency. Prof. Sergio Bernard in précisedthat AI employs quite different mathematical and algorithmic approaches, fromoperational research to constrained programming, and is therefore at the crossroadsof neuro-computing, statistical inference, pattern recognition, data mining, knowledge
discovery, and machine learning (ML). As a subfield of AI, ML is built upon statisticaland optimization concepts. It can be described as the development of computer
programs that learn from experience with respect to task and performance measures.
AI and data science have demonstrated success in image analysis in radiology,
pathology, and genomics analysis for accelerating diagnosis speed; improving
accuracy and enhancing medical expertise. Considering the growing quantity anddiversity of data to which healthcare professionals are exposed as biological data,
genomics, proteomics, clinical observations, and personal records, Data science with
AI will no doubt prove useful for holistic interpretation of the wealth of information inlab Medicine. Prof. Damien Gruson, attending on line, explained that modern medicine
generates a great deal of data stored in medical databases. Data mining, also known
as knowledge discovery in databases, refers to the process of extracting potentially
useful information and knowledge hidden in a large amount of incomplete,
redundancy fuzzy, and random practical application data, and closely related to timeand, medical data mining differs. Analyzing the quantitative and qualitative clinicaldata in addition to discovering relationships among a massive number of samples
using data mining techniques can unveil hidden medical information in terms ofcorrelation and association of apparently independent variables and discover new
relationships among substantial data sets. Data mining is a multidisciplinary field at
the intersection of database technology, statistics, ML, and pattern recognition thatprofits from all these disciplines. Although this approach is not yet widespread in thefield of medical research, several studies have demonstrated the promise of data
mining in building disease-prediction models, assessing patient risk, and helping
physicians make clinical decisions.
At the end of the morning session, Dr. Manu Shetty, MAMC, Delhi (IN), described acomprehensive life cycle for the design, development, and deployment of artificial
intelligence (AI) systems and solutions.

The preliminary risk assessment willcontribute toward an informed practice of AI, as well as the increased awareness,knowledge, and transparency of AI and its capabilities. After a convivial lunch sharedwith the students, the IT and computer team presented a practical guide and exercises
to getting the most out of Excel, using it for data preparation, applying machinelearning models, including cloud services and understanding the outcome of the data
analysis. The second afternoon session started With Dr. Pierre-Jean Lamy, Montpellier
(FR).

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He recalled the origins of the concept of Artificial Intelligence. After the firstdevelopments initiated by the mathematician Alan Turing, modern AI was founded in
1956, at a conference at Dartmouth College, (New Hampshire, USA), where the term
"artificial intelligence" was coined. Based on cybernetics and computer science, AI
benefited from important research funds until 1974. After several reports criticizing
progress in AI, government funding and interest in the field dropped off – a period
from 1974–80 that became known as the “AI winter”. At this time, two AI began tocompete: the symbolic AI and the connectionist AI. Symbolic AI is also known as expert
systems is widely used in laboratory medicine. As connectionist AI tend to mimic more
precisely human intelligence using neural network, its use to resolve complex
problems has grown significantly since the 2000s. Machine learning and deep learning,which are a part of AI were developed for image recognition and exploration of Big
Data. As laboratory medicine continues to undergo digitalization and automation,
laboratorians will likely be confronted with the challenges associated with AI.
Currently, the most common roles for AI in medical settings are clinical decision
support and imaging analysis. Digital pathology, cytology and cytogenetics inhematology, genetics (NGS diagnostics), and automated validation of clinicallaboratory test results are some of the fields of laboratory medicine already has been
impacted by AI development. The biggest challenge for AI in medicine is working on
quality data with the best possible curation. It has a significant cost. Using AI ingenomics is difficult to navigate, not only for the great variety and large amount ofavailable data, not just to understand what question to ask and which equipment touse, but also because this field is highly sensitive to legal, ethical and moral aspects.
AI opens up many possibilities and the road that follows the development of AI is justbeginning to unfold and bringing many promises. AI is just at the beginning of its
potential applications in genomics, the path is still long but irreversible. AI presents
an opportunity to improve the efficiency of lab medicine, health care delivery and thequality of patient care, but there is much work to do for using AI safely and ethically.
AI in medicine has also its own challenges. Four major ethical issues must be
addressed: informed consent to use data, safety and transparency, algorithmic fairness
and biases, and data privacy are all key factors to consider. AI triggers major ethicalconcerns and questions regarding the ability to disseminate their benefits in an
equitable manner. During the preconference, Bernard Gouget first defined Ethics as
the science of morale concerning principle of human duty in the society. It is the social
value which binds the society by uniform opinion/consideration and enables thesociety to decide what is wrong and what is right. Ethics is engaging multiple
disciplines, including philosophy, law, political science, and education. Ethics is notstatic, applicable for all times. What was considered good ethics a hundred years ago
may not be considered the same today The disruptive technologies confront us withmany ethical questions: new genetic knowledge, AI, Big Data, precision medicine organtransplantation, new definition of death, sophisticated means of keeping people alive,
anxiety about the costs of health care, and a more informed and educated public.
These matters are moving well beyond the boundaries of medical ethics. The term
bioethics generally refers to the study of ethical issues arising because of thedevelopment made in the field of medicine.

