Pharmaceutical and biotech researchers convened last week to discuss their latest work on targeting neurodegenerative diseases
With all the news this year alone on progress being made with diagnostic testing for Alzheimer’s disease, clinical laboratory professionals will be interested to know that drug discovery efforts to combat neurogenerative diseases are also at a heightened pitch.
Last week at the one-day Neuroimmunology in Drug Discovery forum in Boston, scientists learned about the latest advances in therapeutic research to better treat Alzheimer’s disease, multiple sclerosis, and Parkinson’s disease. As the treatments advance, demand for them will increase, which goes hand-in-hand with medical lab testing to detect signs of these illnesses.
The concern is urgent. The US Food and Drug Administration (FDA) noted that 10% of people age 65 and older have Alzheimer’s disease, and that number could double by 2050. The FDA recently cleared the first in vitro diagnostics device that tests blood to diagnose Alzheimer’s, and other IVD manufacturers and clinical labs are working on other Alzheimer’s tests, Dark Daily reported.
“It’s looking quite promising for NLRP3 inhibitors,” said Cheryl Leyns, PhD, associate principal scientist in discovery neuroscience at Merck Research Laboratories, in discussing how mutations of the NLRP3 protein can lead to neurodegenerative diseases. (Photo copyright: ELRIG.)
Much of the discussion at the Neuroimmunology in Drug Discovery forum centered on the idea that neuroinflammation—in other words, inflammation of the brain or spinal cord—starts well before neurodegenerative diseases arise. Neuroinflammation can accelerate Parkinson’s disease and other neurodegenerative disorders, said Cheryl Leyns, PhD, associate principal scientist, neuroimmunology, at Merck Research Laboratories in Boston, who spoke at the event.
From that perspective, drug discovery researchers are on the prowl for these early signs of future problems.
Leyns discussed NLRP3, a protein that aids the body’s inflammation process. A mutation of NLRP3 can lead to inflammatory problems, making the protein a prime target for researchers. “We have been interested, in the biopharma space, in the potential of NLRP3 inhibitors,” she noted.
Older Immune Systems Are Susceptible
While many in the public correctly associate Alzheimer’s with a person being outwardly older, a lesser-known aspect is that the body’s immune system also ages, becoming more susceptible over time to chronic inflammation.
Wailings’ assertion was not rhetorical. She pointed to numbers which showed scholarly research that involved the terms “inflammation,” “neurodegeneration,” and “aging” was only about 17% of the total amount of journal articles that addressed the first two terms, but which did not include “aging.”
As the pharmaceutical, biotech, and medical fields move aggressively forward to defend people against neurodegenerative diseases like Alzheimer’s, clinical laboratory scientists should take comfort that diagnostic testing trends are solidly in the mix.
Therapeutic advances, along with increased options for testing, show promising signs that patients and their caregivers will have more tools to use in the battle against these illnesses.
Artificial intelligence tools for radiology, clinical laboratory, and pathology diagnostics continue to advance and improve
Researchers in Germany have developed a fully automated, artificial intelligence (AI) tool that improves the diagnosis of prostate cancer. Developed by mediaire, a company that creates AI-based tools for radiologists, the software reduces clinical workloads and could be beneficial in counteracting issues associated with variability in magnetic resonance imaging (MRI) reporting. This is another example of AI’s growth in the clinical diagnostic industry, including clinical laboratory and pathology medicine.
The software, called mdprostate, has received the mandatory certification mark (CE or European Conformity) for products sold within the European Economic Area (EEA). It is now commercially available in those countries and was recently incorporated into the picture archiving and communications system (PACS) of some healthcare organizations and applied to a group of patients who had undergone a multiparametric prostate MRI (mpMRI).
The goal was to compare the overall performance of mdprostate against radiologists who executed the initial interpretations of the mpMRIs, according to Health Imaging.
“Mdprostate is intended to support radiologists by automating time-consuming processes and improving the objectivity of diagnosis through data quantification,” said Tonia Michaely, chief of staff at mediaire, in a news release.
