dr. miswar fattah, msi 1997 : smak depkes makassar th 2002 ... · development molecular laboratory...

Education

Current position

Dr. Miswar Fattah, MSiMakassar, 6th June 1978

1997 : SMAK Depkes Makassar 2002 : Chemistry - UNHAS

2006 : Master of Science in Clinical Chemistry, Biomedicine- UNHAS

2012 : Doctor of Medicine - UNHAS

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

2. PATELKI : Vice President 2017-Now & Member of Collegium PATELKI 2015 - Now

3. HKKI: Reference Interval & Decision limit, Indonesian Association for Clinical Chemistry 2013- Now

4. President of ASEAN Association of Clinical Laboratory Scientist (AACLS) 2018-2020

5. Member of Board of Directors of Asian Association of Medical Laboratory Science (AAMLS) 2017 - Now

6. Corresponding Member Scientific Committee Asia Pacific Federation for Clinical Chemistry (APFCB) 2010 – Now

DEVELOPMENT MOLECULAR LABORATORY TO SUPPORT COMPETENCY MED TECH POST COVID-19

Poltekkes Bandung Webinar

Jakarta, 05th June 2020

Dr. Miswar Fattah, MSiSpecialty & Research LaboratoryProdia Clinical Laboratorymiswarfattah@gmail.com

KEY EVENTS IN THE 2019-NCOV OUTBREAK

3th march 20201st Case report in Indonesia

Modiefied from Seah I et al. 2020. Eye, pp. 1–3

COVID-19 UPDATE

NEW NORMAL IN EDUCATION

Teacher Andy overseeing seven others online IGCSE classes during the weekend.

“We need to come together not only to address the immediate educational consequences of this

unprecedented crisis, but to build up the longer-term resilience of education systems.”

“Kita perlu bersatu tidak hanya untuk mengatasi konsekuensi pendidikan langsung dari krisis yang belum pernah terjadi sebelumnya ini, tetapi untuk membangun

ketahanan jangka panjang dari sistem pendidikan.”

Stefania Giannini, UNESCO’s Assistant Director-General for Education

https://www.col.org/resources/keeping-doors-learning-open-covid-19

https://microbenotes.com/covid-19-online-courses/

https://microbenotes.com/covid-19-online-courses/

VIRTUAL LABS—SIMULATING PRACTICAL SKILLS OF SCIENCE

MIT Open Course Ware—Life Sciences,

Massachusetts Institute of Technology,

USA (https://ocw.mit.edu/courses/life-sciences/)

HHMI BioInteractive—Howard Hughes

Medical Institute, USA (https://www.biointeractive.org/)

Virtual Mass Spectrometry

Laboratory—Carnegie Mellon University, USA

(https://svmsl.chem.cmu.edu/vmsl/default.htm)

Virtual Human Interaction Lab—

Stanford University, USA (https://vhil.stanford.edu/)

Learn.Genetics—University of Utah, USA

(https://learn.genetics.utah.edu/)

Analytical Sciences Digital Library—National Science

Digital Library (https://www.asdlib.org/)

Virtual Biotechnology Engineering Labs—National Mission on

Education, India (https://www.vlab.co.in/broad-area-biotechnology-and-biomedical-

engineering)

Glencoe Virtual Labs (https://www.biologycorner.com/worksheets/virtual_labs_glencoe.html)

McGraw-Hill Biology Virtual Labs

(https://www.mhhe.com/biosci/genbio/virtual_labs_2K8/)

The virtual laboratory—University

College London, UK (https://www.ucl.ac.uk/~ucbcdab/simulations.htm)

COVID-19 IS CHANGING EDUCATION FOR THE BETTER

INITIATIVE OF COLLABORATION

Inter university

Industrial collaboration

Cross country collaboration

Goverment collaboration

SEVEN COVS THAT CAN INFECT HUMAN AND CAUSE RESPIRATORY DISEASES

HCoV-229E

HCoV-OC43

HCoV-NL63

HKU1SARS-CoV

MERS-CoV

SARS-CoV2

LESSONS LEARNED FROM THE 2019-NCOV EPIDEMIC

Important laboratory medicine expose to society

Molecular & Immunoassay very important in pandemic

Adapt more faster

Need explore current literature

Optimize Digital information

Each College need minimum one Laboratory ready for cervices

We need more focus in Laboratory medicine – curicullum & research

FIRST 4.0 PANDEMIC

A colorized scanning electron micrograph of the SARS-CoV-2 virus. Credit: NIAID https://db.cngb.org/gisaid/