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APFCB News 2023 Issue 1

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Biology, and technology, which might become a cause of concern for humans or
detrimentally affects the association between human and their environment. Gouget
recalled the Core Principles of Bioethics: - Beneficence: duty to help the patient advancetheir own good and to act in a patient’s best interest-Autonomy: duty to honor apatients right to make their own decision and to be self-determining-No
maleficence: duty to do no harm to the patient-Justice: duty to be fair in how care isprovided and in how resources are allocated. No single principle trumps the others;
their relationship is dynamic and requires clinicians to carefully evaluate each situation
on its own merits and patient needs.
As with any transformative technology, some AI applications may raise new ethical andlegal questions, for example related to liability or potentially biased decision-making.
AI must be developed and applied in an appropriate framework which promotes
innovation and respects the human values and fundamental rights as well as ethicalprinciples such as accountability, transparency an equitable healthcare delivery. The
EU guidelines address issues such as the future of work, Informed consent to use data;
fairness, safety, security, social inclusion and algorithmic biases and transparency,
data protection and privacy, cybersecurity, and Intellectual property law. The insertionof an algorithm’s predictions into the patient-physician relationship introduces a third
party, turning it into one between the patient and the healthcare system. It changes
the dynamics of responsibility and the expectation of confidentiality. Later on during
the congress, Prof. Jawahar Kalra (CN) shared his experience with the Delphi technique,a well stablished international protocol used to find consensus among experts andsolutions to complex multidisciplinary challenges, that has identified key ethical issues
pertaining and presented the SHERPA (Systemic Human Error Reduction and Prediction
Approach) a consortium of eleven partners from six countries that analysed how AI
impacts ethics and human rights. Dr. R Dhananjayan, Chennai (IN), discussed on theseveral eras in Lab Medicine practice where the implementation of ethical guidelines
presents challenges. They included: Consent from patients (i.e. consent for unforeseen
complications, usage of leftover samples and bio-banking)- Considerations in genetic
testing-Reporting

implications

inincidental

findings-errors

disclosure-Roleoflaboratories in test utilization-Direct to consumer testing - Emerging diseases settings.
IFCC-TF for Ethics, AACC, ISO have defined ethical recommendations for medical labs.
The

IFCC

TF-E

has

streamlined

documents

available

worldwide(https//www.ifcc.org/taskforceethics/). ISO 15189:2012Its section 4.1.1.3 elaborated
the ethical conduct required in laboratories. Its section 4.1.1.3 elaborated the ethicalconduct expected in laboratories including topics like confidentiality, conflict ofinterest, undue pressures and influences and requirements.
Today, artificial intelligence plays a role in billions of people’s lives. Sometimes
unnoticed but often with profound consequences, it transforms our societies andchallenges what it means to be human. AI has the real potential to provide real social,
Economic and environmental benefits making direct improvements to people ‘everyday
lives. We only can agree with the WHO‘s guidance of June 28th 2021 : "While newtechnologies using artificial intelligence hold great promise to improve diagnosis,
treatment, health research and drug development supporting governments carryingout public health functions, including surveillance and outbreak response, suchtechnologies must put ethics and human rights at the heart of its design, deployment