“By providing objective assessments and standardizing lesion detection and classification, AI has the potential to augment radiologists’ performance throughout the PCa [prostate cancer] diagnostic pathway,” Nadine Bayerl, Dr. med., a radiologist with the Institute of Radiology at University Hospital Erlangen and corresponding author of the mediaire study, told Health Imaging. (Photo copyright: University Hospital Erlangen.)
Scoring Cancer Risk
To perform the comparison, a team of researchers applied the AI tool to 123 prostate MRI exams followed by systematic and targeted biopsies. The software was instructed to automatically segment the prostrate, calculate prostate volume, and classify lesions per the Prostate Imaging Reporting and Data System (PI-RADS).
PI-RADS, according to the America College of Radiology, is a reporting method that indicates how likely a lesion is to be clinically significant cancer on a score of one to five:
PI-RADS 1: very low (clinically significant cancer is highly unlikely to be present).
PI-RADS 2: low (clinically significant cancer is unlikely to be present).
PI-RADS 3: intermediate (the presence of clinically significant cancer is equivocal).
PI-RADS 4: high (clinically significant cancer is likely to be present).
PI-RADS 5: very high (clinically significant cancer is highly likely to be present).
For PI-RADS scores greater than two, mdprostate generated 100% sensitivity and dismissed all cancers for lesions that were below that threshold. For PI-RADS scores of four or higher, the AI tool yielded 85.5% sensitivity and specificity of 63.2% for clinically significant cancers.
Deep Learning in Diagnostic Pathway
“In practical terms, these results indicate that when a case falls below the PI-RADS ≥ 2 cutoff, clinicians can rule out malignancy with a high degree of confidence,” the authors explained in the European Journal of Radiology. “This capability is particularly valuable in clinical decision-making, as it allows for the safe avoidance of unnecessary biopsies or further invasive procedures in these patients.”
“Recent advances in deep learning algorithms, facilitated by larger labeled datasets, improved computing hardware, and refined training techniques, have led to several studies highlighting the diagnostic value of deep learning algorithms in prostate imaging,” radiologist Nadine Bayerl, Dr. med., Institute of Radiology at University Hospital Erlangen and corresponding author of the study, told Health Imaging.
The software “demonstrated high diagnostic performance in identifying and grading prostate lesions, with results comparable to those reported in meta-analyses of expert readers using PI-RADS,” the researchers noted in their published study.
“Its ability to standardize evaluations and potentially reduce variability underscores its potential as a valuable adjunct in the prostate cancer diagnostic pathway. The high accuracy of mdprostate, particularly in ruling out prostate cancers, highlights its clinical utility by reducing workload and enhancing patient outcomes,” they concluded.
AI in Clinical Laboratories and Pathology
Dark Daily has frequently covered AI’s expanding role in clinical laboratory testing and pathology diagnostics. At the recent Executive War College, a dozen sessions explored its growth in the industry. During one session, Sam Terese, CEO and president at Alverno Laboratories said, “AI is allowing us to drive our business. It is really resonating that we need to use AI in the future.”
Members who could not attend the 2025 Executive War College can order audio recordings of these valuable sessions by clicking here.
At least a dozen sessions at the 2025 Executive War College explored artificial intelligence use in clinical labs
Although not explicitly stated, it was clear at the 2025 Executive War College on Diagnostics, Clinical Laboratory, and Pathology Management conference that artificial intelligence must be a path forward for labs to control costs in an unfavorable economic environment.
Even though the technology is largely unproven in clinical lab settings, the potential of artificial intelligence (AI) in labs is enough reason for laboratory leaders to explore it further.
“AI is allowing us to drive our business,” said Sam Terese, CEO and president at Alverno Laboratories, during a general session at the Executive War College. “It is really resonating that we need to use AI in the future.”
Clinical laboratory leaders should constantly ask themselves whether there is an AI solution to a problem, advised Sam Terese (above), CEO and president at Alverno Laboratories. Terese spoke at the 2025 Executive War College. (Photo copyright: LabX.)
