Immunopathology & Immunotherapy

The clinical laboratory has been concentrating on technical accuracy considerably beyond the clinical utility of many observations in clinical medicine.  This is not necessarily appreciated, so when a test is inconsistent with the clinical hypothesis, it may be rejected as error.  Errors may occur, but are rare, except if there is specimen misidentification.  However, we are still focused on a “silver bullet” approach to use of diagnostic tests.  There is some variability of the expression of cancer cells, so that there are subclusters to be expected within a major class.  The level of applied mathematics that is needed to analyze this data has been refined enormously in the last decade, and has to be used on the selected groups of tests referred to with all due respect by Leigh Anderson, who has the imagination to pursue the highest accuracy in large scale MS analysis that his laboratory has pursued for many years.  This reviewer is interested in the “information content” of a combination of tests, when the accuracy of testing is no longer an issue.  By combining the high throuput and lower cost of processing, with vastly better mathematical technology than is customary – on the fly – would be a breakthrough.  That would not be the end of this journey because there would have to be centers for analysis distributed within a few hours of the treatment centers (or at those sites), so that testing and processing would enable better facilitation of treatment.