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APFCB News 2023 Issue 1

Special Reportand use. “Congratulation to Prof. Pradeep K Dabla for the organization of thepreconference at the GIPMER and for its participation at the ACBICON 2022. Training
medical students in AI and Ethics have to be acknowledged as an important need. It
was possible to familiarize students with the development of AI and Ethics in Lab
medicine and to provide students with competencies in the use of IT tools, AI theories
and ethics principles as well as to familiarize students with disruptive technologies.
Photo: AT the GIPMER, GB Pant Hospital, and New Delhi L to R: Sergio Bernardini
Bhawna Mahajan, Pradeep K Dabla, and Bernard Gouge

Photo: IFCC MHBLM Workshop Participants & Speakers at the GIPMER GB Pant

Hospital, New Delhi

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APFCB News 2023 Issue 1

IFCC MHBLM Workshop Participants & Speakers at the GIPMER GB Pant
Hospital, New Delhi

IFCC Speakers AT the ACBICON 2022, New Delhi

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The Learning Lab for Laboratory Medicine:
10,000 Strong!
Contributed by
Prof. Nader RIFAI
Boston Children’s Hospital Department of Laboratory Medicine
Boston, USA
The Learning Lab for Laboratory Medicine on NEJM Knowledge+ program recently hit amajor milestone! Over 10,000 individuals from 149 countries are currently using thisprogram; 80% of users are from outside the United States. This cloud-based program
consists of >115advancedcourses and >80 courses for practicing Medical Laboratory
Specialists,covering

topicsthat

spanacrossall

disciplinesoflaboratory

medicine(https://area9lyceum.com/laboratorymedicine/). The entire program is freeof charge for individual users to eliminate financial barriers and is endorsed andpromoted by IFCC.

Photo: Users of the Learning Lab
The courses are based on the concept of adaptive learning, the closest to personalized
education. Adaptive learning is an ingenious way to communicate information.
Through sophisticated computer algorithms, the platform interacts with the learnerand identifies the areas in which they are not proficient. It then provides targetedlearning materials to remedy the deficiency, thus enabling efficient learning in small
blocks of time. The program can be accessed via mobile devices for added flexibility.

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Over 130 leading clinical laboratory scientists and physicians from the United States,
United Kingdom, Canada, Australia, Iceland, Denmark, Norway, Croatia, Italy, South
Africa, Hong Kong, Turkey, and Singapore have built these courses. Each course
consists of ~100 granular learning objectives; every learning objective is coupled with
one to two probes and a learning resource. The probes are the actual questions andcan be presented in one of nine different formats that meant to be engaging andinteresting to the learner. Each course goes through a rigorous internal and external
Review process followed by a beta testing evaluation. Over 300 laboratory medicine
professionals have participated in reviewing and performing the beta testingevaluation of these courses.
This program has been designed for laboratory medicine professionals in hospital andcommercial laboratories as well as the in vitro diagnostics industry to help them toassess their knowledge, remain abreast with current knowledge, and prepare forcertification exams.
Currently, this program is only available in English. However, efforts are underway tohave the entire program translated to Chinese, both simplified and traditional,
Japanese, French, Arabic, and Bahasa Indonesia. The Chinese and French websites will
be launched in mid-2023; the other languages will follow shortly. Discussions are
currently underway to also include Spanish and Portuguese versions. As daunting as
these efforts are, they are essential to increase accessibility of this program throughout
the world and to enable those who are not comfortable with English to benefit from it.
This ambitious program is a collaborative effort between New England Journal of
Medicine Group, AACC, and Area9 Lyceum, a global leader in education technology.
IFCC YS and all other laboratory medicine professionals worldwide are strongly
encouraged to take advantage of this opportunity and join the over 10,000 users of
this program.

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Newborn screening innovation ramps up
at Murdoch Children’s in Australia

Contributed by:Will Greene
Healthcare Engagement Manager, Roche Diagnostics Asia Pacific
As interest and investment in newborn bloodspot screening (NBS) grows acrossAustralia, the Murdoch Children’s Research Institute in Melbourne is gaining
momentum as an important centre for NBS research and innovation in the country.

