LabMind

Kidney disease affects more than one in seven adults in the United States, but for many patients, the first signs of trouble emerge not from their symptoms but from their laboratory test results. That makes the laboratory a critical starting point for earlier detection, intervention, and better kidney health. In this episode of LabMind, Joseph Vassalotti, MD, clinical professor of Medicine at the Icahn School of Medicine at Mount Sinai and chief medical officer of the National Kidney Foundation, joins us to discuss how laboratory testing and advances in screening are changing the approach to kidney disease and why patient advocacy is an essential part of improving kidney care.

The Friedewald equation has been the standard method for estimating low-density lipoprotein cholesterol (LDL-C) for more than 50 years. However, newer equations can reduce the negative bias that may occur at high triglyceride concentrations or low LDL-C levels, improving the accuracy in cardiovascular disease risk assessment. But if newer calculations are available, why haven't they been adopted more broadly?

This episode of LabMind features three scientists from the National Institutes of Health (NIH): Alan Remaley, MD, PhD, FAHA, senior investigator in the Lipoprotein Metabolism Laboratory at the National Heart, Lung, and Blood Institute; Anna Wolska, MS, PhD, FAHA, associate scientist in the Lipoprotein Metabolism Laboratory, and Maureen Sampson, BSMT(ASCP), research clinical laboratory scientist in the Chemistry Service of the Department of Laboratory Medicine at the NIH Clinical Center. They joined us to discuss the evolution of LDL-C estimates and the opportunities associated with implementing newer equations in clinical laboratories. Listen in for an insightful conversation on how advances in lipid testing can improve the assessment of atherosclerotic cardiovascular disease risk.

Related Information:

• DPYD Genotype-Guided Fluoropyrimidine Dosing: FDA and NCCN Updates to Guide 5-FU and Capecitabine Dosing for Oncologists [https://arup.utah.edu/education/nelson-dpyd-2026]
• William Friedewald on The Friedewald Equation [https://web.archive.org/web/20171121060358/www.epi.umn.edu/cvdepi/essay/william-friedewald-on-the-friedewald-equation/]
• 2026 ACC/AHA Guideline on the Management of Dyslipidemia [https://www.ahajournals.org/doi/10.1161/CIR.0000000000001423]
• A Modified Sampson-NIH Equation with Improved Accuracy for Estimating Low Levels of Low-Density Lipoprotein-Cholesterol [https://pubmed.ncbi.nlm.nih.gov/40629956/]

A single genetic variant can make the difference between effective cancer treatment and life-threatening toxicity. In this episode of LabMind, Ryan Nelson, PharmD, medical director of Precision Medicine at ARUP Laboratories and adjunct professor at the Spencer Fox Eccles School of Medicine at the University of Utah, shares how a growing movement led by patient advocates, researchers, healthcare organizations, and regulators has driven critical updates to guidelines for prescribing fluoropyrimidines, a major class of chemotherapy drugs. Tune in to learn why pharmacogenetic testing is becoming an important tool in cancer care, helping clinicians identify at-risk patients, reduce serious adverse events, and deliver safer, more cost-effective treatments.

Related Information:

• FDA: Safety Labeling Update: Capecitabine and Fluorouracil (5-FU), Risks Associated With DPD Deficiency. 2026. fda.gov
• FDA: VISTOGARD (uridine triacetate) Prescribing Information. 2015.
• NCCN: Clinical Practice Guidelines in Oncology: Colon Cancer, v5.2025 (Oct 30, 2025).
• Nelson R, Shaaban S. DPYD Pretreatment Testing Updates: Guide for Oncologists. ARUP Laboratories, 2026.
• Deenen MJ, et al. Upfront Genotyping of DPYD*2A to Individualize Fluoropyrimidine Therapy. J Clin Oncol. 2016;34(3):227-234. doi:10.1200/JCO.2015.63.1325
• Henricks LM, et al. DPYD genotype-guided dose individualisation of fluoropyrimidine therapy. Lancet Oncol. 2018;19(11):1459-1467. doi:10.1016/S1470-2045(18)30686-7
• Knikman JE, et al. Survival With DPYD Variant Alleles and Dose-Individualized. Therapy. J Clin Oncol. 2023;41(35):5411-5421. doi:10.1200/JCO.22.02780