‘Not a Lot of Trust’ in AI from Patients
Terese acknowledged that patients do not yet feel comfortable with the technology. “When you throw AI and healthcare together, from the public’s perspective, there’s not a lot of trust,” he said.
That said, Alverno is committed to increased use of AI in clinical labs in 2025, including for:
Terese urged laboratory owners and executives to not underestimate how quickly AI adoption could spread within the clinical lab industry. Digital pathology took half a century to evolve into its current state, but “AI took five years. The timeline is moving rapidly,” he observed.
Don’t Move Blindly Forward with AI, Experts Warn
At least a dozen sessions at this week’s Executive War College addressed an aspect of AI in labs.
Lab leaders must advise their staff to use AI with systems or processes that can tolerate mistakes because AI will get things wrong, Cecchini added.
“I treat AI like an eager intern where you have to check everything it does,” he said.
Presenter Ankit Ranjan, PhD, founder of AI company Sample Healthcare, agreed with that sentiment. He suggested that clinical laboratories should consider AI as a copilot until its algorithms can prove to lab staff that conclusions or predictions are accurate. The long game for AI in labs is not to cut a few staff from the budget but instead act as a revenue driver.
“Inserting AI into end-to-end processes is what really addresses problems,” Ranjan said.
Watch for much more coverage about the state of AI in clinical laboratories in upcoming issues of The Dark Report. If you’re not a subscriber, it’s a great time to take a free trial of our business intelligence briefings.
For the past 14 years, healthcare spending as a percentage of US gross domestic product has stayed flat—17.2% in 2010 compared to 17.8% in 2024—according to numbers presented by Robert Michel, editor-in-chief of Dark Daily and founder of the Executive War College.
“This is not auspicious for either the vendor side of the clinical laboratory business or providers,” Michel told attendees during the conference’s opening session.
“Clinical laboratories all must watch for opportunities to earn revenue through new business models,” said Robert Michel (above), editor-in-chief of Dark Daily. Michel spoke during a general session at the 2025 Executive War College on Diagnostics, Clinical Laboratory, and Pathology Management in New Orleans. (Photo copyright: LabX.)
Spending Blockades Will Push New Business Models for Labs
Michel ran through a series of other, similarly grim statistics that put hard numbers on trends that many laboratory executives and owners already suspected:
Half of Americans have less than $500 in a savings account, according to a January 2025 survey by GOBankingRates.com. Those people face tough financial decisions, including whether to postpone healthcare testing and treatment, Michel said.
Growth in Medicare spending by beneficiary generally stopped in 2010 and remained flat at around $12,500 per beneficiary as of 2023.
“Social Security and Medicaid are going to go broke sooner rather than later,” Michel predicted. “Congress has seen this problem and not reacted.”
Such financial challenges will force the need for new clinical laboratory business models. Among the key areas that will inspire these models are diagnostic data and technology, said Sam Terese, CEO and president at Alverno Laboratories, during his general session at the Executive War College.
“It comes back to using data to predict disease,” Terese explained. “If you can prevent someone from getting seriously ill, you will lower the cost of care.”
Terese pointed out the need to effectively use artificial intelligence (AI) to digest the massive amount of clinical data that labs sit on.
Another New Clinical Laboratory Business Model: Closing Care Gaps
Diagnostic laboratories should also be in the business of identifying care gaps among their patients and consumers. One subset to consider is diabetic and prediabetic people.
“Can the lab identify an A1C patient who should have come in to see their doctor based on the test result?” Michel asked. That type of approach raises the value of a lab test beyond just the result it produced, he added.
During another general session, Sonora Quest Laboratories showed how it determines risk stratification for colorectal cancer by using an algorithm that considers a patient’s age, gender, and minimum of two complete blood count test results to flag at-risk people.
“We’re able to get information to physicians to close that care gap,” said Jen Umscheid, senior director of quality, innovation, and performance excellence at Sonora Quest.
