1. Andrew Attia, Miriam Bishay & Carly Sterling September 15, 2015 Diagnostic Blood Testing PHM142 Fall 2015 Instructor: Dr. Jeffrey Henderson

2. Overview 1.What is a Diagnostic Blood Test? 2.Where are They Used? 3.Purposes 4.How are They Used? 5.Examples of Common Blood Test Analytes 6.Recent Innovations in Blood Testing 7.Summary

3. What Is A Diagnostic Blood Test?

4. Diagnostic Blood Tests: Definition: Any medical test performed on samples taken from the blood to aid in diagnosis and detection of disease - Provides objective information about a person's health

5. Where are They Used?

6. Where Are They Used? Centralized laboratory Hospital bedside Physician's office Clinics Homes  Setting depends on the type of test and methods used

7. Purposes

8. Purpose of Diagnostic Blood Testing: Diagnosis & Identification Screening Assessment of Severity Risk Assessment Monitoring Course or Progression Assessment of Response to Treatment Guides Use & Selection of Further Tests and Treatment

9. Screening Diagnosis Treatment Selection Disease Management

10. How are they used?

11. Administered by a healthcare professional Sample is sent to clinical chemistry lab Analyte concentration is determined Test results and reference ranges are sent to physician Physician compares results to “reference ranges” and makes Diagnosis

12. What are “Reference Ranges”? Considered to be “normal” concentrations of analyte A large healthy sample is tested Range is set as ± 2 standard deviations from sample mean Therefore, 95% of sample in reference range Often lab-specific: due to different methods & instruments

13. Miriam’s Hemoglobin Test Result

14. Examples of Common Blood Test Analytes

16. Recent Innovations: 1.PSA (Prostate Specific Antigen) Blood Test 2.Testing for HER2 levels 3.Alzheimer’s Disease, using “biological age”

17. Recent Innovations in Blood Testing

18. And Now... Time for some FUN!

19. HemoCup A flip cup alternative

20. What is the medical term for someone who has high iron? 1.Hyperironemia 2.Hyperferronemia 3.Hemochromatosis 4.High Iron Disease

21. Which of the following analytes would NOT fall under the category of a hormone? 1.Insulin Growth Factor (IGF-1) 2.Prolactin 3.Fibrinogen 4.Testosterone

22. Summary A diagnostic blood test is used to aid in the diagnosis and detection of disease Also used for screening, risk assessment, disease progression and treatment selection Analyte concentration in blood is compared to a reference range (“healthy value”) Can be done in physician’s office, hospital bedsides, labs, or even at home Examples of common blood tests are: glucose, cholesterol, and testosterone… Medical advancements can now help detect susceptibility for diseases like prostate cancer, Alzheimer's, breast cancer

23. Summary Screening Diagnosis Treatment Selection Disease Management

24. References: AdvaMedDX. June 2011. A Policy Primer on Diagnosis, http://advameddx.org/download/files/sections/Policy/Innovation/AdvaMedDx-Policy- Primer-on-Diagnostics-June-2011.pdfhttp://advameddx.org/download/files/sections/Policy/Innovation/AdvaMedDx-Policy- Primer-on-Diagnostics-June-2011.pdf Baron, P. The 10 Most Important Blood Tests. Life Extension, http://www.lifeextension.com/magazine/2006/5/report_blood/page-04http://www.lifeextension.com/magazine/2006/5/report_blood/page-04 Canadian Cancer Society. http://www.cancer.ca/en/cancer-information/diagnosis-and-treatment/tests-and-procedures/prostate-specific- antigen-psa/?region=onhttp://www.cancer.ca/en/cancer-information/diagnosis-and-treatment/tests-and-procedures/prostate-specific- antigen-psa/?region=on Lab Tests Online. AACC, https://labtestsonline.org/understanding/analytes/her2neu/tab/test/https://labtestsonline.org/understanding/analytes/her2neu/tab/test/ Oddoze, C. Stability study of 81 analytes in human whole blood, in serum and in plasma. Clinical Biochemistry, Volume 45. Pg. 464-469 (doi:10.1016/j.clinbiochem.2012.01.012) The Independent Newspaper. http://www.independent.co.uk/life-style/health-and-families/health-news/scientists-develop-blood-test-that- estimates-how-quickly-people-age--and-their-risk-of-alzheimers-10488850.html The Lewin Group, Laboratory Medicine: A National Status Report (Centers for Disease Control and Prevention, May, 2008)