Based at the Royal Children’s Hospital in Melbourne, the capital of the State of Victoria
in south-eastern Australia, Murdoch Children’s is one of the largest child healthresearch institutes in the world. It manages a portfolio of research programmes thatgenerate knowledge and drive benefits for children in Australia and around the world.
It also hosts some clinical services, including Victoria’s NBS programme.
While Murdoch Children’s is known for much more than NBS and clinical genetics, its
impact in this specific space is noteworthy and growing. From expansion of its existing
NBS panels to developing novel approaches for detecting rare genetic diseases innewborns, Murdoch Children’s is running projects that showcase both the power of
NBS as a public health tool and its potential for delivering even more benefits in the
coming years.

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Expanding existing NBS panels
Murdoch Children’s provides NBS services through Victorian Clinical Genetics Services(VCGS), a non-profit subsidiary that offers prenatal, childhood and adult genetics
services. All NBS services at VCGS are publicly funded by the Victorian Department of
Health and offered free of charge to state residents.
In its standard NBS panel, VCGS currently screens for 26 conditions. Last year, it addedcongenital adrenal hyperplasia, and in keeping with federal efforts to expand andstandard dies NBS panels across the states, it is now in the process of adding NBS tests
for spinal muscular atrophy (SMA) and severe combined immunodeficiency disorder(SCID), two tests that were recently made available in the neighboring state of New
South Wales.
Expanding the panels by even one condition requires considerable effort, notes Dr.
Ronda Greaves, Deputy Head of Biochemical Genetics at VCGS. The SMA/SCID tests will
require them to use molecular methods in first-tier analysis for the first time, but
Greaves says that implementing the technology is the easy part. The harder part istraining the staff to adapt to changing workflows without compromising the integrityof the existing NBS programme.
Educating and engaging the community in research
In addition to managing NBS services, Murdoch Children’s also supports community
outreach efforts that ensure high uptake of NBS services and help maintain public trust.
These efforts have increased in recent years, according to Monica Ferrie, head of the
Genetic Support Network Victoria, an organisation that works with rare disease patientgroups and families across the state.
Proactive community engagement also drives support for NBS research programmes.
Dr Meg Wall, CEO of VCGS, estimates that roughly 85-90% of parents who receive NBS
services will consent to sharing DE identified newborn blood spot data with MurdochChildren’s investigators.
Some of this NBS data is also linked with the Generation Victoria (Gen V) initiative, a$55 million whole-of-state natural history study that aims to enroll 100,000 newborns
by late 2023 [1]. Through Gen V, parents of newborns will share longitudinal data
about various health, social and developmental parameters. This will facilitate many
types of research, including better understanding of the clinical utility and economic
impacts of NBS programmes.

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Developing and testing novel NBS methods
Murdoch Children’s also supports researchers who focus on creating and assessing
new NBS modalities. One of these researchers is Dr David Godler, a molecular
geneticist who leads the Diagnostics and Development Laboratory at MurdochChildren’s. Godler is currently developing a low-cost diagnostic method called EpiGNs,
which uses a combination of DNA methylation testing and genomic workflows to
expand NBS panels.
In prior studies, EpiGNs showed promise as a cost-effective method for expanding NBS
panels to cover numerous conditions, including Fragile X, Prader-Willi, Angelman and
Dup15q syndromes [2]. In 2022, Godler won a $3 million grant from the Medical
Research Future Fund (MRFF) [3] and an additional $1.8 million from the National
Health and Medical Research Council Ideas Grants to develop this work further [4].
For next steps, Godler intends to use these two grants to test his EpiGNs method on
an expanded panel that includes 8 conditions, generating further data on its potential
cost effectiveness and clinical utility. Some of this research will leverage the
GenVprogramme, allowing Godler to assess the impact of early detection of genetic
disease on longer-term clinical and health economic outcomes.
Assessing the power of Whole Genome Sequencing (WGS)
Another MRFF-funded researcher at Murdoch Children’s is Dr. SebLunke, who serves
as Head of the Division of Genetics and Genomics at VCGS, where he runs one of thelargest clinical genetics labs in Australia. Last year, Lunke won an AUD $3 million grantfrom MRFF to assess the role of whole genome sequencing (WGS) for NBS.
In the first phase of this project, which will be called Baby Screen+, Lunke will trial a
WGS model of NBS on a thousand babies in Victoria. Although WGS enables screening
for potentially thousands of conditions, Lunke will start with a panel of several hundredconditions that are well validated, clinically actionable and meet predeterminedbioethical criteria. The ultimate goal is to better understand how to use WGS data
responsibly at birth and over the life of care.
Lunke and colleagues are careful to point out that WGS is not a silver bullet for genetic
disease detection and is unlikely to replace traditional NBS methods anytime soon. In
fact, running both methods in parallel may eventually allow NBS labs to detect a
broader array of conditions with greater accuracy, notes Dr. David Amor, a clinicalgeneticist and research group leader at Murdoch Children’s who serves as a coinvestigator on both the EpiGNs and WGS grants.
Building the broader ecosystem of rare disease diagnostics
Beyond NBS, Murdoch Children’s and VCGS are working to drive improvement in the
broader array of rare disease diagnostics that facilitate early and rapid detection ofgenetic diseases. This includes work in carrier screening, non-invasive prenatal testing,and acute care genomics (they are among the fastest providers of whole genome

