Lakewood police officers to be first in state to collect blood samples from DUI suspects
A first of its kind program for Washington state - police officers performing their own blood draws on suspected impaired drivers. It will eliminate taking DUI suspects to hospitals as their blood will be drawn for evidence at the station after a warrant is received. Lakewood Police Chief Mike Zaro spoke at a press conference, stating that six of his officers recently completed phlebotomy courses at Bates Technical College, and they are all certified by the Washington Department of Health.
The new program will help Lakewood police streamline their investigations and can help catch more impaired drivers including drug and marijuana offenders, said officials. “The time savings will allow officers to get out of the hospital waiting rooms and back on the roads to process more DUIs,” said Darrin Grondel, with the Washington Traffic Safety Commission. “Ultimately, this will make our roads safer.” However, some critics worry a police station may not be an appropriate place to gather evidence, especially by a person who may also act as a witness on behalf of the state.
A blood test for autism
Autism spectrum of disorder (ASD) research shows that early intervention can improve development, but diagnosis currently depends on clinical observation of behavior, an obstacle to receiving treatment. Most children are not diagnosed with ASD until after age 4 years.
An algorithm based on levels of metabolites found in a blood sample can accurately predict whether a child is on theASD, based upon a recent study. The algorithm, developed by researchers at Rensselaer Polytechnic Institute, is the first physiological test for autism and opens the door to earlier diagnosis and potential future development of therapeutics. Juergen Hahn, head of the Rensselaer Department of Biomedical Engineering, used data from a group of 149 people, about half on the Autism spectrum. Deliberately omitting data from one of the individuals in the group, Hahn subjects the dataset to advanced analysis techniques, and uses the results to generate a predictive algorithm. The algorithm then makes a prediction about the data from the omitted individual. Hahn cross-validated the results, swapping a different individual out of the group and repeating the process for all 149 participants. His method correctly identified 96.1% of all neurotypical participants and 97.6% of the ASD cohort. Hahn is hopeful his work will lead to a widely available test that can support an early diagnosis, although he does not intend to commercialize his results.
7-day blood diagnostics test for multiple sclerosis
Molecular diagnostics startup IQuity is introducing a pioneering blood test that speeds up multiple sclerosis (MS) diagnosis to just seven days. IQuity began working on its new IsolateMS blood test at Vanderbilt University Medical Center after receiving $2 million in seed funding from the National Institutes of Health.
The test, to be released this May, has a reported accuracy of 90%. Current testing methods such as magnetic resonance imaging scans take much longer to reach a diagnosis because they rely on measuring the progress of irreversible neurological damage. By contrast, doctors can administer IsolateMS as soon as symptoms appear, before the disease has inflicted any significant damage. “This test augments existing clinical practice and eliminates the period of uncertainty that can accompany an MS diagnosis. IsolateMS allows patients and providers to begin discussing next steps immediately.” Said IQuity CEO Chase Spurlock. He is among the first researchers to use machine-learning to investigate the link between gene expression and autoimmune diseases.
Phlebotomy tip of the month: Specimen handling
Proper blood specimen collection is part science and part art. But how you handle, transport and process blood samples can determine if the test results obtained are fact or fiction. To see how your post-collection practices rate, test your knowledge with the true/false statements below:
- It’s not important to keep filled tubes upright during transport and processing.
- Automated delivery systems aren’t appropriate for all samples.
- For samples that require chilling, large ice cubes work best.
- Filled tubes should be kept closed.
- Serum tubes must be allowed to fully clot at room temperature prior to centrifugation.
- When centrifuging gel tubes, fixed-angle centrifuges are preferable to swing-bucket centrifuges.
- Serum or plasma should be removed from cells as soon as possible.
- Exposure to light can affect certain analytes.
Why today’s leaders need to embrace change and uncertainty
"In 2017, I believe it’s safe to say that change and uncertainty represent the new normal for health care. While some may argue this isn’t new, I think we can all agree that the multiplicity of changes in the world — economic, political, demographic, and epidemiological, just to name a few — add up to a complex web of interrelated challenges for health care. Today, "more of the same" simply isn’t an option; instead, we have a great opportunity to respond by being creative, being innovative, taking risks, and thinking differently.
Today’s leaders have a choice: We can take shelter and wait for the storm to pass, or we can take control of what we can, and see the rest as a contribution to innovation. We can seize the opportunity to engage our staff in discussions about the future. We can accept that the world is complex and learn to embrace it. My best advice to leaders at this time would be to do three things: listen, persist, and collaborate."
