Education

1997 : SMAK Depkes Makassar

Dr. Miswar Fattah, MSi 2002 : Chemistry - UNHAS
Makassar, 6th June 1978 2006 : Master of Science in Clinical Chemistry,
Biomedicine- UNHAS
2012 : Doctor of Medicine – Clinical chemistry,
UNHAS
Current position

1. Specialty & Research Laboratory Manager, Prodia Clinical Laboratory 2018

2. Research Laboratory Head, Prodia Clinical Laboratory 2010- 2018
3. HKKI Scientific division : Reference Interval & Decision limit, Indonesian Association for Clinical Chemistry 2013- Now
4. PATELKI : Vice President of PATELKI 2017-Now & Member of Collegium PATELKI 2015 - Now
5. Director of Asian Association of Medical Laboratory Science (AAMLS) 2017 - Now
6. Corresponding Member Scientific Committee Asia Pacific Federation for Clinical Chemistry (APFCB) 2010 – Now
7. Corresponding Member Task Force Young Scientist International Federation for Clinical Chemistry (IFCC) 2016 – Now
BIOLOGICAL INFLUENCES IN
LABORATORY RESULT

Workshop PREANALITYCAL IN
LABORATORY MEDICINE
ACCLS2018
Bali, 26 April 2018
Dr. Miswar Fattah, MSi
Specialty &Research Laboratory Manager
Prodia Clinical Laboratory
Miswar.fattah@prodia.co.id
Miswarfattah@gmail.com
10 FUTURE LAB MED
• Balance Centralize Lab and Periphery Lab
• More Specialize & Unique Test
• Shift to the multiplex Test & Symptom base test
• More Simple Technology & Fast Results
• Less Sample / mini sample
• High Personalize Test
• Increase coverage of INSURANCE for lab test
• High IT utilization (Big Data, IoT & AI)
• More Preventive test
• Increase DCT
 BIOLOGICAL EFFECT RESULTS

Age Gender Race Pregnancy Diet

Starvation Physical activity Caffeine Cigarettes Alcohol

Timing of sampling
diagnostic and
Posture effects of lipemia hemolysis, hyperbilirubinemia
therapeutic
measures
EFFECTS OF RACE AND GENDER ON CREATINE
KINASE
AGE INFLUENCING LABORATORY RESULTS

• Discuss which parameters related aging

CHANGE (%) IN SERUM CONCENTRATION OF SOME
ANALYTES AFTER A STANDARD MEAL
• Discuss why meal
influence laboratory
results
CHANGE (%) IN SERUM COMPOSITION IN SMOKERS:
CHRONIC EFFECTS
ACUTE AND CHRONIC EFFECTS OF ALCOHOL
CONSUMPTION ON SOME ANALYTE CONCENTRATIONS
WHICH ROUTINE LAB TESTS ARE MOST LIKELY TO BE
ALTERED BY CANCER?
liver function tests
(aspartate aminotransferase,
Electrolytes (sodium,
alanine transaminase,
Albumin Protein potassium), calcium,
alkaline phosphatase,
magnesium, phosphorus,
gamma-glutamyl
transpeptidase, bilirubin)

lipids (total cholesterol, low-

renal function tests (blood density lipoprotein
urea nitrogen, creatinine) glucose iron cholesterol, high-density
lipoprotein cholesterol)

CRP uric acid vitamin D LDH

HOW SHOULD LABS INTERPRET ROUTINE TEST
RESULTS IN CANCER PATIENTS?
• Labs may find it helpful to develop investigation algorithms for abnormal results.
When designing these algorithms, labs should keep in mind that factual changes to
routine laboratory results largely reflect the pathobiology and biochemistry of
cancer or the body’s response to therapy. Factitious lab results, on the other hand,
tend to be caused by preanalytical and analytical factors associated with medical
conditions in cancer patients. One example of this is pseudohyperkalemia in
leukemia patients with increased blood cell counts, as mentioned earlier.

• Above all, abnormal results need to be interpreted with caution and a thorough
understanding of cancer biology, since misinterpretation could lead to
inappropriate medical intervention and negative consequences for patients.
IMPACT NO INFORMATION RELATED BIOLOGICAL
CONDITION

false results &

wrong reference
cannot avoided
interval
interference

No pretreatment Misinterpretation
DISCUSS

• Which reference interval related biology

• Which Parameter interference by biology

• Which biological condition need pretreatment

• Potention misinterpretation
DEVELOP TEST DEPEND OF TYPE OF REAGENT/TEST

Reagent Type Test Validation

IVD IVD CompDx
Validation
IVD
ASR
LDT
Verification
RUO/IUO ASR
 DEVELOP NEW
Right test TEST WITH HIGH
for QUALITY RESULTS Right QC
using the concentration
producing
Right
the Right
method
outcome
6R Lab
Med
with the at the Right
3R
Right costs time QC
to the Right Right time to Right QC
patient detect errors material

Right Right Right

- -
Drug Patient Time
Personalized Medicine
THANKS