5th Annual Research and Innovations Symposium

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A celebration of research excellenceHosted at the imposing new Royal College of Pathologists, and coinciding with International Pathology Day, this year’s 5th Annual Research and Innovations Symposium focused on advances in rapid and point-of-care diagnostic testing. With a line-up of internationally renowned speakers, the day highlighted the pioneering research carried out by HSL and its partner institutions, as well as celebrating the vital role pathology plays across the world.

In her opening address, the College’s President, Professor Jo Martin, emphasised the global nature of pathology. As the

bridge between science and medicine, pathology underpins every aspect of patient care, from diagnostic testing and treatment advice to cutting-edge technologies and disease prevention. The poster competition showcased a diverse array of research and innovation, with many projects already having a direct impact on clinical practice. Congratulations to HSL’s Dr Rebecca Gorton, who won the competition with her poster evaluating the analytical specificity of PCR assays in the detection of Candida species.

Environmental pathology: preventing hospital-acquired infections

The morning’s session kicked off with a stark reminder about the challenges of maintaining effective hygiene in the battle to treat and prevent transmission of hospital-acquired infections.

Professor Peter Wilson, Consultant Microbiologist and the UCLH / London Specialty Training Committee Chair for Microbiology, gave a fascinating insight into the role simple design elements can play in reducing transmission of microorganisms – from anti-splash fins in sinks to copper inserts in taps. He said that while new cleaning methods

Rapid diagnostics in critical care

Dr David Brealey, Consultant Anaesthetist and Clinical Lead for Critical Care Service and Trials at UCLH, focused on the changing face of critical care and the role of rapid diagnostics in improving patient outcomes. His presentation centred on variations in the definition, coding and reporting of sepsis – the diagnosis of which remains highly non-specific.

Early identification of causative microorganisms in patients with sepsis is crucial to optimise antibiotic use and improve survival. However, current culture-based diagnostics are very slow: the median time from sample to results is 70 hours. As a precaution, patients are often started on broad-spectrum antibiotics – carrying risks of overtreatment, toxicity and

selection of multidrug-resistant bacteria.

In his talk, Dr Brealey discussed a variety of novel, molecular technologies which are transforming the diagnosis and management of sepsis. Using the IRIDICA system as an example, Dr Brealey explained how Polymerase Chain Reaction (PCR) and Electrospray Ionisation Mass Spectrometry (ESI-MS) technology can be used to detect and identify causative pathogens in as little as six hours. This ensures targeted antimicrobial therapy can be administered more quickly, improving clinical outcomes and reducing treatment-related side effects in those who are critically ill.

such as UV-C and hydrogen peroxide vapour were effective, there were practical drawbacks to their use as well as significant variation in the quality of devices.

With multidrug-resistant gram-negative bacteria posing a serious and escalating threat to hospitalised patients, Prof Wilson suggested that, alongside new technologies and better design, effective cleanliness could and should be achieved with better-trained and managed cleaners. In the fight against hospital-acquired infections, education is key.

Introduction of qFIT testing in the communityColorectal cancer is the second biggest cancer killer in the UK – but curable if diagnosed early. While colonoscopy remains the gold standard for diagnosis, a new, at-home test – known as the Quantitative Faecal Immunochemical Test (qFIT) – is being introduced to help GPs reliably rule-out colorectal cancer in primary care, reducing unnecessary referrals and easing pressure on endoscopy services.

In her presentation, Dr Clare Stephens gave an overview of the take up and early results of qFIT among GP practices in North London. qFIT is a simple, non-invasive test that can detect and quantify microscopic amounts of blood in stool samples. As well as being highly accurate, it is significantly

cheaper than colonoscopy, and has recently been introduced into the national bowel cancer screening programme. NICE currently recommends that GPs use qFIT to guide two week wait referrals in low risk patients; 73 GP practices across London are taking part in a study to examine whether qFIT can safely rule out cancer in high risk patients too.

The programme is still at a relatively early stage but has already helped reduce urgent referrals by 20%. With positive feedback from patients, Dr Stephens is optimistic about the role of qFIT in primary care, and the growing body of evidence supporting its validity as a diagnostic tool

The PITHIA trial: a national biopsy service for kidney transplants

Consultant surgeon, Gavin Pettigrew, introduced the PITHIA trial – a pioneering project evaluating whether the introduction of a national, pre-implantation biopsy histopathology service increases numbers and improves outcomes of kidney transplants performed in the UK.

There are currently 5,000 patients on the waiting list for a kidney transplant, but a great shortage of kidneys available. While the largest pool of potential kidneys comes from people over 60, donor age is unfortunately strongly associated with poor function and early failure. Standing for the Pre-Implantation Trial of Histopathology on Renal Allografts, the

PITHIA trial aims to improve identification of high-quality kidneys from older donors, maximising the number of transplants performed without compromising outcomes.With a stepped-wedge cluster randomised design, the PITHIA trial uses urgent biopsy and digital histopathology to identify age-related damage in kidneys from donors over 60 years old – offering a greater degree of assurance of viability for marginal kidneys. Mr Pettigrew anticipates that 24/7 biopsy availability will increase the use of kidneys from elderly donors by about 10%, equating to an additional 150 kidney transplants each year

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Research in the pathology training curriculum In the final session of the morning, Dr Martin Young, Consultant Histopathologist, Clinical Director for Pathology at the Royal Free and Director of the HEE London / KSS School of Pathology, outlined opportunities for research in the pathology training curriculum. The school is responsible for the recruitment, training and assessment of over 400 trainees in a variety of pathology specialities, including chemical pathology, haematology, histopathology, immunology, and medical microbiology and virology.

Dr Young stressed the importance of research in the curriculum, keeping pathology at the frontline of scientific

Pathology is globalThe day ended with a roundtable discussion focusing on ‘a question of quality’ in rapid and point-of-care testing (POCT). Chaired by Professor Jo Martin in support of International Pathology Day, the panel included Dr Charles van Heyningen, Lieutenant Colonel Emma Huntley, Professor Tahir Pillay and Dr Wale Atoyebi and was live streamed to 47 different countries.

Discussing the use of POCT in resource-poor settings, the panel highlighted its diverse applications across the globe, from stemming outbreaks of Yellow Fever in Brazil to improving diagnosis of Sickle Cell Disease in Nigeria. However, they emphasised that the benefits POCT brings in

terms of accessibility, cost and convenience must not come at the expense of quality. Robust validation, verification and quality assurance remain critical if POCT is to lead to positive and sustainable health outcomes.

The fascinating discussion was a timely reminder that technology does not exist in a vacuum. As pathologists, we have a duty to advocate for quality diagnostics and ensure the infrastructure exists to support the safe and effective use of novel technologies. As advances in rapid diagnostics and POCT transform the face of medicine, collaboration between laboratory and clinical settings has never been more important.

discovery as well as to develop critical thinking among its pool of trainees. However, he also explained that including a research element to a training programme was a significant commitment. Citing the example of a research module in the histopathology training programme, a student would have to write up their research, submit six work-placed based assessments, maintain a log book and get it signed off by an educational supervisor – all within three months. Given the commitment required, relatively few trainees choose to take the research module in any specialty, but those that do say they benefit enormously.

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