Forthcoming webinars - information and registration.

Speaker: Ana-Maria Simundic (HR)
Moderator: João Tiago Guimarães (PT)

Date: 21st November at 18:00 CET

Registration is open (enter the course to register).

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European National Societies, members of EFLM, have agreed in Porto, during the 3rd EFLM-BD European Preanalytical Phase Conference that harmonization of preanalytical practices and policies is necessary and possible in each and every country in Europe as well as internationally, at the European level. The Working group for Preanalytical phase (WG-PRE) of the European Federation for Clinical Chemistry and Laboratory Medicine (EFLM), has taken the leading role in this process. The aim of this e-seminar is to present past, ongoing and future WG-PRE activities and various projects which aim is to improve the quality of preanalytical phase in Europe as well as to promote wide harmonization of preanalytical practices, patient safety improvement and reduction of unnecessary waste and healthcare expenses.

Speaker: Giuseppe Lippi (IT)

Date of live webinar: 19-12-2017 at h. 18.00 CET

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Hemostasis is a complicated mechanism finalized to preventing unjustified bleeding during vascular injury, or unwarranted thrombosis when the vessels are substantially intact. Hemostasis is typically classified in two essential steps. The first event is an endothelial injury, which activates primary hemostasis and is then followed by activation of secondary hemostasis. Specifically, primary hemostasis develops with recruitment of a many platelets being at site of vascular injury. Platelets are subjected to a sequential process of activation, adhesion and aggregation. This initial hemostatic plug is however unstable, since it is vulnerable to fast dissolution within in the local blood, especially in arteries. To prevent dissolution, additional fundamental mechanisms of secondary hemostasis (also known as blood coagulation) are activated, with the aim to stabilize the initial plot by large fibrin deposition.

The diagnostics of bleeding disorders of primary and secondary hemostasis remains a challenge for laboratory professionals, especially those lacking experience background, experience and skill on this topic. Bleeding is essentially due to many acquired or congenital conditions, impairing either primary or secondary hemostasis. A universal consensus on the diagnostics of bleeding diseases remains an unmet target, so that the aim of this Webinar is providing practical guidance for laboratory professionals who are less familiar with this important area of in vitro diagnostic testing. A practical strategy for diagnosing bleeding disorders of primary and secondary hemostasis is necessarily based on a multifaceted and multistep strategy, entailing accurate personal and family history collection, interpretation results of the so-called first-line hemostasis tests, then followed by interpretation (when necessary) of second- and third-line test to identify the both nature and severity of bleeding disease.

The observation of profound hemorrhages rather than muco-cutaneous bleeding suggests a disorder of secondary hemostasis. Although positive family history can be frequently seen in patients with congenital disorders, the absence of clinically significant symptoms in relatives cannot be considered always suggestive of acquired disorders. The next phase is based on performance of the so-called first-line coagulation tests, mainly represented by activated partial thromboplastin time (APTT), prothrombin time (PT) and fibrinogen, especially when the family history is not indicative of specific factor deficiencies. The observation of abnormal results of these tests and the combination of results can help driving performance of the so-called second-line tests, which especially entail clotting factor assays. The so-called third-line tests (especially entailing immunologic tests of coagulation factors and molecular biology) are then useful to make a final diagnosis and/or for detecting the specific nature of the protein deficiency.

Speaker: Callum G. Fraser (UK)
Moderator: Sally C Benton (UK)

Date: 23rd January 2018 at h. 18.00 CET

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Abstract: Colorectal cancer (CRC) is still a very important health problem world-wide.  It is the third most common cancer and the fourth leading cause of cancer-related death. Fortunately, many screening programmes have now been set up to detect neoplasia in those who do not have any symptoms of bowel disease. These programmes lead to early detection of CRC and its precursors, which significantly improves outcomes.  There are a number of strategies available for CRC screening, but faecal immunochemical test for haemoglobin (FIT) are now considered as the best currently available non-invasive investigation and are being widely established.  FIT are available in two formats, qualitative FIT and quantitative FIT: the former are often used in opportunistic screening, whereas the latter are widely used in population-based programmatic screening. Quantitative FIT have many advantages, a major benefit being that the faecal haemoglobin concentration (f-Hb) can be estimated. This Webinar will explore the diagnostic accuracy of FIT, and factors affecting f-Hb, including age, sex and socioeconomic status.  The difficulties in selecting the f-Hb cut-off to be used for CRC screening will be addressed in detail.  

However, most CRC are not detected through screening programmes, but when a person with symptoms seeks medical advice. The symptoms of serious bowel disease are very common presentations in primary care, but most with these do not have serious disease. Generally, people with symptoms are referred to secondary care for colonoscopy, which is inadequate in many countries. A particular problem is that the number of patients with symptoms being referred from primary care is increasing rapidly, in large part due to local, regional and national campaigns raising awareness of the need to get symptoms investigated. This Webinar will discuss the significant evidence now available that demonstrates that triage using FIT at a low cut-off around 10 μg Hb/g faeces has the potential to correctly rule-out CRC and avoid colonoscopy in many symptomatic patients. Importantly, secondary care referral following a positive FIT allows the identification of other significant bowel pathology in patients who are found not to have CRC, mainly inflammatory bowel disease. This very recent use of FIT is an excellent example of translation of research into clinical practice: the first study investigating the use of quantitative FIT using numerical data on f-Hb was published on-line in 2012 and, only five years later, a national guideline has recommended its use in routine clinical practice.