94

sequencing services in Asia Pacific).

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APFCB News 2023 Issue 1

Advances in these areas may shape the future of NBS, and as Australia continues to drive
research and innovation in this exciting field, Murdoch Children’s and VCGS will be places
to watch.
This article was written by Will Greene, Healthcare Engagement Manager at Roche
Diagnostics Asia Pacific and co-lead of Project Strong bow, an initiative to drive bestpractices in NBS through educational content and community building. Other articles andvideos that were produced as part of this project can be found on our Newborn
Screening page.
References:[1] Generation Victoria. Available at: https://www.genv.org.au/[2] Should newborn screening include chromosome 15q disorders? Lab Insights. Available
at: https://www.labinsights.com/get-inspired/content/should-newborn-screening-includechromosome-15q-disorders[3] Federal funding for genomics projects aiming to improve child health (Sept2022). Murdoch Children's Research Institute. Available at: https://www.mcri.edu.au/newsstories/federal-funding-for-genomics-projects-aiming-to-improve-child-health[4] Federal grants to advance earlier diagnosis and treatments for childhood conditions (Dec2022). MurdochChildren's

Research

Institute. https://www.mcri.edu.au/news-

stories/federal-grants-advance-diagnosis-treatments-childhood-conditions

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In a Taiwan Clinical Lab, Molecular
Consolidation offers Key Benefits

By Dr. Fang-Yeh Chu
Director, Department of Clinical Pathology and QMC, Far Eastern Memorial
Hospital, Taiwan

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Molecular consolidation is a significant improvement over the long tradition of buying a
specific platform for each test offered by a clinical lab. These single-test technologies had
to be implemented and validated individually, and each one required its own training andcalibration protocols. In many cases, each platform also required a substantial financial
outlay. For labs looking to provide more than just a few types of tests, having test-specificinstruments was a major limiting factor in their ability to respond to patients’ needs.
Today, though, diagnostic platform manufacturers are addressing these challenges bydesigning systems that can be operated with many different assays. These flexible
platforms might operate at low, medium, or high throughput, allowing laboratories tochoose the system that best fits their testing needs. Instrument manufacturers offer many
types of assays that can be run on the platform, making it easy for labs to expand theirtest menus simply by ordering new kits. Some platforms can even be used as thefoundation for laboratory-developed tests, greatly increasing their flexibility and value toclinical labs.
At Far East Memorial Hospital in Taiwan, Dr Fang-Yeh Chu leads a team that recently
implemented a diagnostic platform that enables them to run a broad range of tests. Theirevaluation of the molecular consolidation approach has been very successful and wasparticularly important for meeting increased testing demand in the COVID-19 pandemic.
According to Dr Chu, molecular consolidation offered his team a number of key benefits.
Broad test menu implementing a flexible, high-throughput molecular diagnostic
platform allowed the clinical lab to run many different types of tests at scale with excellent
precision. They use it for virology assays, including HIV, HBV, HCV; transplant assays,
including CMV, EBV and BKV; and respiratory assays, including influenza and SARS-CoV2. They are now working to add HPV and MTB/MAI testing to their offerings.
Lean lab While COVID-19 testing temporarily doubled the clinical lab’s staff size, the teamis normally composed of just five lab members. Consolidating more tests onto a single
automated platform that requires minimal hands-on time makes it possible for even avery small team to handle a wide array of testing needs.
Standardisation Since all tests are designed to operate on the same instrument, training
time for new tests is minimal. Once the team members learn the system, anyone can run
any of the tests provided for it, making it easy to achieve higher precision. Dr Chu believes
this is one of the most important benefits of molecular consolidation, and notes thattraining for the system in his lab was very easy. “My colleagues can use the device very
quickly,” he says. He added that setup was very quick too, with the new assays up andrunning in the lab in less than a week.
LIS Simplicity Typically adding a new test to a clinical lab involves not just validating the
new technology, but also dealing with the inevitable challenge of connecting the newplatform to the lab information system (LIS). But when new tests can be added to an
existing platform.

