American Association for Clinical Chemistry
Better health through laboratory medicine
History of the NACB

The National Academy of Clinical Biochemistry: A Historical Perspective

Written by MYRON WARSHAW, PH.D., FACB in commemoration of the Academy's 25th anniversary in 2001. Updated and edited by Charles D. Hawker, Ph.D., FACB.

In the 1970's, doctoral clinical chemists were increasingly interested in enhancing their stature and position as is even true now. When the American Association of Clinical Chemists chose to broaden its base and open membership to all persons active in the field (its name was changed to American Association for Clinical Chemistry in 1976), a significant number of doctoral clinical chemists became even more concerned. This concern was especially strong among members of the Chicago Section, some of whom had been founding members of AACC. A core group began meeting to discuss the possibility of organizing a learned society that would represent the academic, research, and hospital-based clinical chemists.

And so, frequent meetings began in 1975 to organize and define this new professional society. The participants were: Dr. Stanley Bakshy, Professor Alvin Dubin, Dr. Morton Epstein, Dr. John Kachmar, Dr. Samuel Natelson, Dr. Amadeo Pesce, Dr. Max Rafelson, Dr. Newton Ressler, Dr. Alex Solonicki, Dr. George Sumyck, Dr. Myron Warshaw, and Dr. Harry Weisberg. By the spring of 1976, the purpose and structure of the National Academy of Clinical Biochemistry was decided and a draft set of Bylaws was written. Although revised in later years, the original Bylaws included committees for Education and Publication, Accreditation of Hospital Laboratories, Employment, and Professional Ethics and Standards, all of which were important concerns of the founding members.

Dr. Larry Demers designed the Academy's logo of a caduceus in a test tube.

The Academy's membership objective was to emphasize the board-certified doctoral laboratory scientist as well as those who were active in research and teaching. Governance was divided between the officers (President, Vice President, Secretary, and Treasurer) and a Board of Directors. The Board was lead by a separate Chairman elected by the Board. Both the membership definitions and the governance structure have evolved over the first 25 years. Morton Epstein was asked to be the first President. Dr. George Grannis was invited to become his successor until elections were held.

During early 1976, personal contacts were made to many clinical chemists around the country to invite them to become members. Informational meetings also were held during the AACC Houston meeting. President George Grannis presided over a membership meeting held during the 1977 AACC meeting in Chicago. The Academy's long range plan was to conduct annual high level symposia on selected clinically-relevant scientific topics and to have the proceedings published in a journal, with a focus on the human in health and disease, not just on analytical methods. The first symposium, "Biochemical Aspects of Learning Disability," was held as part of the second annual meeting, July 21-22, 1978, at the St. Francis Hotel in San Francisco.

The third national meeting was held July 14-15, 1979 in New Orleans on "Nutritional Elements of Clinical Biochemistry." The co-chairs were Marge A. Brewster, PhD and Herbert K. Naito, PhD. A most memorable and scientifically rewarding symposium was held in Toronto in 1989 on the topic: "Diagnostic Applications of Nucleic Acid Probes in the Clinical Laboratory." The keynote speaker was Kary B. Mullis, Ph.D., the inventor of PCR, who received the Nobel Prize in Chemistry four years later. This NACB national meeting was held between the meetings of the International Society of Enzymology and The Canadian Society of Clinical Chemistry. The last NACB annual meeting (18th) in the symposium format was held in New Orleans, in 1994, on "Atherogenesis: Current Topics on Etiology and Risk Factors."

The Academy's second major objective was to have a journal, a necessary element of a learned society. To that end, an editorial board was selected and Dr. Max Rafelson volunteered to be U. S. co-editor of the already existing Journal of Clinical Biochemistry published by Karger. After six years with this journal, a trial was commenced in 1990 with Clinical Biochemistry, a Canadian journal. Dr. James Wittliff, representing NACB, shared co-editorship with an editor who represented the Canadian Society of Clinical Chemists. That relationship lasted three years. Now the Academy is associated with Clinical Chemistry.

The membership grew both nationally and internationally and reached a peak of 490 members in the mid 1980's. As the number of board certified clinical chemists grew, so did interest in the Academy increase. In the late 80's, the officers of the AACC and the NACB began discussions to develop a closer association between them. By 1995 the National Academy of Clinical Biochemistry became the Academy of the AACC. Co-membership in AACC was required in order to be a member of NACB. The NACB logo began appearing with the AACC logo in Clinical Chemistry in 2000. In 1998, the NACB began holding its SOLP programs (see below) as EduTrak sessions at the AACC annual meetings. The first such program was titled "Recommendations for the Use of Cardiac Markers in Coronary Artery Disease." The guidelines from this effort were published in Clinical Chemistry in July 1999.