LABORATORY TESTING RELATED PANDEMIC

Patient management Perspective

Epidemiology & Control outbreak

THE ETIOLOGICAL DIAGNOSIS OF SARS-COV-2 INFECTION ISCURRENTLY BASED ON:

Collection of an upper respiratory specimen

(i.e.,nasopharyngeal AND oropharyngeal swabs)

Analysis of the sample by (real-time) reverse

transcription polymerase chain reaction (rRT-PCR)

https://www.cdc.gov/coronavirus/2019-nCoV/lab/guidelinesclinical-specimens.html

some reagent producers are not very well known by clinical laboratory scientists

in just 3 months the production of new reagents is very muchnot all reagents are listed on this website

https://www.finddx.org/covid-19/pipeline/

Sethuraman N, Jeremiah SS, Ryo A. 2020. JAMA

DIFFERENT TYPE OF ANALYTE LABORATORY TESTING RELATED COVID-19

RNA

RdRp

ORFla/b Gene

N Gene

E Gene

S Gene

Antigen

N Protein

S Protein

Antibody

IgM

IgG

IgA

Host Respons

CBC

CRP

D Dimer

SGOT

Albumin

LDH, etc

Potential susceptibility

ACE2 Gene

TMPRSS2 Gene

HLA Gene

rRTPCR, LAMP, NGS

ELISA, Immuno-chromatography

ELISA, Immuno-chromatography,

Chemiluminoscence immnoassay

Enzymatic, colorimetry,

flowcytometry, impedance

Genotyping microarray, RTPCR,

Sanger Seq, NGS

IFCC Information Guide on COVID-19 - IFCC. www.ifcc.org

High potencial False Negative

High Potencial False Positive

Common problem in diagnostics new disease outbreak

Unclear Mechanism of

Disease

Diagnostic tool under develop

Lack of standardization of sampel type

Unclear Sampling, storage,

handling sample Protocol

Not yet standardize

method

Donation kit without kit

review

7 SHOCK IN COVID-19

Travel &entertainment

shock

Retail and manufacture

shock

Supply chain shock

Personal debt shock

Currencyshock

Market shock Believe shock

7 SHOCK IN LABORATORY MEDICINE RELATED COVID-19

Knowledge shock

Reagent shockLaboratory

Facility shockPPD shock

Insecurity shock

Workload shock

Digitalization shock

BelieveQuality test

shock

RACING TO DEVELOP COVID-19 TESTS

HE tissueElectron

microscopeViral Culture NGS

RT PCR, LAMP

Protein Isolation

Spesific Antibody

ELISA

Rapid Lateral Flow

Chemiluminoscence

Autoanalyzer

“If you have a sequence today, you have a PCR tomorrow”

STEP IN NUCLEI ACID ANALYSIS

Sample preparationNucleic Acid Extraction

DNA quantification

PCR /AmplificationDetection

amplified DNAData analysis

AN ALGORITHM FOR CURRICULUM DECISIONS IN MEDICAL LABORATORY SCIENCE EDUCATION

Susan Beck and Tara C. Moon, American Society for Clinical Laboratory Science April 2017, 30 (2) 105-111; DOI: https://doi.org/10.29074/ascls.30.2.105

PRACTICAL AND SIMUTATION BASED ON REAL EXAMPLESelect

method

How to Validate/ve

rification

Electronical PCR, primer probe check

How to contact

distributors

How to Sampling

How to Preparatate the Sampel

How to extract

DNA / RNA

How to PCR

How to cut target with

Enzyme (RFLP)

How to gel electrophoresis

How to maintaine

Quality

How to interpretate RTPCR graph

How to confirm with Sanger or

Next generationSequencing

Bioinformatics compare genebank

Troubleshooting

How to report results

How to summarize

mothly results

How to communicate

results

How to communicate

limitation

How to publish

Student must have skill how to select better method

Student must have soft skill how to communicate and negotiate

Student must have soft skill to explore and adopt guideline

3-5 different cases

TYPES OF IN VITRO DIAGNOSTICS

RUOs (Research Use Only)

