Scientific Workshops

Scientific Workshops will be held on Sunday June 19.

 

Sunday June 19 Morning – 0800-1100

Note: If you select WS1001, you are precluded from registering for WS1002 and WS1003 and vice-versa.

  • WS1001 How to implement LC-MC/MS into your laboratory (0800-1100)
  • WS1002 Point of Care Testing and Accreditation Canada (0800-0930)
  • WS1003 Monoclonal gammopathy-related nephropathy: pathogenesis, laboratory investigations and controversies (0930-1100)

 

Sunday June 190 Afternoon – 1300-1600

Note: If you select WS2001, you are precluded from registering for WS2002 and WS2003 and vice-versa.

  • WS2001 Reference Interval Harmonization – getting it right in Canada! (1300-1600)
  • WS2002 Practical epidemiology and biostatistics for laboratory medicine professionals (1300-1430)
  • WS2003 Alcohol misuse and medical cannabinoids use: interactions (1430-1600)

 

 

WS1001 How to implement LC-MC/MS into your laboratory
Sunday June 19 Morning, 0800-1100

 

Jessica Boyd, Calgary Laboratory Services

Hossein Sadrzadeh, Calgary Laboratory Services

 

Objectives:

At the end of the session, the participants will be able to:

  • Develop a business case to justify getting an LC-MS/MS system.
  • Choose the most appropriate system for their labs.
  • Develop an implementation plan for bringing LC-MS/MS into their laboratory.
  • Learn how to implement appropriate toxicology test utilization.

Liquid chromatography Tandem Mass Spectrometry (LC-MS/MS) has become an important part of new modern clinical laboratories. Within the next 5-10 years, almost all clinical labs in western countries need to implement this technology. LC-MS/MS technology offers the most sensitive and specific approach to measure most analytes in the clinical chemistry laboratory. Although the cost to purchase a LC-MS/MS system is relatively high, the operational cost is significantly lower compared to that of immunoassays. In addition to high original cost, several other factors may prevent laboratorians from adopting this technology including the sophisticated nature of LC-MS/MS, selection of appropriate testing panels and obtaining physician buy-in.

The focus of this worship is to show participants how to successfully obtain and implement an LC-MS/MS system in their lab, using examples from the author’s previous experiences. The first 2 hours will focus on introducing LC-MS/MS technology to the participants, explaining how to prepare a business plan and get their laboratories and technologists ready for LC-MS/MS. The second part, which is new to this year’s workshop, will cover the author’s recent experience in moving drug screening from GC-MS to LC-MS/MS at Calgary Laboratory Services. This section will provide practical strategies for proper utilization of clinical toxicology tests, selection of test panels for specific physicians and their patient populations, and training staff on new LC-MS/MS systems.

 

 

WS1002 Point of Care Testing and Accreditation Canada
Sunday June 19 Morning, 0800-0930

 

Julie Shaw, The Ottawa Hospital

Paul Yip, University Health Network

 

Objectives:

At the end of the session, the participants will be able to:

  • State the most recent Accreditation Canada standards for point of care testing (POCT) where additional validation above the current Provincial standards will be expected.
  • Identify strategies aimed at meeting Accreditation Canada POCT standards in those areas.
  • Describe areas of POCT growth in clinical settings outside of the hospital.

This workshop is designed for laboratory professionals who oversee the POCT programs in their institution or for healthcare professionals who deliver POCT within their institution. The workshop will begin with an overview of the current POCT standards released by Accreditation Canada (AC). These standards share many components with ISO-based provincial POCT accreditation standards such as those of the BC Diagnostic Accreditation Program, Alberta College of Physicians and Surgeons, and IQMH Accreditation in Ontario and Eastern Canada. However, Accreditation Canada has released additional criteria for POCT where additional validation will be sought. Potential challenges in achieving compliance to the Accreditation Canada POCT standards will be discussed and participants will derive strategies to apply with their organization. In the second portion of this workshop, the imminent and potential growth of POCT activities outside of the hospital will be discussed. As these are widely used for patient care in settings unaccredited for POCT, the risk for error is augmented. Laboratory professionals should be prepared to critique the standards (or lack thereof) in their province to ensure best practices towards quality assurance.

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WS1003 Monoclonal gammopathy-related nephropathy: pathogenesis, laboratory investigations and controversies
Sunday June 19 Morning, 0930-1100

 

Ivan Blasutig, University Health Network

PC Chan, Sunnybrook

 

Objectives:

At the end of the session, the participants will be able to:

  • Have a better understanding of how a monoclonal immunoglobulin protein/protein fragment may cause kidney damage and the importance of investigating monoclonal gammopathy in renal patients.
  • Be able to critically appraise the utility, performance and limitations of various biochemical techniques for the investigation of monoclonal gammopathy in renal patients.
  • Be able to devise a cost-effective strategy for the investigation of monoclonal gammopathy-related kidney diseases in their own laboratory.

Kidney disease/damage has long been recognized as a major manifestation of overt monoclonal gammopathies such as multiple myeloma, AL-amyloidosis and Waldenstrom Macroglobulinemia. Recent evidence showed that even at a low and previously considered insignificant tumor load e.g. in the pre-malignant state of Monoclonal Gammopathy of Undetermined Significance (MGUS), the small amount of circulating monoclonal immunoglobulin and/or fragments are capable of causing kidney damage, rendering an overtone of renal significance to the condition. Moreover, the underlying mechanisms by which these monoclonal proteins cause kidney damage are varied and differ among different monoclonal gammopathic conditions. Understanding the pathogenesis and presenting features of these monoclonal gammopathy-related kidney diseases is crucial in rationalizing and developing effective investigational strategies.