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There is no need for additional LIS connections. Dr Chu says the system he choseconnected to his LIS very easily. Now, new tests can be added at any time without requiring
additional LIS setup.
Reliable support with any new test platform, clinical lab teams take a gamble on thequality of technical support they will receive from the vendor. Some manufacturers haveterrific support resources, while others can leave their customers hanging. By
consolidating tests on a single system from a reliable vendor, clinical labs can avoid thepossibility of inadequate support. “We always select the device based on the performancenot only of the device, but also of the support team,” Dr Chu says, noting that his teamhas been able to get answers immediately for the system they adopted.
As Dr Chu’s experience shows, molecular consolidation offers many benefits. It allows
clinical labs to broaden their test menu with ready-to-use reagents while streamlining theirworkflows, simplifying LIS connectivity and minimising training demands, all while
maintaining excellent performance and without necessarily requiring new headcount.
Through partnership with instrument manufacturers that offer high-quality systems andfast and reliable support, consolidated molecular systems give clinical labs the power toscale up or down based on rapidly shifting demands, such as those brought about by
current and future pandemics.

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Quiz Section

APFCB News 2023 Issue 1

Quiz Section!!
Question 1: (Case 1)
Patient: 63-year-old Male
Clinical information: Myeloma?
Episode: Since abnormal serum Haptoglobin data was obtained (1st test, Table 1), a
biomedical laboratory scientist checked the time course of the reaction as shown in Figure
1. After diluting the serum with saline, serum Haptoglobin level in the diluted serum wasmeasured (2nd test).
Table1 Data from auto analyzer (1st and 2nd)
AnalyteResult (1st test)

Result (2nd test)

Haptoglobin－10 mg/dL

32 mg/dL

Total protein

9.0 g/dL

Albumin

3.3 g/dL

IgG

513 mg/dL

IgA

45 mg/dL

IgM

4,021 mg/dL

Haptoglobin, IgG, IgA, and IgM levels were measured byimmunoturbidimetric assay:
Reagent 1 and Reagent 2 mainly include reaction buffer and their corresponding
antibodies, respectively.

Figure 1 Reaction time course of haptoglobin (1st
test)
Figure 1: Reaction time course of haptoglobin (1st test)99

APFCB News 2023 Issue 1

Quiz Section

Which of the following is the most likely cause of the abnormal data?
a)Sampling errorb)

Reagent dispensing errorc)Turbidity of reaction solutiond)

Deterioration of halogen lampe)Air bubbles on the reaction vessels

Question 2: (Case 2)

Patient: 58-year-old Male
Location: Ward
Clinical information: Myeloma
Analyte (Serum for clinical chemistry tests, whole blood (EDTA-2K) for CBC)
Episode: After whole blood obtained from the patient was centrifuged to isolate serum
sample, the appearance of the test tube was as shown in the Figure 2. The volume of theserum sample was not enough to perform all analyses. Blood test results on the day before
are presented in Table 2.

