- With which professional societies/organizations (e.g. AACC) are you involved?
I became a member of the Belgian Society for Clinical Chemistry (BSCC; previously the Royal BSCC/RBSCC) in the late 1970s. In 1980 I joined the American Association for Clinical Chemistry (AACC). During the years I focused on analytical research, I was a member of the American Chemical Society (ACS) and in 1996, I had the opportunity to be appointed by the International Federation for Clinical Chemistry and Laboratory Medicine (IFCC) as chair of the WG-Standardization of Cortisol Measurements. In 2001, I joined the Clinical Laboratory and Standards Institute (CLSI, the former NCCLS) as chair of the C45-A Subcommittee-Free Thyroid Hormone Measurements and continued to serve as a member of the Area Committee on Clinical Chemistry and Toxicology (2003-2008), and later on as an adviser/volunteer. A milestone in my professional career was the opportunity to join the Joint Committee for Traceability in Laboratory Medicine (JCTLM) in 2002 and become co-chair (with Prof. L. Siekmann) of the WG-Reference Measurement Laboratories. More recently, I joined 2 clinical societies: The Endocrine Society (TES) and the European Thyroid Association (ETA).
- How did you get started in these organizations and what advice do you have for young people wanting to get involved?
It was on advice of my PhD-promoter (advisor), Prof. A. De Leenheer, that I joined our national society (RBSCC) during my combined PhD-study and clinical chemistry fellowship. This gave me the first opportunity to be in contact with talented people. However, very shortly after that my promoter convinced me of the importance to leave the comfort zone of the laboratory I was working in and, therefore, urged me to also join the AACC. He emphasized that this membership would offer me many opportunities, such as access to the leading journal Clinical Chemistry (remember in those days electronic databases were not available!), attendance to interesting annual conferences and allow me to cross paths with experts in the field. Another reason was to let me discover the efficient approach, typical for Americans, which he had experienced during his sabbatical stay with Prof. JE Sinsheimer (College of Pharmacy, University of Michigan, Ann Arbor). He was right, because my AACC membership became a true gateway for me to develop connections and build lifelong professional relationships. Therefore, I would like to pass my promoter’s advice along to young scientists.
Another recommendation is they should not be afraid of being curious. For example, I remember having this attitude allowed me to simply drop in on an open CLSI meeting, which was being held satellite to an AACC conference. For me this was an opportunity to begin showing my interest to established scientists in the field like Dr. Basil Doumas, who I met in this meeting. Indeed, this occasional contact opened the door for being involved in the CLSI. Young scientists should also know that in order to actively pursue and receive interest from their discipline, it is important to sufficiently work early towards a specific profile and obtain publications. Indeed, once a place is achieved invitations to join professional societies/organizations will follow. My own invitation to commit to the IFCC followed my scientific achievements as a postdoctoral fellow, i.e. the development of reference measurement procedures for standardization of hormone immunoassays. Once I became the director of my own reference laboratory at the University of Ghent, it was again through an IFCC proposal that I became co-chair and member of the Executive Board of the JCTLM. Finally, through my activities as chair of WG and later on Committee for Standardization of Thyroid Function Tests (C-STFT), I realized how important it was to give my work more visibility to clinicians. This was the onset for me to join the TES and ETA.
- What area(s) do you specialize in and what initiated your interest in this (these) area(s)?
Being a clinical chemist, I see specializing in different aspects of analytical quality in laboratory medicine as leitmotif in my professional life. Indeed, knowing the effect on the reliability of laboratory test results on the intrinsic quality of IVD assays and the way they are performed in the laboratory, my contributions mainly focus on quality in a broader sense: they range from simply looking at what quality products/devices are available to offering quality solutions for improvement. In this regard I work on concepts to define analytical quality commensurate with the intended use and establish traceability of measurement (probably better known as standardization/harmonization). Besides developing concepts, I specialize in the development, validation and implementation of mass spectrometric reference measurement procedures and reference measurement systems. This area of expertise has given me the opportunity to chair several exciting projects with IVD manufacturers and laboratories. A recent area of interest is developing new concepts for improved quality assurance in laboratory medicine. Last not least, I also focus on tailored statistical education for laboratorians in different aspects of quality assurance.
- What, in your opinion, has been the most important contribution you have made to the field of laboratory medicine?
