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AUTOMATION IN DIAGNOSTIC MICROBIOLOGY
TIME TO KNOW THE TROUBLE SHOOTING?
Dr.T.V.Rao MD
Today many laboratories are making the matters easier by adopting to automation in the
Laboratory Medicine and Microbiology is no exception, automation serves the ends from the means,
today we have a huge samples and least man power, at one stage we will have to automate many of
our laboratories with newer methods with instrumentation, and emerging technologies. The
potential value of such instrumentation includes the possibility of substantial cost savings,
standardization of initial specimen processing, more rapid and consistent provision of both
identification and antimicrobial susceptibility test results, and a diminished risk for laboratory-
acquired infections. However, as with any new diagnostic modality in clinical microbiology, there
now exists a pressing need for investigations aimed at elucidating the performance characteristics of
this new technology. “It makes getting what we want easier, but it distances us from the work of
knowing, if the Microbiology practised without conventional ideas soon the Microbiologists lose the
power of thinking on many clinical interpretations with grave impact on patient care if automation is
solely depended upon, As we transform ourselves into creatures of the screen, as we see on the
personal computer monitors, we face an existential question: Does our essence still lie in what we
know, or are we now content to be defined by what we want? If we don’t grapple with that
question ourselves, our gadgets will be happy to answer it for us.” On the bacteriology side
“phenotypic testing involves relatively low-cost systems to begin with when you’re doing manual
methodology. There are scaled systems for blood cultures and for automated bacterial ID and
susceptibility testing and so forth, but some of the new technologies like MALDI-TOF are priced
pretty high and may be harder for smaller labs to cost-justify. Soon many laboratories with critical
patients should find better methods to identify the septic conditions in the patients for better
survival and decreasing mortality and morbidity, Today many of Our Blood culture systems
automated with Bact alert and Vitek 2 advances, someone asked me to speak on Conventional
methods in Diagnostic Microbiology it enlightens me unless one is proficient in the traditional
knowledge it is not possible to control the results generated on any automation protocols. While
machine-generated data is not the same thing as machine-generated knowledge, in the same way
that automation is not the same thing as artificial intelligence, if we consider how much of our
knowledge, and our responsibility for doing something with it, we’re turning over to machines
through automation, it might give us pause to hit the pause button—if not the stop button—in some
cases. – Going forward, it will be imperative that laboratories assess this new technology in
objective, comparative, and preferably prospective clinical studies. Such studies will be necessary to
define the true, rather than perceived or hoped-for, value of front-end and total laboratory
automation in clinical microbiology. My early challenges were in 1993 at Apollo Hospital Chennai
when I was working with the modern automated tube ELISA from Abbot Singapore, many errors
from sampling to reading at the final documentation, as we can control many modern machines with
wisdom and certainly not our man power. While machine-generated data is not the same thing as
machine-generated knowledge, in the same way that automation is not the same thing as artificial
intelligence,
WHY WE NEED TO KNOW CONVENTIONAL METHODS WELL - Automation has many limits on
many matters however we cannot allow machine to be better than man or our purpose with
qualifications with MD awarded by our colleges / Universities will be lost, above all you lose the
power to control the laboratory staff, Technicians will become the master of the Game In addition
to the higher cost and thus higher latency of automated testing, it is also possible that automated
testing will just miss things. Sometimes really obvious things. Just like the computers in House that
missed the parasites, in the computer testing so too will test automation miss things. Effects are
common. Automation cannot catch all of these. Each one has to be specifically programmed for. At
some point, the returns diminish and the test is set in stone people lose confidence and try
evaluating qualified people, Any bugs which lie outside that circle will never be found. At least, not
until the program is shipped and people try to actually use it. There are a near-infinite amount of
things that can go wrong in software. Side effects are common. Automation cannot catch all of
these. Each one has to be specifically programmed for the problem, is that the automation is at an
intermediate level of intelligence, powerful enough to take over control that used to be done by
people, but not powerful enough to handle all abnormalities. Moreover, its level of intelligence is
insufficient to provide the continual, appropriate feedback that occurs naturally among human
operators. This is the source of the current difficulties. To solve this problem, the automation should
either be made less intelligent or we should start improving to trouble shoot errors
THE GREAT QUESTION TO MANY MICROBIOLOGITS “Obviously, you need to ask not only the
cost-benefit but also the impact of a new technology in your lab and the impact clinically. Will it
work in your practice setting and for your patients and your technical staff? So it’s always a
multifactorial decision WHAT TO DO WITH THE AUOTMATION HOW FAR WE REACH OUR GOALS A
QUESTION HUNTS AFTER INVESTING GREAT AMOUNT OF MONEY.
I WISH TIME IS RIGHT TO GET OUR POSTGRADAUTE STUDENTS TO BE TRAINED IN CREDITED
LABORATOREIS WITH AUTOMATION AND MOLECULAR METHODS AND MORE OF THE SYLABBS TO
STRUCTURED ON AUTOMATION WITH EQUAL EMPHASIS ON IMPORTANCE ON CONVENTIONAL
MICROBIOLOGY.
Ref 1 Automation and the Danger of Lost Knowledge by: Ocdqblog
2 The Dangers of Test Automation Steve Rowe Blogs
3 Microbiology automation: finding the right mix Anne Paxton
Dr.T.V.Rao MD Professor of Microbiology Freelance writer

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AUTOMATION IN DIAGNOSTIC MICROBIOLOGY TIME TO KNOW THE TROUBLE SHOOTING?