Figure 2 Appearance of the centrifuged test tube
Table 2 Clinical chemistry and CBC test results on the day before

100

AnalyteResultTotal protein

11.3 g/dL

Albumin

3.1 g/dL

IgG

7,200 mg/dL

IgA

112 mg/dL

IgM

34 mg/dL

RBC counts

320 ×104 cells/μL

hematocrit

30.2 %

hemoglobin

10.3 g/dL

Quiz Section

APFCB News 2023 Issue 1

Which of the following is the most likely action that laboratory scientist should do?
a)

Measure only some analytes, and no additional actionb)

Try re-centrifugation of the test tube to further the isolate serumc)Request the additional blood sample collection using serum test tubed)Request the additional blood sample collection using heparin-lithium test tubee)

After diluting the serum sample to get enough volume, use the diluted sample formeasurement.

Contributed by:
Dr. Ryunosuke Ohkawa, PhD
Professor of Analytical Laboratory Chemistry, Graduate School of Medical and Dental
Sciences, Tokyo Medical and Dental University. Committee member of Communication &Publications Committee

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APFCB News 2023 Issue 1

Quiz Answer

Answer Section!!

Answer for question 1: (c)You sometimes encounter a negative value output from an auto analyzer. In case ofthat, just re-test or re-test using the diluted sample can be helpful to obtain the true
value. However, since it might be caused from a technical hitch of the auto analyzer,
exhaustive investigation is essential to avoid or solve the problem. One of the effective
way for the investigation is having a look at the reaction time course. Generally, for
immunoturbidimetric assay using two types of reagents, Reagent 1 is used for bufferingand measuring sample blank, and Regent 2 is added for actual immune reaction. Hence,
the absorbance is not supposed to change after mixing sample and Reagent 1. In caseof the reaction observed in serum from case 1, the increased absorbance after adding
Reagent 1 would provide negative value by subtraction of the absorbance (after mixing
Reagent 1) from absorbance at the end of reaction after mixing Reagent 2. Serum frompatient with myeloma often includes lots of gamma globulin to make the reaction
solution turbidity after mixing with buffer. If you find such a time course in which theabsorbance is increasing just after addition of Reagent 1, you can doubt a non-specificaggregation from numerous gamma globulin, and dilution of serum sample is one ofuseful way to obtain true value. In addition, there are some ways including gel-filtration
chromatography, use of serum from the corresponding animal species andpolyethylene glycol to investigate the cause.
Answer for question 2: (d)Serum specimen is collected after centrifugation of clotted whole blood sample. In
clotting process, fibrin monomer formation from fibrinogen, polymerization of fibrin
monomer, and clot retraction resulting in the blood clot becoming smaller size. Some
immunoglobulins produced in myeloma patient inhibit the fibrin polymerization (1).
Laboratory sometimes encounters bulky blood clot and cannot obtain a sufficientserum quantity. Especially, in case of CBC results with low hematocrit, the laboratory
should not request additional blood collection for serum. Myeloma patients tend tohave anemia, and actually, the whole blood must have a large liquid component.
Measuring some test items is not necessarily wrong, but that does not become asolution to the root of the problem. Using test tube with heparin-lithium, you can obtain
expected amount of specimen (plasma) because of no blood clotting.
(1) O’Kane MJ, Wisdom GB, Desai ZR, Arch bold GP, Inhibition of fibrin monomer
polymerization by myeloma immunoglobulin. J Clin Pathol. 1994, 47(3): 266-268.

