Prof. Dr. Harald Renz is Medical Director of the University Hospital Marburg and also Director of the Institute for Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics at the University Clinic of Giessen and Marburg (UKGM). In this interview he explains the importance of individualized clinical diagnostics — precision diagnostics — and its current challenges.
What is laboratory medicine concerned with?
Prof. Renz: With the help of our work we hope to gain a better understanding of the mechanisms and misregulations on the cellular level that lead to the development of a certain disease. We are mainly concerned with chronic inflammatory diseases such as allergies, asthma and autoimmune diseases, but also with cardiovascular metabolic diseases, such as metabolic disorders – which are also chronic diseases. If we know the exact triggers and causes of a disease, we can develop so-called biomarkers and use them in our tests. The biomarker diagnostics, in turn, are important for choosing the appropriate therapy.
What exactly is your daily routine in the hospital laboratory like?
Prof. Renz: We laboratory physicians do all the in vitro diagnostics for our patients. To do this, we examine biomaterials such as blood and urine, but also punctures and all other fluids that are taken from patients, for more detailed examination. We provide this basic care around the clock, 365 days a year. In emergencies, we have to diagnose life-threatening and serious illnesses reliably. But also before surgical interventions, our examinations help to identify patients at risk and provide information for pre- or post-operative measures. Our special laboratories also perform tumor, allergy, inflammation, metabolism and hormone diagnostics. We also offer our patients high-end diagnostics, for example by using mass spectrometry, which are only available at a few locations in Germany.
What are some of the major challenges in your field?
Prof. Renz: First and foremost, logistics and data processing. Every day we receive several thousand blood samples from patients at our Marburg hospital, but also from other hospitals in the vicinity. That makes a total of several tens of thousands of individual pieces of evidence. All data must be organized and processed. The large amount of information that we obtain here on each case of illness enables us to create a kind of illness map for each individual patient. We are, therefore, right at the interface between laboratory and patient. Our results provide the basis for the therapeutic approach, which today is increasingly moving towards precision medicine.
How exactly do you create the disease maps, i.e. so-called precision diagnostics?
Prof. Renz: We are closely involved in MIRACUM, a nationwide network for medical informatics at university hospitals, in which we link research and patient data and thus create a prototype for the construction of new disease maps. The challenge here is to perform a large number of measurements on a patient sample in a very short time. This requires rapid technological progress in biomedicine and major investments in high-tech equipment.
So digitalization has been part of your company for some time, then?
Prof. Renz: Absolutely, because we also have a second dimension in patient data: Many patients are with us for several weeks. If we collect laboratory results over such a long period of time — possibly even from intensive care medicine — we must also register pathological changes in good time. In the future, we will be increasingly dependent on IT-supported systems. The keywords here are artificial intelligence and electronic health records. Because we not only want to treat patients optimally during their stay in our hospital, but we also want to know what is going on with them, who is treating them and what medications they are taking. This is important information that helps us to care for our patients even better.
As an addition to this interview, you can also read this article.