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Dr. Ross Molinaro Shares His Insights about Tests to Monitor and Diagnose Diabetes at the 2012 ASCP Annual Meeting

Monday, July 23, 2012

Ross J. Molinaro, PhD, MT(ASCP), DABCC, FACB, will present “Hemoglobin A1c: Potential Effects of Analytical and Clinical Factors on Result Interpretation” on Nov. 2 at the 2012 ASCP Annual Meeting in Boston. He will cover real world case exercises using the hemoglobin A1c biomarker, which is commonly used to monitor average glycemia in diabetic patients. Recently, hemoglobin A1c was recommended as a criterion for the diagnosis of diabetes, but in some cases the test has limitations that may preclude its usefulness in patient care.

“Every day, I learn about new clinical laboratory tests and discover new ways that laboratory results can affect patient care. The learning process never stops, and this information is valuable for providing the best health care for patients. I find it astounding that so many patients are affected by what clinical chemists do every day.”
—Ross J. Molinaro, PhD, MT(ASCP), DABCC, FACB

This test has distinct advantages and disadvantages for patients, and it is important for the entire laboratory team to understand both. One disadvantage is that hemoglobin A1c is not recommended for use in patients who have sickle cell diseases or any clinical situation that alters the life span of the red blood cells, according to Dr. Molinaro, the Medical Director of the Core Clinical Laboratory, Emory University Hospital Midtown, and Co-Director of the Emory Clinical Translational Research Laboratory, Emory University School of Medicine, Atlanta. He works in the southeastern United States, where the prevalence of both sickle cell and diabetes are quite high.

“Clinical chemists are at center stage for developing and validating the utility of new methods in laboratories,” he said. “Many significant discoveries can often have a twist to their interpretation in the clinical setting. For example, both mass spectrometry and immunoassays can and are currently being used in medical laboratories to measure immunosuppressants. The specificity of the mass spectrometer, a more recent player in the medical laboratory, is an advantage. However, if the laboratory is transitioning from immunoassay to mass spectrometry, the numbers can be quite different and lead to confusion in the interpretation of results by both the clinicians and patients. Understanding and clearly communicating these differences directly to laboratory users is critical to quality patient care. As a clinical chemist, one of my goals is to work with the clinical teams to develop the best and most useful tests for patients.”

His own experience drew Dr. Molinaro toward science. Diagnosed with type 1 diabetes when he was 12 years old, he has first-hand knowledge of the disease. Dr. Molinaro clearly remembers entering the hospital laboratory where a phlebotomist asked him to drink a terribly sweet orange beverage and collect tubes of his blood over several hours. He wondered how drinking an orange drink and collecting his blood could determine that he was a diabetic.

During his college years, Dr. Molinaro gravitated toward the laboratory, becoming a medical laboratory scientist and then earning a master’s degree in the same subject. His doctorate and post-doctoral fellowship in clinical chemistry have led him to his current position at Emory University.

“Every day, I learn about new clinical laboratory tests and discover new ways that laboratory results can affect patient care,” Dr. Molinaro explained. “The learning process never stops, and this information is valuable for providing the best health care for patients. I find it astounding that so many patients are affected by what clinical chemists do every day.”

Finding new ways to improve patient care is one of Dr. Molinaro’s mantras and drives his devotion to finding new solutions. Like a detective, he investigates patient cases to determine the reasons behind potential inaccuracies or misinterpretations of laboratory test results.

“Through collaboration and common goals, clinical chemists and physicians help patients,” he said. “We confirm or reject diagnoses, determine prognoses [when and how patients will recover their health] for patients, and monitor their treatment. Together we work to ensure current laboratory tests are being used appropriately for patient care and evaluate new markers or tests for determining disease risk and diagnosis.”

Outside of work, Dr. Molinaro paints and plays the piano. He is also an avid golfer and devotes some of his spare time to playing the sport. Much of his free time lately has been spent enjoying time with his wife, Jamie, and their 14-month-old son, Ross.


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