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Painting Story

APFCB News 2023 Issue 1

My Acrylic on Canvas painting of A Bunchof Ripening Bananas with Flower Bud Still
Attached, in my Home Garden createdduring the first week of the lunar "Year of
the Rabbit"
Contributed by:
It Koon TAN (gpttik@gmail.com)
A Bunch of Ripening Bananas with Flower Bud Still AttachedThis painting of a ripening bunch of bananas in my home garden was created during
the first week of the Lunar New Year in late January 2023, when continuous rain for
3 days prevented many people from leaving home to visit friends and places for thefestive holiday celebration activities. I have been growing several banana trees at acorner of my garden since the 1970s. At the time of fruiting, they would produce longbunches of up to some 100 delicious fruits each. I would share the abundant harvest
with neighbors and friends. I would take the opportunity to make banana fritters or
cook different varieties of dessert which can be kept in the refrigerator for several
days. After fruiting, the plant would die, but new ones will emerge from the groundas its replacement.
Bananas originated in the hot, tropical climates of the Malay Archipelago in Southeast
Asia. It is widely believed that there are more than 1,000 types of bananas in the world.
They are subdivided into 50 groups. Today, they are grown in tropical regions acrossthe globe, from India, China, Australia, Africa to South and Central America, in morethan 150 countries. Some 105 million tons of fruit are produced each year.
Currently, the largest producers of the fruit are India and China. Bananas are one of
the most popular fruits worldwide. They are important as a fruit crop in tropical andsubtropical regions of the world. Banana fruit is a good source of energy andminerals and is normally consumed fresh, cooked or processed to make many
products such as chips, powder, jam and even home-made wine in a few countries.
It contains essential nutrients that have a beneficial impact on health. Other thanbeing rich in carbohydrate, they are a good source of potassium, magnesium,
vitamin B6 (pyridoxine), vitamin C and various other antioxidants, dietary fiber andAn essential amino acid, tryptophan which is converted into serotonin andserotonin, 2 mood and sleep-regulating neurotransmitters, necessary for regulating
good sleep. Potassium and magnesium are essential minerals and that play importantroles in many bodily processes. The electrolytes work synergistically together
performing many functions including regulating muscle movement and the nervous
system. In addition, potassium regulates fluid balance and magnesium helps control
blood pressure and also maintains and repairs DNA. Together they influence overallmood, sense of satisfaction and calmness. Vitamin B6 is important for normal brain
development and for healthy function of the nervous system and immune system.
Vitamin C and other antioxidants prevent our bodies against oxidative stress and free103

APFCB News 2023 Issue 1

Painting Story

radical damage. As a soluble fiber with unique gelling properties, pectin aids digestionin many ways. The soluble fiber turns into gel in our digestive tract in the presenceof water. As such, they soften the stool and speed the transit time of material throughthe digestive tract, reducing constipation.
Bananas are also a good source of prebiotics that activate friendly probiotic bacteria
found in yogurt and kefir. Probiotics are important because they support our immune
system, keep our digestive system healthy and promote urinal and genital health.
The skin of the fruit has been used as facial and skin beauty aid. Banana peel contains
a variety of phytochemicals, such as polyphenols and carotenoids that can promoteskin health by fighting free radical damage. These compounds have protective effects
and may help to remove lines and lighten dark spots on the face and give our skin amore youthful appearance.
Banana peels are also used as supplementary feed for livestock, goats, poultry,
rabbits, fish, and other species. They provide healthy phytonutrients and antioxidants.
They also serve as an excellent fertiliser for flowering plants, such as the orchids.
Pectin, a gelatinous polysaccharide present in ripe fruits, is a high value functional
food ingredient because of its excellent emulsifying properties and stability which
can be used as a gelling agent and stabilizer. As banana peel extracts yield 15.89 to
24.08% of pectin, studies are being carried out to determine the usefulness of bananaskin as a source of commercial pectin production for use as food additive.
Banana leaves are often used for preparation, wrapping, and serving of food inSoutheast Asian countries. They are used for decorative and symbolic purposes innumerous Hindu and Buddhist ceremonies. In traditional homebuilding in tropicalareas, roofs and fences are made with dry banana-leaf thatch.
I remember during my childhood days, that after fruiting, banana tree trunks were cut
down to be used as food for the pigs. Their fibers were used to make strings and ropes.
In India and Philippines, the fibers contained in banana peels and trunks have been
turned into valuable textile products, fabrics and clothing’s. Banana symbolizes good
health, fertility and abundance. May the year of 2023 be one of productivity andabundance in good quality patient-care services, innovative research anddiscoveries of new diagnostic tests for more speedy and accurate clinical diagnosis
and patient management, like the abundance of fruits in a bunch of banana shownin the painting.

Dr. Tan It Koon (BSc, 1st Class Hons), PhD, MCB, FRC Path
FACB, FRSC, CChem, PPA, PBM)
Founding President of APFCBFounding President of SACB
Executive Board Member of IFCC
Member, Expert Committees of WHO104