In this workshop, the presenters will provide an overview of how kidney damage may be caused by monoclonal proteins, how these kidney diseases present and are investigated in the laboratory. While a number of hematological, histo- and immuno-pathological techniques will be touched upon, focus will be put on critically appraising the diagnostic performance and controversies surrounding the use of various immunochemical and electrophoretic techniques, as well as different sample types (serum and urine) for the investigation of monoclonal gammopathy in renal patients.

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WS2001 Reference Interval Harmonization – getting it right in Canada!
Sunday June 19 Afternoon, 1300-1600

 

Khosrow Adeli, Hospital for Sick Children

Christine Collier, Kingston General Hospital,

 

Objectives:

At the end of the session, the participants will be able to:

  • Identify different types of harmonization, and their importance to improving laboratory practice and patient care.
  • Discuss the pros and cons of harmonized reference intervals, and identify the various inherent challenges.
  • Consider the strategies that might be useful in developing harmonized reference intervals in Canada.

Reference intervals are one of the most widely used decision-making tools in laboratory medicine, serving as standards for the interpretation of laboratory test results. Numerous studies have shown that there is wide variation in reference intervals, even between laboratories using the same analytical equipment and the same reagents. For some analytes, the variation in the reference intervals is greater than the analytical inaccuracy of their measurement. This poses a major problem for test result interpretation and patient safety, contributing to the lack of consistency in test result interpretation and decreased transferability of test results between labs. Furthermore, physicians are often unaware of this variability and how it can affect laboratory test result interpretation.

Over the last decade, harmonization of reference intervals has emerged globally as a major area of focus in laboratory medicine. With successful harmonization initiatives currently underway in the UK, Australia, USA and Europe, it is time to consider harmonization of reference intervals across Canada. This initiative should occur with a subset of common tests that are important for clinical decision making (e.g. routine biochemical markers, thyroid hormones, cardiovascular disease markers).

The main goals of this workshop are: a) to introduce and discuss the concepts and potential applications of harmonization in laboratory medicine, b) review the various strategies that have been employed in different countries, c) identify potential barriers that need to be addressed, and d) introduce the key objectives, and potential strategies that could be employed by the CSCC Task Force on Reference Interval Harmonization.

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WS2002 Practical epidemiology and biostatistics for laboratory medicine professionals
Sunday June 19 Afternoon, 1300-1430

 

Lawrence de Koning, Alberta Children’s Hospital

 

Objectives:

At the end of the session, the participants will be able to:

  • Design a structured epidemiologic research question.
  • List the different epidemiologic study designs, and select the best design to answer a research question.
  • Understand the advantages and disadvantages of each study design.
  • List the main criteria for determining whether an observed exposure-disease association is causal.
  • Become familiar with the different types of biases.
  • Understand how to calculate measures of association (e.g. odds ratio).
  • Develop a working understanding of statistical inference, frequently used statistical tests, and practical application to data sets.

A major responsibility of clinical chemists and pathologists is to remain current with medical literature. Knowledge from literature reviews is critically important to inform a diagnosis, select additional tests, develop new tests, or create utilization strategies. But which studies are more believable than others? Which are most applicable to a case or research project? And how does one design a ‘good’ study?

This interactive workshop will help laboratory medicine professionals become better at answering these questions by reviewing the practical methodologic and statistical aspects of epidemiologic studies (those dealing with human populations and disease). A large part of the workshop will be devoted to understanding the pros and cons of each study design, and how to attain a balance of analytic rigor and practicality when attempting to answer a research question. The workshop will also review the rationale behind statistical testing, as well as a ‘toolkit’ of frequently used techniques for analyzing different types of data.

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WS2003 Alcohol misuse and medical cannabinoids use: interactions
Sunday June 19 Afternoon, 1430-1600

 

Manuela Neuman, In Vitro Drug Safety and Biotechnology

Cristiana Stefan, CAMH

 

Objectives:

At the end of the session, the participants will be able to:

  • Evaluate the interaction of alcohol in medical cannabinoids.
  • Describe ethical problems in using medical cannabinoids and their therapeutic monitoring.
  • Describe hepatocytotoxicity as a result between misuse of alcohol when using other therapeutics and medical cannabinoids.

Cannabinoids are derived from the cannabis plant, which contains over 400 compounds, including more than 60 cannabinoids. The primary psychoactive cannabinoid is delta-9-tetrahydrocannabinol (THC, also known as dronabinol). Cannabinoid molecules such as THC interact with an endogenous system that includes cannabinoid-like ligands as well as multiple receptors in both the periphery and central nervous system.

Although concern about the abuse potential of cannabinoid drugs has slowed their development, several cannabinoid-type drugs are commercially available, and others are under study. The two US-approved cannabinoids (dronabinol and nabilfone) are approved only for chemotherapy-induced nausea and vomiting, and appetite stimulation in wasting illnesses, respectively. An oromucosal spray containing THC plus cannabidiol, called nabiximols, is approved in more than 20 countries for treatment of spasticity related to multiple sclerosis. In Canada, it is also approved “as adjunctive analgesic treatment in adult patients with advanced cancer who experience moderate to severe pain”. Short-term adverse effects included dizziness, dry mouth, nausea, fatigue, euphoria, vomiting, disorientation, drowsiness, confusion, loss of balance, and hallucination.

The misuse of alcohol in the patients taken medical cannabinoids can be deadly.
Given the legal status of marijuana, differences in cannabinoid concentrations across strains of cannabis, the lack of information about potential drug-drug interactions, alcohol misuse and cannabinoids’ interaction it is the role of clinical chemist to work with the physicians. Physicians should be aware of withdrawal symptoms, such as anxiety, headache, and hypersomnia, after sudden cessation of cannabis use, and the potential for this phenomenon to manifest, often unexpectedly, after hospital admission.

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