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Held every two years, BioMedica is Ireland’s largest conference and exhibition dedicated to laboratory medicine and presents a unique opportunity to update scientific and technical knowledge. Laboratory News reports on the highlights of BioMedica 2008 directly from …

‘BIOMEDICAL Science – A patient centred quality service’ was the theme of BioMedica 2008, a 2-day event held at the RDS, Dublin in April this year. Organised by the Academy of Medical Laboratory Science (AMLS), the focus was very much on the multi-disciplinary Scientific Programme which aimed to highlight the difference Medical Scientists make to patient diagnosis, treatment and care. With a full programme of lectures devoted to all major pathology disciplines, a packed Plenary Session highlighting various patient safety initiatives and a well-supported industry trade show & exhibition running throughout the event, BioMedica really did have something for everyone.

Speaking shortly before the conference opened, AMLS President Mr Kevin O’Connell hoped that the event would afford an opportunity to address various issues facing laboratory professionals everywhere. “Our continuing contribution and positive interaction with the patient needs to be acknowledged,” he said, adding that the BioMedica event was an opportunity both to promote the role played by medical scientists and to help raise their profile. Commenting on the BioMedica Trade Show Exhibition itself, Kevin was delighted that over 60 leading diagnostic companies, manufacturers and laboratory suppliers including Olympus, Roche, BD, Abbott, Anachem and Fisher Scientific would be present to unveil their new products and emerging technologies.

Officially opening the 2-day event, Dr Jimmy Devins, Minster of State at the Department of Health and Children, Ireland, said that he believed the BioMedica conference to be an important showcase for the latest advances and developments in the field of medical science, both nationally and internationally. In his address, Dr Devins outlined that health is a dynamic environment which is constantly changing and presenting new challenges to which the medical science profession must respond to. The Minister considered the delivery of healthcare to be highly dependent on the people working in the system, commenting: “We have to have the flexibility to adapt to make the best use of our resources, our people and our facilities and we must continue to work together in a collaborative manner to address these challenges”. The Minister went on to highlight various areas of the BioMedica scientific programme such as patient safety, saying that although there will always be some risk attached to efforts to treat patients, no treatment is completely without risk of harm, therefore systems need to be established which keep the extent of avoidable risk to an absolute minimum. Dr Jevons concluded that medical scientists are key members of the multi-disciplinary team who provide healthcare services to patients and that the patient-centred quality approach which the AMLS is advocating is central to this process. as well as ensuring a challenging and innovative workplace for those delivering the service.

Cervical cancer is the second biggest cause of female cancer deaths in European women under 44 years of age. About 50,000 European women a year are diagnosed and of these 25,000 women die. The crucial point is that these deaths are avoidable and these women need not die, as Ms. Imelda Read, President, European Cervical Cancer Association pointed out in her presentation ‘Cervical cancer – A European campaign perspective’. The European Cervical Cancer Association (ECCA) is an umbrella organisation for 85 European organisations from 32 countries, and several international organisations The ECCA’s main aims are to increase awareness of Cervical Cancer and its prevention in Europe and to campaign for the implementation of population based screening equitably across Europe by the integration of new technologies.

Imelda outlined how the disease can be easily found while in a pre-cancerous stage by screening when treatment is both simple and almost 100% effective. Furthermore the use of the new vaccines in combination with screening means that almost every case of cervical cancer could be prevented. Continuing the patient safety theme, Ms Hilary Coates, Health Information and Quality Authority (HIQA)/World Health Organisation’s World Alliance for Patient Safety examined the topic, ‘When things go wrong – driving learning while supporting patients, families and clinicians’. According to Hilary, there is now an increased awareness of the patient safety problem by both the public and healthcare providers alike. Additionally there is growing recognition that, although many patients receive good quality care, there are times that the treatment of patients does not go according to plan and that some patients experience unintended harm as a result of care. Hilary believes however that globally there has been very little attention paid to supporting patients after such adverse events. “Research shows that patients and their families endorse disclosure and want information about what went wrong, why the incident occurred and what are the long-term consequences but most importantly want acknowledgement that something has gone wrong”.  Hilary went on to describe how the latest HIQA project will develop international consensus best practice for communicating with and supporting patients, their families and clinicians following an adverse event in order to facilitate more responsive positive outcomes for all parties. 
Haemochromatosis was the central theme of the Clinical Chemistry programme at BioMedica, concentrating particularly on the clinical management, screening and genetic testing for the condition. Haemochromatosis is common in European populations, as Dr. Alan Balfe, Principal Biochemist, St. James’s Hospital, Dublin pointed out in his presentation examining genetic testing for hereditary haemochromatosis. He explained how due to the inheritance of genetic mutations, iron accumulates in the body and eventually causes widespread tissue damage. Early detection is important therefore as this enables the prevention of irreversible damage. Genotyping studies can detect the genetic predisposition to haemochromatosis before there is biochemical or clinical evidence of iron accumulation, and this can confirm the aetiology in cases of observed iron overload. To underline how important this can be to the individual, a patient’s perspective of the condition given by a member of the Ireland Haemochromatosis Association highlighted the human effects of this which can eventually develop into liver, heart and pancreatic disease.