  • 1. AUTOMATION IN DIAGNOSTIC MICROBIOLOGY TIME TO KNOW THE TROUBLE SHOOTING? Dr.T.V.Rao MD Today many laboratories are making the matters easier by adopting to automation in the Laboratory Medicine and Microbiology is no exception, automation serves the ends from the means, today we have a huge samples and least man power, at one stage we will have to automate many of our laboratories with newer methods with instrumentation, and emerging technologies. The potential value of such instrumentation includes the possibility of substantial cost savings, standardization of initial specimen processing, more rapid and consistent provision of both identification and antimicrobial susceptibility test results, and a diminished risk for laboratory- acquired infections. However, as with any new diagnostic modality in clinical microbiology, there now exists a pressing need for investigations aimed at elucidating the performance characteristics of this new technology. “It makes getting what we want easier, but it distances us from the work of knowing, if the Microbiology practised without conventional ideas soon the Microbiologists lose the power of thinking on many clinical interpretations with grave impact on patient care if automation is solely depended upon, As we transform ourselves into creatures of the screen, as we see on the personal computer monitors, we face an existential question: Does our essence still lie in what we know, or are we now content to be defined by what we want? If we don’t grapple with that question ourselves, our gadgets will be happy to answer it for us.” On the bacteriology side “phenotypic testing involves relatively low-cost systems to begin with when you’re doing manual methodology. There are scaled systems for blood cultures and for automated bacterial ID and susceptibility testing and so forth, but some of the new technologies like MALDI-TOF are priced pretty high and may be harder for smaller labs to cost-justify. Soon many laboratories with critical patients should find better methods to identify the septic conditions in the patients for better survival and decreasing mortality and morbidity, Today many of Our Blood culture systems automated with Bact alert and Vitek 2 advances, someone asked me to speak on Conventional methods in Diagnostic Microbiology it enlightens me unless one is proficient in the traditional knowledge it is not possible to control the results generated on any automation protocols. While machine-generated data is not the same thing as machine-generated knowledge, in the same way that automation is not the same thing as artificial intelligence, if we consider how much of our knowledge, and our responsibility for doing something with it, we’re turning over to machines through automation, it might give us pause to hit the pause button—if not the stop button—in some cases. – Going forward, it will be imperative that laboratories assess this new technology in objective, comparative, and preferably prospective clinical studies. Such studies will be necessary to define the true, rather than perceived or hoped-for, value of front-end and total laboratory automation in clinical microbiology. My early challenges were in 1993 at Apollo Hospital Chennai when I was working with the modern automated tube ELISA from Abbot Singapore, many errors from sampling to reading at the final documentation, as we can control many modern machines with wisdom and certainly not our man power. While machine-generated data is not the same thing as machine-generated knowledge, in the same way that automation is not the same thing as artificial intelligence, WHY WE NEED TO KNOW CONVENTIONAL METHODS WELL - Automation has many limits on many matters however we cannot allow machine to be better than man or our purpose with qualifications with MD awarded by our colleges / Universities will be lost, above all you lose the
  • 2. power to control the laboratory staff, Technicians will become the master of the Game In addition to the higher cost and thus higher latency of automated testing, it is also possible that automated testing will just miss things. Sometimes really obvious things. Just like the computers in House that missed the parasites, in the computer testing so too will test automation miss things. Effects are common. Automation cannot catch all of these. Each one has to be specifically programmed for. At some point, the returns diminish and the test is set in stone people lose confidence and try evaluating qualified people, Any bugs which lie outside that circle will never be found. At least, not until the program is shipped and people try to actually use it. There are a near-infinite amount of things that can go wrong in software. Side effects are common. Automation cannot catch all of these. Each one has to be specifically programmed for the problem, is that the automation is at an intermediate level of intelligence, powerful enough to take over control that used to be done by people, but not powerful enough to handle all abnormalities. Moreover, its level of intelligence is insufficient to provide the continual, appropriate feedback that occurs naturally among human operators. This is the source of the current difficulties. To solve this problem, the automation should either be made less intelligent or we should start improving to trouble shoot errors THE GREAT QUESTION TO MANY MICROBIOLOGITS “Obviously, you need to ask not only the cost-benefit but also the impact of a new technology in your lab and the impact clinically. Will it work in your practice setting and for your patients and your technical staff? So it’s always a multifactorial decision WHAT TO DO WITH THE AUOTMATION HOW FAR WE REACH OUR GOALS A QUESTION HUNTS AFTER INVESTING GREAT AMOUNT OF MONEY. I WISH TIME IS RIGHT TO GET OUR POSTGRADAUTE STUDENTS TO BE TRAINED IN CREDITED LABORATOREIS WITH AUTOMATION AND MOLECULAR METHODS AND MORE OF THE SYLABBS TO STRUCTURED ON AUTOMATION WITH EQUAL EMPHASIS ON IMPORTANCE ON CONVENTIONAL MICROBIOLOGY. Ref 1 Automation and the Danger of Lost Knowledge by: Ocdqblog 2 The Dangers of Test Automation Steve Rowe Blogs 3 Microbiology automation: finding the right mix Anne Paxton Dr.T.V.Rao MD Professor of Microbiology Freelance writer