Ana-Maria Simundic
Prof. Ana-Maria Simundic has received her graduate and postgraduate education at the Faculty of Pharmacy and Medical Biochemistry at the Zagreb University where she currently holds a professor position at the department of Medical Biochemistry. She is also teaching at the Tuzla University and Dubrovnik International University.
Prof. Simundic is currently employed at the Department of Medical Laboratory Diagnostics at the Clinical Hospital Sveti Duh in Zagreb, where she works as the Department Head. She was the President of the Croatian Society of Medical Biochemistry and Laboratory Medicine 2012-2018. Until the end of 2017, she has served as the Editor-in-chief of the journal Biochemia Medica, published by Croatian society of Medical Biochemistry and Laboratory Medicine. She now holds a Senior Editor position in that Journal.
Prof. Simundic has also reached wide international recognition with her engagement in the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) over the years, in her role of Executive Board Secretary (2011-2017), as the chair of the Working group for Preanalytical Phase (WG-PRE) (2012-2018), Vice President of the EFLM (2018-2019), and currently as the President of EFLM (2020-2021). In her capacity of the chair of the WG-PRE, Prof. Simundic has been the chair of the Organizing Committee of the past four highly successful Conferences in Preanalytical phase, which took place in Parma (2011), Zagreb (2013), Porto (2015), Amsterdam (2017) and Zagreb (2019), as well as the chair of the Scientific Committees of the Conferences in Preanalytical phase in Zagreb (2013), Porto (2015), Amsterdam (2017) and Zagreb (2019).
She was awarded with the Best Young Scientist award (2000) and Best Research award (2011) by the Croatian Society of Medical Biochemistry and Laboratory Medicine, with the Per Hyltoft Petersen Award (2012) by the Slovak Society of Laboratory Medicine and with the Honorary membership of the Hungarian society for Laboratory medicine (2012) and Italian society for Clinical Chemistry and Laboratory medicine (2020). In 2015 she was among the Top 100 Powerlist of the British journal: The pathologist. Prof. Simundic has authored or co-authored numerous peer reviewed manuscripts. Her research activities focus on quality management and preanalytical phase.
Brief overview of the talk
Quality of the preanalytical phaseThe aim of this lecture is to address some unresolved challenges and offer a glimpse into the future of preanalytics. Preanalytical phase has been recognised as a major source of variability already couple of decades ago. Major focus in preanalytical research was initially on understanding the mechanisms and effects of various preanalytical sources of variability. Many of the publications at that time were focused on determining the frequency of preanalytical errors. This led to the full understanding of the size of the problem. It became clear that preanalytical phase is the most vulnerable part of the total testing process and there was a common understanding that we as a profession have the responsibility to address this issue with great care.
What was not so sure at that time was the link between the preanalytical errors and patient outcome. It is clear today that every improvement in preanalytical phase will not necessarily lead to the reduction of the frequency of diagnostic errors and better patient outcome. The key question is which preanalytical errors have major contribution to patient outcome. This question has become the focus of preanalytical research during the last decade or so. There is now growing understanding among laboratory professionals that preanalytical studies should aim to address such issues by showing how and to what extent preanalytical variability affects patient well-being. Clearly, we need high quality outcome studies which employ evidence-based metrics to measure not only the effects of various preanalytical errors on test results, but also on the patient outcome and healthcare expenses. We need good studies to demonstrate to what extent falsely elevated or decreased values may affect medical decision making, quality of patient care and associated costs. Future studies need to be well designed and their protocols standardized in order to increase their transparency and assure transferability of results.
Working group for Preanalytical Phase (WG-PRE) of the European Federation for Clinical Chemistry and Laboratory Medicine (EFLM) has been established in 2011 to promote the importance of the quality of the preanalytical phase and contribute to the standardization and harmonization of some critical activities in the preanalytical phase. WG-PRE has over the years produced a number of recommendations and guidance documents, for some major preanalytical issues such as: venous blood sampling, patient identification, patient preparation along with the definition for the fasting state, sample stability, demand management, detection and management of haemolysis, quality assurance for serum indices etc. In this lecture I provide an overview of the past and future preanalytical issues, give some guidance on how to manage preanalytical issues and propose the agenda for the future.