Allergy testing is very much a topical issue at the moment which is why the Immunology BioMedica programme concentrated specifically on this area. ‘Making snse of alergy: from the cinic to the laboratory and back again’ was the title of Dr Niall Conlon, Specialist Registrar, Beaumont Hospital, Dublin. Dr Conlon’s talk placed allergy very much in a clinical context by examining case histories illustrating the spectrum of allergic diseases from nuisance to life threatening conditions. Dr Conlon focussed on the current role of the diagnostic laboratory by exploring the strengths and limitations of the widely used allergy aids. “Correct interpretation of allergy tests continues to be a significant problem for clinicians,” he said, and went on to examine the application of these tests in the clinical setting. Dr Conlon concluded by looking at alternative medicine in the diagnosis and management of allergic disease before ending by posing the question, “where do we go from here?”

Continuing the theme, ‘Advances in allergy testing’ was discussed next by Dr Alistair Crockard, Consultant Clinical Scientist, Kelvin Laboratories, Royal Hospital Trust, Belfast. Dr Crockard explained how specific IgE antibody assays are now widely used in the laboratory diagnosis of allergic disease. Whilst current assays, using semi-automated platforms, offer the possibility of testing for a large repertoire of allergen specificities, he believed that microarray technology and flow cytometric approaches will impact significantly on future testing strategies. He went on to outline the potential applications of recombinant allergen / microarray–based technology. “This technology offers the prospect of simultaneous analysis of large numbers of allergen-specific IgEs on small volumes of serum. It is likely that symptom-based chips and/or dedicated microarrays to common groups of allergens will emerge”. He concluded however that the diagnostic characteristics of these assays in relation to current methods need to be demonstrated and economic benefits demonstrated.

‘Transfusing the patient in an out-of-hospital environment’ was a  presentation which epitomised the whole BioMedica theme of placing the patient at the very centre of the service, as  Mr Barry Hill, Chief Biomedical Scientist, Blood Transfusion Department, Wigan Royal Infirmary explained. Administering red cell and other blood component transfusions in an out-of-hospital environment has been deployed for many years and is growing in popularity, in line with the move towards make more medical treatment and near patient testing schemes available within primary care settings.

 Barry outlined the advantages of this system to both patients and hospitals in terms of patient transportation and alleviating acute bed shortages, particularly in the case of infirm, transfusion-dependant individuals who can be transfused at home or in a suitable nearby community setting, patient selection criteria being a key factor. “A multi-disciplinary team approach between blood bank staff, the nursing team and also the patient are the key to the success of the service” he stated, adding that the service must also comply with all existing clinical, pre-transfusion and blood administration guidelines. Additionally all associated blood collection, transportation and storage criteria must adhere to the latest blood quality regulations outlined in the ‘EU Blood Directive’ particularly in relation to the traceability of blood components.

In terms of patient safety, Barry stressed the possibility of a transfusion reaction occurring, all nursing staff must therefore be trained in the identification and management of emergency anaphylaxis, and be fully equipped with all the necessary drugs and equipment to do so. Barry concluded that if hospital Trusts are prepared to invest the necessary resources of time and money in out-of-hospital transfusions then many much-needed hospital beds can be freed up, whilst also making transfusions much less arduous for some patients.