APMP TCQM WEBINAR

20 SEPTEMBER 2024, UTC 04:00 – 07:00

METROLOGY AND ITS IMPACT TO THE CLINICAL LABORATORY COMMUNITY

  At the 39th General Assembly (GA) of the Asia Pacific Metrology Programme (APMP) in December 2023, it was agreed that our regional metrology organisation should shift its focus from the COVID-19 pandemic to tackling measurement issues related to public health. The APMP Technical Committee for Amount of Substance (TCQM) is well-positioned to lead the development of measurement capabilities with direct impact on human health.

  Today, 70% of all medical decisions depend on laboratory test results, underscoring the crucial role of clinical laboratories in our healthcare systems. Chemical metrology plays a critical part in this. Notably, metrology institutes provide certified reference materials (CRMs) to meet traceability requirements for in-vitro diagnostic devices and offer assignment services using reference measurement procedures (RMPs) for accuracy-based quality assessment programmes. These metrological services directly and indirectly benefit clinical laboratories.

  In the realm of laboratory medicine, the importance of metrological traceability cannot be overstated. With these considerations in mind, the TCQM organised a webinar to discuss the relevance of metrological services to laboratory medicine. The TCQM was privileged to invite six speakers to share real examples during a 3-hour webinar on 20 September 2024. The webinar was opened by TCQM Chair, Dr Byungjoo Kim from Korea Research Institute of Standards and Science in the Republic of Korea, and hosted by the TCQM Chair-Elect, Dr Tang Lin Teo from Health Sciences Authority in Singapore. The topics drew the attention of many colleagues, not only from metrology institutes but also participants from accreditation bodies, standards bodies, research institutions, clinical laboratories, universities, and IVD suppliers. About 100 attendees joined the webinar.

  As highlighted by Dr Tony Badrick, CEO of the Royal College of Pathologists of Australasia and President of the Asia Pacific Federation for Clinical Biochemistry and Laboratory Medicine, non-standardised measurands due to a lack of CRMs or RMPs can lead to discrepancies in results across clinical laboratories and methods. Dr Badrick illustrated the critical impact of measurement variability on patient care through compelling real-world examples, and discussed how inconsistent results can lead to serious consequences such as misdiagnosis or inappropriate treatment decisions.

  The production of CRMs, as explained by Dr Mark Lewin of Australia's National Measurement Institute, requires meticulous planning and characterisation. This process involves assessing commutability, homogeneity, and stability, adhering to international standards such as ISO 17034 and ISO 33405. Building on this, Dr Liqing Wu from China's National Institute of Metrology emphasised the particular significance of commutability in CRMs and accuracy-based proficiency tests. To aid in this crucial aspect, he shared the availability of guidelines for commutability evaluation such as CLSI EP14, CLSI EP30, and the IFCC approach.

  National initiatives in South Korea, Singapore, and Thailand demonstrate the practical application of CRMs and accuracy-based EQA programmes in improving healthcare outcomes. Dr Ji-Seon Jeong of the Republic of Korea’s Korea Research Institute of Standards and Science illustrated how the South Korea's National Standard Reference Data (NSRD) achieves traceability through KRISS’s CRMs, thereby enhancing disease prevention and health management. Dr Qinde Liu of Singapore's Health Sciences Authority highlighted how HSA's accuracy-based EQA programmes using commutable sera and urine samples have significantly impacted clinical measurements and/or licensing regulation linking to diabetes control. As explained by Dr Jintana Nammoonnoy of the National Institute of Metrology Thailand (NIMT), their focus on creatinine standardisation efforts helps to address the country's renal failure concerns. These examples illustrate how metrology institutes are actively contributing to improved diagnostic accuracy and patient care in our region.

  As laboratory medicine continues to evolve, the collaborative efforts of metrology institutes, regulatory bodies, and healthcare professionals in developing and implementing CRMs and traceability standards will be crucial in ensuring accurate diagnoses and optimal patient care. The TCQM will continue its efforts in the field of clinical measurements as one the drivers of its broader public health strategy. During the 40th APMP GA and related meetings in November 2024, the TCQM can look forward to a full-day workshop focusing on high accuracy measurement methods for clinical markers, followed by a discussion session on TCQM’s strategy plan to support public health. 

Contributor: Dr. Tang Lin TEO, HSA, Singapore