JALM Talk Podcast

Plasma Protein Profiling by Proximity Extension Assay Technology Reveals Novel Biomarkers of Traumatic Brain Injury – A Pilot Study

Engaging Pathology Residents in Clinical Chemistry: The Essential Ingredient Is a Committed Teacher

Comparison of Two Automated Immunoassays for the Detection of SARS-CoV-2 Nucleocapsid Antibodies

A Shared Diagnostic Stewardship Approach toward Improving Autoimmune Encephalopathy Send-out Testing Utilization

On the Basis of Race: The Utility of a Race Factor in Estimating Glomerular Filtration

The Medical Students' Perspective of Health Disparities and a Raced Based Curriculum: Addressing Disparities in Medical Education

Recognizing Laboratory Medicine's Collaborative Role in Identifying and Eliminating Health Disparities

Impact of COVID-19 Pandemic on Laboratory Utilization

Ten-Month Evaluation of the Routine Application of Patient Moving Average for Real-Time Quality Control in a Hospital Setting

Liquid biopsy to detect circulating tumor cells: is it ready for a value proposition in laboratory medicine?

Detection of Intravascular Hemolysis in Newborns Using Urinary Carbonic Anhydrase I Immunoreactivity

Intelligent Liver Function Testing: Working Smarter to Improve Patient Outcomes in Liver Disease

Demand for Interpretation of a Urine Drug Testing Panel Reflects the Changing Landscape of Clinical Needs; Opportunities for the Laboratory to Provide Added Clinical Value

Current Practices When Reporting Quantitative Human Chorionic Gonadotropin Test Results

Correlation of Chemical Urinalysis to Microscopic Urinalysis and Urine Culture: Implications for Reflex Urinalysis Workflows

Unexpected Troponin Elevation in a Patient Treated with Atorvastatin

AACC Guidance Document on Biotin Interference in Laboratory Tests

Volumetric Microsampling of Capillary Blood Spot vs Whole Blood Sampling for Therapeutic Drug Monitoring of Tacrolimus and Cyclosporin A: Accuracy and Patient Satisfaction

Bridging the Gap: Acute Neurology and a Metabolic Acidosis

Cannabinol (CBN) Cross-Reacts with Two Urine Immunoassays Designed to Detect Tetrahydrocannabinol (THC) Metabolite

The 2018 AACC/SYCL PhD Clinical Chemist Compensation Survey

Unleashing the Power of Laboratory Developed Tests: Closing gaps in COVID diagnosis and beyond

Contingency planning in the clinical laboratory: lessons learned amidst COVID-19

A Laboratory Risk Assessment during the Coronavirus (COVID-19) Pandemic

Clinical Laboratory Detection of a High-Level Hemoglobin Abnormality in a Patient with Suspected Recreational Drug Ingestion

Rapid Diagnosis, Triage, and Treatment of a 59-Year-Old Man with Sudden-Onset Right-Sided Weakness and Difficulty Speaking

Bad Tests Die Slowly: The Myelin Basic Protein Example

Reproducible Research and Reports with R

Practical Approach to Eliminate Bilirubin Interference in Icteric Samples for Creatinine Measurement

Clinical chemistry assays are widely impacted by inherent interferences in patient blood samples such as hemolysis, icterus, and lipemia.  These interferences can cause inaccurate laboratory results and may even prevent the laboratory from releasing test results to ordering health care providers.  In particular, the interference of bilirubin in various creatinine assays is common.  Inaccurately reported creatinine, or the inability to report creatinine, can have adverse implications in the m...

Laboratory Test Utilization and Repeat Testing for Inpatients of Age 80 and Over in Australia

An original research article published in the September 2019 issue of the Journal of Applied Laboratory Medicine describes a study which investigated whether laboratory tests were being properly utilized for hospitalized patients aged 80 years and older.

A Multicenter Assessment of the Sensitivity and Specificity for a Single High-Sensitivity Cardiac Troponin Test at Emergency Department Presentation for Hospital Admission

An original research article published in the September 2019 issue of the Journal of Applied Laboratory Medicine describes the validation of a clinical chemistry score which incorporates high sensitivity troponin with other laboratory results of glucose and estimated glomerular filtration rate as an alternative assessment strategy for emergency room patients with possible myocardial infarction.