Laboratory billing is a complex and often challenging aspect of healthcare, yet appropriate reimbursement is essential to sustain operations and support high-quality patient care. In this episode of LabMind, Ashley Zarling, director of Business Development and Marketing at Doc Lab, shares practical strategies for developing and maintaining effective laboratory billing solutions. This discussion also explores key trends and emerging challenges in the evolving landscape of laboratory billing and compliance. Join us for an insightful and engaging conversation on this critical, but often underappreciated, component of clinical laboratory operations.

Vaccination has been at the forefront of public discourse in recent years, yet the role of clinical laboratory testing in evaluating vaccination status has been largely overlooked. In this episode of LabMind, Dr. Patricia Slev, professor of Pathology at the Spencer Fox Eccles School of Medicine at the University of Utah, explores how immune response to vaccines can be assessed through clinical laboratory diagnostics. This conversation brings a scientific and personal health perspective to a complex topic, highlighting how evidence-based laboratory medicine can help inform our understanding of this important issue. Join us for this timely and thought-provoking discussion about vaccine-induced immunity.

Related Information: To Vaccinate or Not To Vaccinate: A Laboratory Perspective by Patricia R. Slev, PhD, D(ABCC) [https://arup.utah.edu/education/slev-vac-2026.php]

Clinical laboratories play a critical role in patient care while also generating substantial waste, including single‑use plastics, paper, and e-waste. In this special Lab Week episode of LabMind, we sit down with Dr. Joseph Wiencek, associate professor of Pathology, Microbiology, and Immunology at Vanderbilt University Medical Center, to explore practical and attainable ways laboratories can reduce their environmental footprint. Dr. Wiencek shares actionable strategies for improving sustainability through laboratory stewardship, recycling initiatives, and effective advocacy without compromising quality or safety. Whether you’re a laboratorian, administrator, or trainee, this conversation offers ideas you can implement immediately. Listen in as we rethink waste in the clinical laboratory and consider how you can contribute to a more sustainable future in laboratory medicine.

Related Information:

• Estimated Waste Generation From 1 Million Basic Metabolic Panels: A Multisite U.S. Study [hyperlinked to: https://pubmed.ncbi.nlm.nih.gov/41048040/]
• Potential Savings of Two Practical Interventions on Vitamin D Ordering Practices at a Large Academic Medical Center [hyperlinked to: https://pubmed.ncbi.nlm.nih.gov/41140116/]

The doctorate in clinical laboratory science (DCLS) is designed to address critical practice needs involving high-complexity CLIA laboratory directorships and effective laboratory representation with clinical services across the health system. This episode of LabMind features guests Dr. LaShanta Brice, scientific engagement and clinical education scientist at Diagnostica Stago, Dr. Melody Nelson, assistant clinical professor in the Department of Pathology at the University of Kansas Medical Center, and Dr. Kacy Peterson, director of laboratory optimization and clinical integration and laboratory service line administrator at Avera Health. They join us to discuss their laboratory careers, the value of the DCLS degree, and the ways the degree has helped to empower their laboratory, clinical, and scientific leadership across different practice settings.

New blood-based tests for Alzheimer's disease (AD) are advancing and reshaping how this devastating disorder is detected and treated. In this episode, Dr. Christine Cliatt Brown, assistant professor in the division of Cognitive Neurology at the University of Utah, and Dr. Heather Nelson, assistant professor in the department of Pathology at the University of Utah and medical director of Clinical Chemistry and Mass Spectrometry at ARUP Laboratories, discuss how emerging diagnostics are transforming the diagnosis and management of AD. Together, they explore how collaboration across clinical and laboratory disciplines can accelerate diagnostic innovation and support advances in patient care.