In 1994, NACB organized the first of two POCT meetings both held in Philadelphia: "Medical, Economic, and Regulatory Issues Affecting Point-of-Care Testing." Around the same time, NACB's scientific programming changed under the leadership of Dr. Larry Kaplan and the Board chose a new format called the Standards of Laboratory Practice (SOLP) to replace the symposium format. The model for this new format was a small meeting that developed guidelines for nutritional assessment, and a monograph was published "Laboratory Support in Assessing and Monitoring Nutritional Status."

In 1995, the first SOLP meeting was held in Anaheim at the Disneyland Hotel. The topic was "Standards of Laboratory Practice: Guidelines for the Diagnosis and Monitoring of Thyroid Disease." A monograph was published and nearly 50,000 copies were distributed worldwide. Beginning with the guidelines for hepatic injury presented at the AACC Annual Meeting in 1999 and published in 2000, the guideline format was changed from Standards of Laboratory Practice (SOLP) to Laboratory Medicine Practice Guidelines (LMPG). Under the leadership of Carole Spencer, Ph.D., FACB and Laurence Demers, Ph.D., FACB, the 1996 monograph on thyroid disease was updated, revised, and published in 2003 as a sole issue of the journal, Thyroid, as well as an Academy monograph. Whereas the original 1996 guidelines had been translated into Italian, the 2003 Thyoid guidelines have been translated into French and Spanish, and translations into Polish, Chinese, Farsi, and Italian are underway.

The Laboratory Medicine Practice Guidelines (LMPG), "Recommendations for the Use of Laboratory Tests to Support the Impaired and Overdosed Patient from the Emergency Department," which is the ninth in this series, was held at the 2001 AACC meeting as a two day EduTrak session. NACB also held an evening session at that same AACC meeting to review the draft thyroid guidelines that were then being updated. Similar presentations on these proposed updated guidelines were made to the Annual Meetings of the Endocrine Society, the American Thyroid Association, and the European Thyroid Association during 2001. This recognition of NACB's work on LMPGs by relevant national and international medical societies is highly significant, and three of the Academy's guidelines (Hepatitis, Diabetes, and Thyroid) are currently listed on the National Guideline Clearinghouse.

The NACB and AACC have developed a strong partnership, seeking new ways for the Academy to serve both its members and AACC. Strong ties through Clinical Chemistry and the respective home pages have helped. Since 2001, the NACB Annual Awards have been announced on Sunday evening at the AACC Annual Meeting along with the awards presented by AACC. Also in 2001, the NACB's 25th year, interest in the Academy reached its highest level since the 1980's with membership exceeding 500. In 2003 it totaled 536. Many of the AACC's awardees for the past several years have been Fellows of NACB and many of the nominees in AACC's annual election are Academy members. Several individuals have been President of both organizations. In 2004, the NACB took responsibility for developing the program for AACC’s biannual Beckman Conference as a forum for presentation and discussion of the draft LMPG on Cardiac Markers. This program was a huge success, and AACC was delighted to extend the opportunity to NACB to develop and coordinate the 2006 Beckman Conference, which will be on emerging cardiac risk factors.

Beginning in 2004 the NACB began selecting Distinguished Abstracts from among all the abstracts submitted to the AACC Annual Meeting. The process requires two reviews - an initial review by AACC members during the course of the entire abstract review cycle, and a second review by Fellows of the NACB. In 2004, sixteen abstracts were selected from nearly 650 submitted to AACC, and in 2005 twenty five abstracts were chosen for the IFCC/AACC/CSCC meeting. The recipients of the NACB Distinguished Abstracts Award received letters from the NACB President (with copies to AACC local section Chairs) and ribbons were placed on each poster. The winners were recognized at the NACB awards luncheon and also publicized in a variety of printed and electronic AACC and NACB formats as well as posted on placards near the poster sessions. The Distinguished Abstracts program is perhaps a high point of the cooperation between AACC and NACB and is a strong example of the mission of the NACB as the Academy of AACC - to elevate the science and practice of clinical laboratory medicine by promoting research, education, and professional development in clinical biochemistry and by serving as the leading scientific advisory group to AACC and other organizations. This mission statement, adopted by the NACB in 1998, reflects both the goals of our founders and the role of the Academy in furtherance of the practice of clinical biochemistry for the benefit of mankind.