Development of Reference Materials for Noninvasive Prenatal Aneuploidy Testing by Massively Parallel Sequencing: A Proof-of-Concept Study

An original research article published in the July 2019 issue of the Journal of Applied Laboratory Medicine, describes a proof-of-concept study which tested the possibility of using artificial plasma matrix spiked with fragmented genomic DNA from immortalized cell lines to produce reference material for noninvasive prenatal testing assays. 

Isotyping of Paraprotein Irresolvable by Routine Immunofixation Electrophoresis

Serum protein electrophoresis and immunofixation electrophoresis are critical laboratory assays in the identification of monoclonal proteins.  Monoclonal proteins, also called “M spikes” or “paraproteins,” may be due to monoclonal gammopathy of undetermined significance, but they may also indicate malignant diagnoses such as multiple myeloma or lymphoplasmacytic lymphoma. Protein electrophoresis separates the proteins in a patient sample by their size and charge and allows for the detectio...

Generation of Highly Biomimetic Quality Control Materials for Noninvasive Prenatal Testing Based on Enzymatic Digestion of Matched Mother–Child Cell Lines

Non-invasive prenatal testing based on cell-free DNA is now a widely used technique. However, quality control materials that have properties identical to clinical samples and that are applicable to a wide range of procedures are not available to support assay development, internal or external quality control, and proficiency testing. The June 2019 issue of Clinical Chemistry includes a study describing the development of such quality control materials that comprise simulated human plasma and...

D-dimer: Common Assay, Challenges Abound, Caution Advised

Venous thromboembolism, or VTE, is a serious medical condition characterized by a blood clot in a vein, also known as deep vein thrombosis. If the clot breaks free from the vein, it can cause a life-threatening pulmonary embolism by blocking blood supply to the lungs. Over 100,000 Americans may die from VTE per year. If recognized quickly, VTE may be effectively treated with anticoagulant therapy; however, it can be difficult to detect when VTE is occurring and when treatment is warranted, t...

It’s Not Just a Needlestick: Exploring Phlebotomists’ Knowledge, Training, And Use of Comfort Measures in Pediatric Care to Improve the Patient Experience

Analytical Concordance of Diverse Point-of-Care and Central Laboratory Troponin I Assays

Cardiac troponin is the supreme biomarker for the diagnosis of acute myocardial infarction.  The ability of the clinical laboratory to provide rapid and reliable troponin results is critical for patient management in the emergency room.  In clinics and environments far from a laboratory, point-of-care troponin testing may be necessary for timely results and patient triage.  However, questions remain about the concordance among point of care and laboratory-based methods and whether the same r...

Case of Sudden Acute Coma Followed by Spontaneous Recovery

Clinical laboratories play a crucial role in emergency medicine through toxicology and drug testing.  The type of testing provided is often a balance between laboratory resources and the patient population served.  Each approach to drug screening comes with advantages and disadvantages depending upon the specific drug exposure or illicit drug suspected. A “Case of Sudden Acute Coma Followed by Spontaneous Recovery” was published in the November 2018 issue of The Journal of Applied Laboratory...

AUC-Based Monitoring of Vancomycin: Closing the Therapeutic Window

Measuring vancomycin levels has long been an important component of laboratory therapeutic drug monitoring.  Such measurements are important for obtaining optimal targets serum concentrations for drug dosing, while avoiding vancomycin induced nephrotoxicity.  “AUC-Based Monitoring of Vancomycin: Closing the Therapeutic Window” was published in the January 2019 issue of The Journal of Applied Laboratory Medicine.  This review evaluates shifting the conventional therapeutic drug monitoring app...

Clinical Effect of Expedited Pathogen Identification and Susceptibility Testing for Gram-Negative Bacteremia and Candidemia by Use of the Accelerate PhenoTM System

“Clinical Effect of Expedited Pathogen Identification and Susceptibility Testing for Gram-Negative Bacteremia and Candidemia by Use of the Accelerate PhenoTM System” was published in the January 2019 issue of The Journal of Applied Laboratory Medicine.  This work evaluates the clinical impact on a new device for pathogen identification and antimicrobial susceptibility testing.

Elimination of 72-Hour Quantitative Fecal Fat Testing by Restriction, Laboratory Consultation, and Evaluation of Specimen Weight and Fat Globules

The gold standard for identification of fat malabsorption has conventionally been 72h fecal fat analysis.  Despite its long use, fecal fat analysis poses both preanalytical and analytical challenges for both the patient and the laboratory.  Implementing changes to well-established tests can be difficult in healthcare systems.  “Elimination of 72-Hour Quantitative Fecal Fat Testing by Restriction, Laboratory Consultation, and Evaluation of Specimen Weight and Fat Globules” was published in th...