The Executive War College continues through Thursday, with an expected attendance of just over 1,000 delegates, speakers, and vendor representatives. Friday’s Dark Daily will explore how AI topics played out among curious attendees.
30th edition of the conference returns to New Orleans this week, bringing together diagnostic lab executives and innovators
Medical laboratory leaders and executives, along with diagnostic innovators from across the country, are convening in New Orleans this week for the 30th annual Executive War College on Diagnostics, Clinical Laboratory, and Pathology Management.
Given the political, regulatory, and financial upheaval occurring in the US, this year’s Executive War College gathering offers a timely opportunity for lab leaders to discuss important strategies and network with sellers.
Featuring 85 sessions across two days, attendees will delve into key topics such as revenue growth strategies, regulatory updates, AI integration, workforce development, and evolving payer dynamics.
With clinical laboratories playing an increasingly pivotal role in value-based care and patient outcomes, the 2025 conference agenda reflects a growing need for labs to operate not just as diagnostic services but as critical business units driving healthcare innovation.
Robert Michel (above), founder of the Executive War College and outgoing editor-in-chief of Dark Daily, will lead a closing session on Wednesday looking at common themes that emerged during the Executive War College. “It’s important that lab leaders take note of what they learned—whether it was during a session, networking reception, or chance meeting with a peer—before heading back to their organizations,” he said. (Photo copyright: LabX.)
Event Will Illustrate Paths Forward for Lab Industry
Robert Michel, founder of the Executive War College and outgoing editor-in-chief of Dark Daily, previously noted that smart laboratory leaders are viewing financial, staffing, and operational pressures as opportunities to move ahead.
“This path forward is informed by two longstanding precepts recognized by innovative managers,” Michel said. “One precept is ‘Change creates new winners and losers.’ The other precept is ‘Change creates opportunity.’ Savvy lab leaders recognize the powerful truths in each precept.”
The general sessions kick off Tuesday morning with a keynote address from Michel titled, “Healthcare at a Tipping Point: Why Lab Opportunities and Challenges in Coming Years Will Be Different than Those of the Past 30 Years.” The keynote will synthesize nationwide trends, setting the stage for two days of in-depth discussion.
Other general sessions on Tuesday will explore the continued move towards precision medicine, how to take innovative steps to improve lab operations, and ways to elevate the value of laboratory services.
Agenda Features More than One Dozen AI-Themed Sessions
Artificial intelligence (AI) will be another hot topic this year, particularly as labs grapple with how to harness a technology that just in the past year seems to have proliferated exponentially.
This year’s Executive War College will devote more than a dozen sessions to AI discussions, as experts from both the technology and pathology sectors dissect AI’s current capabilities, legal aspects, and financial implications.
Another major focus for 2025 is the regulatory environment. Several sessions will provide updates on the latest CLIA inspection deficiencies, where regulators stand on current concerns, and the future of laboratory developed test oversight given a federal court’s recent decision to vacate the Food and Drug Administration’s final rule on LDTs.
Wide Swath of Laboratory Influencers Expected
Nearly 1,000 attendees, speakers, and vendor representatives are expected at the Executive War College, including C-level executives, pathologists, lab directors, and business development leaders.
Watch Dark Daily this week for further updates from New Orleans, including coverage of the opening day’s general sessions and a wrap-up of what lab leaders learned during the event.
Lab professionals will learn more at the upcoming 30th annual edition of the event
Big changes and challenges are coming for the clinical laboratory anatomic pathology industry, and with them a slew of opportunities for lab and pathology practice leaders. At the upcoming 30th Annual Executive War College on Diagnostics, Pathology, and Clinical Laboratory Management, expert speakers and panelists will focus on the three most disruptive forces.
There will be more than 169 presenters at this year’s Executive War College. Those speakers include:
David Dexter, MD, clinical and laboratory pathology at M Health Fairview, and Sam Terese, president and CEO at Alverno Laboratories, who will present a strategic case study about the support labs can provide to parent hospitals when navigating new waters.