This is of course a difficult question to answer because I am very modest in nature. On the other hand, false modesty is also not necessary. Therefore, I proudly say that in an era that prioritizes metrological traceability of measurements I succeeded, after Prof. I. Björkhem (Sweden), to leave the ivory tower of academic interest in the topic and translated my scientific activities into actionable tools for the IVD industry. In fact, I made the click at the 4th Bergmeyer Conference in 1992 (on “Improvement of comparability and compatibility of cortisol and hCG immunomethods”), where I publically showed for the first time that a panel of native sera with values assigned by a reference measurement procedure were key for the IVD industry to establish the trueness of their test methods. This became the common approach in all standardization/harmonization activities I chaired later on. Through the years, I defended the concept with all my heart; consequently, I have great satisfaction to see it is generally accepted today. Meanwhile, I developed a series of reference measurement procedures and succeeded in setting up a reference laboratory that can continuously offer services to the IVD industry and other interested parties. Equally important is that during all those years working in this field, I have kept the issue of analytical quality in the focus of the discipline at a time where everyone else talked about pre- and post-analytics. I think that I also may say that, together with my group, I created awareness about the importance of decent statistical understanding of quantitative analytics.
- What were some of the most rewarding and/or challenging moments of your career?
Challenging: particularly challenging in 1985 was participating in the certification program for progesterone and estradiol measurement of the Bureau Communautaire de Références (BCR) from the European Commission. I still remember the stress on the day that the results from the different reference measurement procedures were made public. Fortunately, I successfully passed the test. Afterwards, another big challenge was to put the reference measurement procedures I successfully developed and validated into practice--with the premise that they had to be performed continuously with the same quality. As long as I could run the measurement procedures myself this was not an issue because I knew the crucial steps and had control over everything. However, after my appointment as professor at the University of Ghent, it became more critical because I had to transfer my knowledge of the measurement procedures to my laboratory staff. This taught me the importance of defining a quality benchmark for each procedure. In this regard I consider myself happy because I have staff members in whom I can have “blind” confidence. A concomitant challenge was establishing an operational reference laboratory, and concluding sufficient contracts with the IVD industry and other partners to become self-supporting.
Rewarding: receiving the opportunity as a postdoc to develop expertise and skill in isotope dilution mass spectrometry (ID-MS), oriented towards applications in laboratory medicine. This allowed me to come into contact with the BCR certification program, which then became a milestone in my professional life. The program evoked my academic interest in developing trueness-based reference measurement procedures and as mentioned earlier, I had fortunately made the switch early on to implement calibration of the IVD assays. These activities led to the establishment of my own reference laboratory that I have lead since 1991. Although these developments often required me to give up precious personal time, the effort was rewarded a thousand fold for me and for my staff. The respect and confidence we enjoy from all the global players in laboratory medicine we work for is simply terrific, and is the driving force for sustaining a top-quality reference laboratory. The crown on my reference laboratory work came in 2011 when I received the IFCC Robert Schaffer Award for Outstanding Achievements in the Development of Standards for Use in Laboratory Medicine. Knowing that this award is given based on proposals from of an international advisory panel this was again an expression of the satisfaction of many colleagues I ever worked with. I also consider my appointment as an Editorial Board member of Clinical Chemistry very much rewarding. Last but not least, I promise myself much from my current chair of the IFCC Committee for Standardization of Thyroid Function Tests and my membership of the AACC Harmonization Oversight Group (HOG), because I believe both projects have the ambition to undertake pioneering work to the benefit of the patient.
- How would you recommend achieving an optimal work/life balance?
Although I don’t think there is one successful formula, I would say you should define your professional goals very early in your life and pursue them consequently. Nevertheless, constantly cross-check your goals with the needs of your “beloved”. If these require you to temporarily perform in your profession at a lower level, don’t feel guilty and follow your heart.
- What are you predictions for advances in laboratory medicine and/or your area over the next 10 years?
I see that in the field of laboratory medicine, providing metrologically traceable measurements independent of time, location and assay will become the rule, not the exception anymore. The IVD industry will take a leading role in the endeavor towards standardization and harmonization. There will be a breakthrough in what the discipline considers medically relevant analytical performance goals. In view of the increasing trend towards huge commercial laboratory associations and networking of hospital-based laboratories, laboratories will become more influential with regard to defining the analytical quality they require.
- What do you see as the challenges facing young scientists in laboratory medicine?
In the competitive world we live, young scientists in laboratory medicine will be more challenged than ever to excel. This might make it difficult to not succumb to the temptation of making opportunistic compromises to accomplish their objectives at a faster rate. Other challenges I see are realizing that science is part of our society, in political as well as economical terms, and that in science it is wise to also keep room for pragmatism.
- What specific goals would you recommend that young scientists in your discipline set for themselves? Any suggestions on how to achieve them?