Algorithms Used in Ovarian Cancer Detection: A Minireview on Current and Future Applications

Ovarian cancer is the fifth most common cause of cancer death among women in the U.S. The high rate of mortality for ovarian cancer is multifactorial, but it is estimated that more than 60% of cases have already metastasized at the time of diagnosis. Despite more invasive surgical treatments and targeted chemotherapies, ovarian cancer survival rates have remained similar over time. “Algorithms Used in Ovarian Cancer Detection: A Minireview on Current and Future Applications” was published in...

The (Sun)Light and Dark of 25-Hydroxyvitamin D Testing

The potential benefits of maintaining sufficient vitamin D levels has led to a steady increase in testing of vitamin D status in the general population.  This increase has impacted laboratories in a variety of ways, as organizations adapt to growing demand while striving for accuracy and test standardization.The potential benefits of maintaining sufficient vitamin D levels has led to a steady increase in testing of vitamin D status in the general population.  This increase has impacted labor...

Creation of a Professional Development Program for Women in a Major US Medical School Pathology Department

The November 2018 issue of the Journal of Applied Laboratory Medicine published a Special Report by Drs. Ann Gronowski and Carey-Ann Burnham at the Washington University School of Medicine in St. Louis that discussed the formation of a professional development group for women in the pathology department of a major medical school. Dr. Gronowski, who is Professor in the departments of pathology and immunology, and obstetrics and gynecology, joins us in this podcast.

Interventions That Can Help Reduce Diagnostic Errors

Diagnostic errors in medicine continue to be a large problem for effective healthcare delivery.  As a result, moderate and severe consequences from the errors, including death, account for 75% of diagnostic errors in the United States.  “Interventions That Can Help Reduce Diagnostic Errors” was published in the July 2018 issue of The Journal of Applied Laboratory Medicine.  The editorial discusses the associated JALM Review “The Definition and Scope of Diagnostic Error in the US and How Diag...

False Positive Carbamazepine Results by Gas-Chromatography Mass Spectrometry and VITROS 5600 Following a Massive Oxcarbazepine Ingestion

Conventional approaches to drug testing rely on a primary screening step followed by a secondary confirmation.  Best practice dictates that the secondary confirmation step utilize a separate methodology than the initial screening step and have improved sensitivity and specificity.  This approach is widely utilized in clinical, pre-employment, and forensic settings.  Despite the standard adoption of this approach, issues can occur that impact the accuracy of results. “False Positive Carbama...

Keeping Up with Fentanyl: Failure to Do So Is Not an Option

The rapid rise in the prevalence of fentanyl and fentanyl analogs has contributed significantly to an increase in overdose death rates in North America.  Laboratories, healthcare providers, and government agencies struggle to effectively detect and reduce negative outcomes associated with fentanyl use in the absence of accurate data on prevalence and use.  “Keeping Up with Fentanyl: Failure to Do So Is Not an Option” was published in the July 2018 issue of The Journal of Applied Laboratory...

Automated Laboratories: When Technology Needs a Human Touch

Laboratory automation holds the promise of enhanced workflows, improved efficiency, and decreased turnaround time while mitigating an environment of rising costs, constrained resources, and staffing shortages.  Many publications tout improved outcomes from laboratory automation but realizing these results may not come easily. Automated Laboratories: When Technology Needs a Human Touch was published in the May 2018 issue of the Journal of Applied Laboratory Medicine.  This work reflects on ...

Thrombophilia: Women-Specific Reference Ranges Can Prevent Misdiagnosis in Women

“Thrombophilia: Women-Specific Reference Ranges Can Prevent Misdiagnosis in Women” was published in the March 2018 issue of The Journal of Applied Laboratory Medicine.  This work presents the establishment and impact of female-specific reference intervals for a variety of coagulation markers during pregnancy.

High-Throughput LC-MS/MS Method for Determination of the Alcohol Use Biomarker Phosphatidylethanol in Clinical Samples by Use of a Simple Automated Extraction Procedure—Preanalytical and Analytical Conditions

A high throughput LC-MS/MS method for the determination of phosphatidylethanol (PEth) in clinical samples using a simple automated extraction procedure was published in the May 2018 issue of The Journal of Applied Laboratory Medicine.  This work describes an improved automated approach to analysis of the alcohol marker phosphatidylethanol that uses liquid chromatography mass spectrometry instead of conventional HPLC.