Paul Wilder, executive director of CommonWell Health Alliance, who will speak on the effort to improve the transferability and portability of patient and healthcare data in ways that improve the quality of care.
“Since the inception of The Dark Report in 1995 there has been continual change both within the US healthcare system and within the profession of laboratory medicine,” noted Robert L. Michel, Dark Daily’s editor-in-chief and creator of the Executive War College. “Now, three decades later, the following three items are imperatives for all labs: controlling costs; having adequate lab staff across all positions; and having enough capital to acquire and deploy new diagnostic technologies, along with the latest information technologies.”
“Most clinical laboratory managers would agree that many of the same operational pain points faced by labs in the 1990s exist today,” said Robert L. Michel (above), founder of the Executive War College. In an interview with Dark Daily, Michel broke down the nuances of this triad of forces and what participants in the Executive War College can expect. (Photo copyright: LabX.)
Forces at Work in Clinical Labs and Pathology Groups
Here’s a more detailed look at each of the forces that Michel noted.
Force 1: An acute shortage of experienced lab scientists
“When you look at the supply-demand for laboratory personnel in the United States today, it is recognized that demand exceeds supply, and that gap continues to widen,” Michel noted. “For example, in the case of anatomic pathologists, the increased number of case referrals grows faster than medical schools can train new pathologists. Currently, the ability of pathology laboratories large and small to hire and retain an adequate number of pathologists is a challenge.”
Executive War College attendees can expect panelists and speakers to highlight creative problem solving techniques to circumvent the challenges labor shortages cause.
Force 2: New applications of artificial intelligence
“Today every instrument vendor, every automation supplier, every software supplier, every service supplier is telling labs that they have artificial intelligence (AI) baked inside,” Michel observed. “It is important for lab managers to understand that a variety of technologies are used by different AI solutions.”
Clinical laboratory managers and pathologists interested in acquiring a deeper understanding of where to start with AI in their lab will find numerous sessions on artificial intelligence at this year’s Executive War College. “There will be a number of sessions this year where clinical labs discuss their success deploying various AI solutions,” Michel said.
Force 3: Financial stress across the entire US healthcare system
“It’s recognized that a significant number of US hospitals and integrated delivery networks (IDNs) are struggling to maintain adequate operating margins,” Michel noted. “This obviously impacts the clinical laboratories serving these hospitals. If the hospitals’ cash flows and operating profit margins are being squeezed, typically the administration comes to the lab team and says, ‘Your budget for next year will be x% less than this year.’
“There are many IDNs and hospital labs where budget cuts have happened for multiple years,” Michel continued. “As a consequence, labs in these hospitals must be nimble to maintain a high-quality menu of diagnostic tests. Several years of such budget cuts by the parent hospital can undermine the ability of the clinical lab team to offer competitive salary packages to attract and retain the clinical lab scientists, pathologists, and clinical chemists they need.”
Recognizing Opportunities in Today’s Lab Market
The good news is that—despite the negative forces acting upon the US healthcare system today—clinical laboratories, genetic testing companies, and anatomic pathology groups have a path forward.
“This path forward is informed by two longstanding precepts recognized by innovative managers. One precept is ‘Change creates new winners and losers.’ The other precept is ‘Change creates opportunity,’” Michel said. “Savvy lab leaders recognize the powerful truths in each precept.
“As healthcare has changed over the past four decades, nearly all the regional and national laboratories that were dominant in 1990, for example, don’t exist today!” he noted. “And yet, even as these lab organizations disappeared, new clinical lab organizations emerged that recognized healthcare’s changes and organized themselves to serve the changing needs of hospitals, office-based physicians, payers, and patients.”
All of these critical topics and more will be covered during the 30th Annual Executive War College on Diagnostics, Clinical Laboratory, and Pathology Management on April 29-30, 2025, at the Hyatt Regency in New Orleans. Signup today to bring your lab’s management team by registering at https://www.executivewarcollege.com.