European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for Preanalytical Phase (WG-PRE): Recommendation for venous blood sampling

Speaker: Zorica Šumarac (SRB)
Moderator: Anna Maria Simundic (HR)

Date: 27th February 2018 at 18:00 CET

Registration is open (enter the course to register).

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European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for Preanalytical Phase (WG-PRE) as the leading professional entity involved in preanalytical phase, has provided a document named European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for Preanalytical Phase (WG-PRE): Recommendation for venous blood sampling. The aim of this document is to provide a simple, condensed, risk and evidence based recommendation for venous blood sampling. The current document provides a comprehensive overview of the most critical steps for a standardized blood collection procedure and practical guidance on how to successfully overcome potential barriers and obstacles to its widespread implementation. In addition to  specialists in laboratory medicine, the authors of this document are representatives of national nursing associations, hospital nurses, phlebotomists and representatives of manufacturers of blood collection systems. The recommended procedure is based on the best available evidence. Each step was graded using a system that scores the quality of the evidence and the strength of the recommendation. The process of grading was done at several face-to-face meetings involving the same mixture of stakeholders stated previously. The main parts of this recommendation are: pre-sampling procedures, sampling procedure, post-sampling procedures and implementation. 

The aim of the webinar is to present this document and to give recommendations for its  successful implementation in practice, such as establishing a system of certification of staff involved in the blood sampling procedure, organizing continuous education, auditing and re-training for all staff members, implementation of quality indicators and others. 

With this objective, EFLM WG PRE has prepared the following tools for the implementation of this recommendation: a power point presentation, a video describing the entire procedure, a knowledge test to assess the level of knowledge and raise awareness of the staff prior and after the education, a checklist for auditing the blood sampling procedure during periodical observational audits and posters with a cartoon describing the entire procedure. 

Speaker: Aasne Karine Aarsand (NO)
Moderator: Bill Bartlett (UK)

Date: 06-03-2018 at h. 18.00 CET

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Biological variation (BV) data has many appliances in the daily laboratory life, being used both when evaluating the diagnosis and monitoring of disease and for setting analytical performance specifications. Thus, the quality of our work directly depends on the reliability of the BV estimates used as basis for these processes. Widely varying BV estimates are available for different measurands, and it is likely that this may be caused by differences in study design and statistical handling. Addressing this issue, the EFLM established in 2014 an EFLM Task and Finish Group (TFG) for the Biological Variation Database. The TFG is made up by members from the EFLM Working Group on Biological Variation, the Analytical Quality Commission of the Spanish Society of Clinical Chemistry and experts in the area. The TFG has developed a critical appraisal list for evaluation of studies on BV and this will be used as basis for the setup of a database with measures of BV, the derived performance specifications and the evidence behind it.


Speaker: J.F.M. (Hans) Jacobs (NL)

Moderator: Jill Tate (AU)

Date:  27th March 2018 at 14:00 CET

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Treatment of multiple myeloma (MM) has substantially changed with the recent introduction of therapeutic monoclonal antibodies (mAb) which have further improved the rates and depth of clinical response. mAb therapy in MM patients has introduced new challenges in how therapy responses can be defined. On the one hand, recently approved mAb interfere with routine M-protein diagnostics. On the other hand, given the high rates of complete responses, new response categories need to be defined to measure minimal residual disease. As a reaction to these challenges research has focused on adaptations of conventional M-protein diagnostics to mitigate interference and on the introduction of novel methods that enable the identification of minimal residual disease. The aim of this e-seminar is to discuss how mAb therapy has changed both the therapeutic as well as the diagnostic landscape of MM.

Presenter: Federica Braga (IT)
Moderator: Anne Stavelin (NO)

Date: 17th April 2018 at 18:00 CET

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The participation to EQA schemes that meet specific metrological criteria is mandatory for the evaluation of performance of participating laboratories in terms of standardization and clinical suitability of their measurements. The requirements for this type of EQA are as follows: in addition to the use of commutable control materials, it is necessary to assign values (and uncertainty) to them with reference measurement procedures (RMP) performed by an accredited laboratory and to define and apply clinically allowable performance specifications to verify the suitability of laboratory measurements in a clinical setting. Unfortunately, there are few permanent EQA programs covering these requirements because some practical constraints including technical, psychological and economic aspects, which limit their introduction. It is, however, clear that these aspects should be immediately solved. Indeed, EQA schemes are in a unique position to add substantial value to the practice of Laboratory Medicine, by identifying analytes that need improved harmonization and by stimulating and sustaining standardization initiatives that are needed to support clinical practice guidelines. This will definitively help those manufacturers that produce superior products to demonstrate the superiority of those products and oblige users (and consequently industry) to abandon assays with demonstrated insufficient quality.