Related Information: Plasma-Based Diagnostics for Alzheimer’s Disease: Current State and Clinical Relevance of pTau 217 [aruplab.com/pTau217-2026]

Change is the new constant—especially in clinical laboratories and healthcare organizations. In this episode of LabMind, Danny Diaz, senior director of Clinical Application Services at Memorial Sloan Kettering Cancer Center, shares why resilience is more than a buzzword—it’s an imperative. As he explores his own career journey, Diaz offers practical strategies for building networks, advancing ideas, advocating for yourself, and driving meaningful transformation.

Related Information:

When Uncertainty Knocks: How To Regain Control and Reclaim Confidence https://www.linkedin.com/pulse/when-uncertainty-knocks-how-regain-control-reclaim-confidence-diaz-hn6we/?trackingId=XcqMp8lVT6upzDtJUH%2Fnfg%3D%3D

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a genetic condition that can lead to life-threatening hemolysis in both children and adults. Early and accurate diagnosis is critical, but identifying G6PD deficiency in newborns and young children isn’t always straightforward—most reference intervals are based on adult values, which don’t necessarily apply to pediatric patients. In this interview, Dr. Kelly Doyle, an ARUP medical director of Special Chemistry, Endocrinology, and Mass Spectrometry, shares insights from novel methods to establish pediatric-specific reference intervals. Using an innovative indirect approach and a large dataset of patient results, Dr. Doyle explains how these new standards can improve diagnosis and care for children worldwide.

Related Information: Webinar: Development of Pediatric G6PD Reference Intervals Through Integration of Indirect Methods and Molecular Data https://arup.utah.edu/education/doyle-g6pd-2025.php

After seven years and almost 100 episodes of LabMind recorded, Dr. Brian Jackson, former medical director at ARUP Laboratories and faculty with the Spencer Fox Eccles School of Medicine at the University of Utah, has moved into a new clinical laboratory leadership position at the University of Maryland—leaving the podcast mic behind for a clinical challenge he always knew he wanted to take in his career. During Dr. Jackson’s final episode, he shares his thoughts on a variety of topics, including the state of U.S. healthcare and the contributions of pathology, while also reflecting on his time hosting this podcast.

Related Information:

• LabMind - An Interview With Dr. Carl Kjeldsberg (Part I): Founding and the Early Shaping of ARUP https://arup.utah.edu/education/podcasts/labmindEp2.php

• LabMind - An Interview With Dr. Carl Kjeldsberg (Part II): Scaling ARUP into a Mature Company https://arup.utah.edu/education/podcasts/labmindEp3.php

• LabMind - An Interview With Lab Superheroes: Stories of Ingenuity, Creativity, and Grit (Part II) https://arup.utah.edu/education/podcasts/labmindEp50.php

• LabMind - An Interview With Rick Panning: How Laboratories Can Reduce the Total Cost of Care https://arup.utah.edu/education/podcasts/labmindEp36.php

In 2016, Dr. Shaiba Ansari-Ali, a rheumatologist with Northwestern Medicine, experienced a near-fatal stroke that was followed by a misdiagnosed case of sepsis. In this interview, she explains how her positivity and tenacity were key to her successful rehabilitation and recovery, and she illustrates how this experience has made her a better physician despite her physical limitations.

Related Information:

• YouTube Series: “Mansplaining Medicine” (https://www.youtube.com/channel/UCkpqin9U2WgT423DqJo2guQwould)
• Book: “When the Doctor Has a Stroke: (How I recovered, and you can too)” (https://www.amazon.com/dp/B08LNLCLF9/ref=cm_sw_r_cp_ud_dp_G68R6WEVAJEPMFJFY2CP?skipTwisterOG=1)

As laboratory professionals, we’re often focused on our critical role as part of the healthcare team in delivering results to providers. But, do we ever stop and think about the power laboratory data can have in the hands of the patients themselves? In this interview, Cherise Shockley, a diabetes social media advocate, describes her experience being diagnosed with an under-recognized form of diabetes and shares how her continuous glucose monitor (CGM) and laboratory test results have helped her take control of her disease and her life.