General goals: develop “soft-skills” such as communication, economic thinking, selling.
Discover what your strong and weak points are and listen to the constructive critique issued to you. “Market yourself”, i.e., consider your person as a “one-man” company trying to establish a position on the market. Be prepared for lifelong learning.
Goals specific to the discipline of laboratory medicine: achieve sufficient knowledge about the key to quality of a test. Keep the benefit of the patient central in the goals you pursue.
- What is your favorite line from a movie or book?
It is actually a favorite statement I encountered during my classical Latin-Greek education: “γνῶθι σεαυτόν” or “know yourself” (Socrates).
- How did you discover lab medicine/science?
During my university studies I became particularly interested by the course “Medical Biochemistry and Clinical Analysis”. After my studies, I contacted the professor who taught that course and was fortunate to be invited to become his PhD-student. He gave me the opportunity to further develop my initial interest in laboratory medicine in his academic laboratory, and to get a clinical chemist fellowship.
- If you could start your career again, what would you do differently?
I probably would cut unproductive activities earlier and try to say “no” from time to time.
- What are your top three favorite laboratory tests and why?
It was cholesterol testing for a while. I learned a lot from following the efforts undertaken to improve the quality and standardization of assays for measurement of this analyte. Then it became calcium testing, the evergreen: starting from the Belk & Sunderman statement in 1947 “The accuracy of the measurements is below any reasonable standard”, over the 1991 Clinical Chemistry Forum comment by Dr. B. Doumas: “I am more concerned about calcium. I think the target (i.e., proficiency testing) is dismal and the performance is equally dismal; a tolerance range of ± 1 mg is atrocious. Do you have any idea why inter-laboratory performance for calcium is so bad?”, to a 2004 report that “the potential economic impacts (of bias) range from $60 million to $199 million per year for analytic biases of 0.1 and 0.5 mg/dL, respectively’’. Also sodium testing is important for me, because I consider it THE benchmark analyte for required and achievable quality. In this regard I refer to a recent publication of one of my PhD-students in Clinical Chemistry. Although you asked only for 3 favorites, I want to add FT4 testing. I hope that by having developed a reference measurement procedure for that important hormone, I will be able, together with the C-STFT and project participants from the IVD industry, to contribute to improving the comparability and quality of the controversial immunoassays.
- What is the riskiest thing you've ever done?
Actually, I am a very cautious person that does not necessarily seek thrills for a kick, but now that you ask, it might have been doing phlebotomy after too short of a initiation period. The circumstances were a pharmacokinetic study as part of my PhD-thesis, for which my late parents volunteered. Thinking that I was sufficiently trained, I decided to collect the blood samples. This was not wise, since my beloved parents suffered all the consequences of my inexperience. Fortunately, they recovered quickly, but I was left for a while with the name “vampire of the family”.
- What is an average day like in your life?
I wake up early in the morning and have breakfast with my husband, allowing10 min time to browse the newspaper. Once at the university, I start immediately to work. Dependent on the semester, this includes teaching, preparing and administering exams, follow-up and steering of PhD-research/publications, preparing lectures, administration, physical/telephonic meetings with colleagues, etc. If necessary, I take sufficient time to discuss pressing analytical issues with my laboratory staff in the reference laboratory and even assist them with troubleshooting. If there is still sufficient time in the late afternoon I try to work through a number of tasks on my to-do list, because I hate for this list to become too long. I try to not return too late at home because there I can do some activities to relax, such as preparing/having a decent dinner, followed by 40 min biking on my home trainer. For the last decade, I have tried to keep intellectual work in the evening to a strict minimum. I close my day with enjoying a good Belgian beer.
- What is one thing that most colleagues in AACC do not know about you?
With regard to the expertise and achievements I am esteemed for by my colleagues, many do not know that these are the result of an equally shared endeavor with my husband Dietmar. I am the visible part that earns the credits of what, factually, is conceived and executed by the two of us.
- Do you have any other specific comments or advice that you like to provide to the members of SYCL?
Be disciplined and productive in your work. Be flexible, and don’t be afraid to explore the unknown. Be enthusiastic in all you pursue, don’t give up too early, but have the courage to set priorities. Have sound ambition and try to make a difference, but always remain true to yourself and never surrender to opportunistic compromises. Don’t confine your interest to what is immediately related to your field of expertise, but always look in an angle of 360° and be open to “peripheral” information. Keep an eye on economic developments in your discipline, and try to adapt early enough. If you commit to something, actively participate and always fulfill your commitment, even if voluntary work is concerned. I wish you success with your career!