Sounds simple, right? It’s not! Read this article to hear advice from the Institute for Healthcare Improvement’s (IHI) Leader Alliance and IHI’s President and CEO Derek Feeley.
Related Article: High-Impact Leadership: Improve Care, Improve the Health of Populations, and Reduce Costs
Pediatric reference intervals for biochemical markers: Gaps and challenges, recent national initiatives and future perspectives
Reference intervals (RI) provide valuable information to medical practitioners in their interpretation of quantitative laboratory test results and are critical in assessment and decision-making. While the concept and its utility is straightforward, the process of establishing accurate and reliable RI is complex.
Currently, many pediatric laboratory tests are inappropriately interpreted using RI derived from either adult populations, hospitalized pediatric populations or from outdated and/or inaccurate technology. These are critical gaps and it is imperative to establish appropriate RI for pediatric populations based on specific age- and sex-stratifications.
In the present review, specific issues, challenges and deficiencies in pediatric reference intervals for biochemical markers are discussed. Early studies using hospitalized patients are examined, followed by a review of recent national and global initiatives on establishing reference intervals from healthy pediatric population. The authors highlight the achievements and milestones of the Canadian CALIPER project, including the establishment of a comprehensive biobank and database which has addressed several of these critical gaps.
Read the details and get up to speed on the latest information.
A new spin on an old test: Rethinking the D-dimer
The thromboembolism service at Hamilton Health Sciences is pioneering a method to reduce unnecessary CT scans by 60%, and has teamed up with the emergency department (ED) in a unique research partnership to do so. They are researching if they are able to divert unlikely pulmonary embolism (PE) patients from having CT scans by more accurately identifying this through a blood test.
Dr. Clive Kearon, a thrombosis specialist, is leading the research, which is funded by the Canadian Institutes of Health Research. Dr. Kerstin deWit has trained ED staff and physicians to use and evaluate a new way to interpret the D-dimer blood test results, which allows pulmonary embolism to be "ruled-out" in many more patients, provided the ED physician also thinks that the patient is unlikely to have a thrombosis.
Using the new method, they are able to rule out PE in 40% of patients without doing a CT scan, a significantly higher portion. In the study, these patients are then closely followed to make sure they don’t run into problems because a PE was missed. By not having a CT scan, patients avoid unnecessary radiation and dye that can be harmful to the kidneys.
Automation and the future of microbiology laboratories
When it comes to automation, clinical microbiology has for many years lagged behind other laboratory disciplines. Early attempts at microbiology automation were foiled not only by the variety of specimens and container types but also by the variety in methods required to identify organisms. Now, however, that may finally be changing. Total laboratory automation systems currently are available to handle specimens, streak plates, incubate and digitally image cultures.
Two microbiology total laboratory automation systems are now available in the United States, BD Kiestra TLA and COPAN Diagnostics WASPLab. While these systems can reduce labor costs and improve turnaround time, some lab directors are still skeptical (see examples both for and against the technology in the article). However, new features are coming soon to total automation systems. Manufacturers have already piloted modules that will pick colonies from plates, send samples to mass spectrometry for identification, put up a suspension for susceptibility testing and read the results.
For instance, Dr Nathan Ledeboer, medical director at the Medical College of Wisconsin, and others showed that WASPLab automation software could read chromogenic plates to detect methicillin-resistant Staphylococcus aureus with 100% sensitivity in over more than 57,000 samples, in many cases detecting positives that technologists missed.
Philips and LabPON plan to create world's largest pathology database of annotated tissue images for deep learning
Royal Philips and LabPON, the first clinical laboratory to transition to 100% histopathology digital diagnosis, announced its plans to create a digital database of massive aggregated sets of annotated pathology images and big data utilizing Philips IntelliSite Pathology Solution.
The database will provide pathologists with a wealth of clinical information for the development of image analytics algorithms for computational pathology and pathology education, while promoting research and discovery to develop new insights for disease assessment, including cancer.
LabPON will contribute its repository of approximately 300,000 whole slide images they prospectively create each year to the database. This will contain de-identified datasets of annotated cases that are manually commented on by the pathologist, and will comprise of a wide variety of tissue and disease types, as well as other pertinent diagnostic information to facilitate deep learning.
"The role of the pathologist remains important by making the definitive diagnosis, which has a high impact on the patient's treatment. Software tools could help to relieve part of the pathologists' work... as well carrying out measurements in a more accurate and precise way," said Alexi Baidoshvili, pathologist at LabPON. "This ultimately could help to improve the quality of diagnosis and make it more objective."
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