Whenever a new infectious disease enters the scene (or reenters, as in the case of measles), developing precise and accurate diagnostic tests as quickly as possible is critical. In this interview, Dr. Ben Bradley, ARUP medical director of the Institute for Research and Innovation in Infectious Disease Genomic Technologies, High Consequence Pathogen Response, Virology, and Molecular Infectious Diseases, describes various challenges in rapidly setting up and maintaining testing capacity for these kinds of diseases and why we need collaboration between academic, clinical, and public health labs.

Webinar: Emerging Viral Diseases: A 2025 Update for Laboratorians [https://arup.utah.edu/education/bradley-emergingviral-2025.php]; Measles by Real-Time PCR: A Rapid and Reliable Method for Measles Testing [https://www.youtube.com/watch?v=NZdZDPv-oTw]

In this age of algorithms, how do we ensure clinical care is both science based and personalized? In this interview, Dr. Ryan Metcalf, section chief of Transfusion Medicine at ARUP Laboratories and University of Utah Health and associate professor of Pathology at the University of Utah School of Medicine, shares the story behind the new platelet transfusion guideline from the Association for the Advancement of Blood and Biotherapies (AABB). He describes how the authors addressed patient-specific variation and the inherent uncertainty of scientific evidence.

Related Information:

• Platelet Transfusion: 2025 AABB and ICTMG International Clinical Practice Guidelines [https://arup.utah.edu/education/metcalf-platelet-2025.php/]
• JAMA® Article: Platelet Transfusion: 2025 AABB and ICTMG International Clinical Practice Guidelines [https://jamanetwork.com/journals/jama/fullarticle/2834703]
• JAMA® Clinical Reviews Podcast: Platelet Transfusion: Best Practice Guidelines [https://edhub.ama-assn.org/jn-learning/audio-player/18977738]

Health equity and personalized medicine share a common goal: tailoring care to the needs of each individual. In this interview, Dr. Octavia Peck Palmer from the University of Pittsburgh Medical Center, immediate past president of ADLM, explains how diversity is foundational to advancing clinical science and improving patient outcomes.

After nearly dying from a mysterious disease during medical school, Dr. David Fajgenbaum dedicated his career to breaking down barriers in biomedical research. Fajgenbaum is now an associate professor of medicine at the University of Pennsylvania and cofounder of Every Cure. In this conversation, we discuss his personal diagnostic journey and the errors and delays he encountered along the way. We also explore why academic medicine needs to go beyond generating disparate pieces of scientific knowledge and instead turn that information into nodes on a network that spans specialty silos to speed the discovery of effective treatments.

Every specimen represents a potential mystery, and laboratory professionals often play the role of detectives. For the 2025 Lab Week episode of LabMind, Amanda Openshaw, a genetic counselor at ARUP, shares examples illustrating the importance of good investigative work in the laboratory to discover accurate diagnoses.

Why hasn’t there been more progress in developing therapies for Alzheimer’s disease and related forms of dementia? One reason has been the lack of specific laboratory tests that can properly diagnose and characterize these diseases. In this interview, Dr. Qinwen Mao from the University of Utah describes how her research team is helping to bring new blood and cerebrospinal fluid biomarkers into clinical practice to step up the fight against these devastating diseases.

Related Information: Webinar: Innovations in Diagnostics for Alzheimer’s Disease and Related Dementias (aruplab.com/AlzInnovations)

As laboratory professionals, we may think we have a good understanding of how physicians use our services. But how often do we ask them for practical feedback? In this interview, family physician Dr. Keith Elkins shares his perspectives on what clinical laboratories and pathologists do well, and what opportunities they may be overlooking to better support frontline clinical care.