IUOs (Investigational Use Only)

ASRs (Analyte Specific Reagents)

LDTs (Lab Developed Tests)

EUO IVD

Companion Diagnostic IVDs

IVDMIAs (in vitro diagnostic multivariate index assay)

SKILL FOR SELECT METHOD

Basic Patomechanism of

DiseaseEconomics of Test Positioning of Test Regulation of Test

Instrumentation How to BenchmarkHow compare package insert

How to compare based on study

How to compare based on avaibility

& matc current intstrument

How to compare

TYPES OF IN VITRO DIAGNOSTICS

RUOs (Research Use Only)

IUOs (Investigational Use Only)

EUA (Emergency Use Authorization) IVD

ASRs (Analyte Specific Reagents)

LDTs (Lab Developed Tests)

adequate IVD (In vitro diagnostics)

Companion Diagnostic IVDs

Higher utility in pandemic

Higher utility in pandemic

Higher utility in pandemic

“ICE BERG” IN MOLECULAR BIOLOGY

Nucleic Acid Isolation, PCR, Electrophoresis, DNA quantifiction, RFLP, Real time PCR (QPCR), POCT

PCR

Cloning, Primer Design, Sequencing, HRM, Digital PCR, Multiplex PCR

MicroArray, Hybridization,

PCR MALDI TOF MSNext Generation Sequensing

PENGETAHUAN

Prinsip dasar ekstraksi DNA, amplifikasi asam nukleat, PCR, enzyme restriction

Primer design, optimation molecular testing, validation molecular testing.

Bioinformatic for molecular diagnostics, experimental silensing, microRNA

Penemuan biomarker, merancang metode baru, modifikasimetode.

STEP EXPERT DIBIDANG BIOMOLEKULAR

Mengenali Struktur, fungsi dan mekanisme Asam Nukleat

Mengetahui berbagai metode Isolasi & Analisa Asam Nukleat

Dapat melakukan pemeriksaan Asam nukleat & ahli dalam memahami prinsip dasarpengukuran

Mengenali karakteristik teknologi yang digunakan dalam pemeriksaan Asam nukleat

Mengetahui kelebihan & kekurangan setiap teknologi & dapat memilih sesuai kebutuhan

Memahami faktor yang dapat mempengaruhi pemeriksaan dan cara menghindarinya

Mampu menyelidiki kondisi analitis abnormal & memperbaiknya

KEY TRICK TO FAST LEARN PCR

Menelaah video prinsip PCR (minimum 5 video)

Simulasi perhitungan master mix (minimum 10 Protokol)

Simulasi set up alat PCR (minimum 5 jenis software berbeda danmasing masing 3 protokol bereda)

Simulasi pipetasi volume 2 uL, 1 uL, 0,5 ul (minimum 20 kali dandiulang dalam 7 hari berbeda)

Simulasikan pembelian reagen PCR (minimum untuk 5 protokol)

Optimasi minimum 1 (SATU) protocol

SarjanaBiologi

• Pelaksanateknis

• Scientist

Dokter• Peneliti &

Scientist

TeknoBiologi

• PelaksanaTeknis & Scientist

ATLM• Pelaksana

Teknis

Profesi yang berkaitan dengan Molekular Diagnostik

Realita Di Indonesia *

• Pengetahuan dan teknologi di Indonesia 5-10 tahun terlambat

• Perlu Revolusi sistem training dan pendidikan yang mengakomodir laju perubahan

• Penggunaan original artikel dalam pembelajaran….. UNTUK >=S1& D4

Ide sampai selesai

Karya ilmiah

(2 – 4 tahun)

2 – 3 Tahun 3 – 5 Tahun

REVOLUSI SISTEM PENDIDIKAN ANALIS KESEHATAN

DIGITAL KNOWLEDGE

• Online Course

• EDX

• Coursera

• Codecademy

• My open campus

• Udacity

• Udemi

• Online Conference

• TED

• Mayo clinic

• Arup

• AACC Trainee Council

TERIMA KASIH