Laboratory and Analytical Device Standard (LADS): A Communication Standard Based on OPC UA for Networked Laboratories.

In a similar vein to Industry 4.0 in manufacturing industries, digitisation is making inroads in the laboratory industry in the form of Laboratory 4.0, or networked laboratories. Companies can gain decisive competitive edges by automating their work processes and systems and networking them with each other and primary IT systems. A uniform communication standard such as OPC UA, a well-established global standard in the aforementioned manufacturing industries, is essential to a modular, scalable network of heterogeneous laboratory structures. Can the laboratory industry benefit from this standard and the years of development experience? In SPECTARIS, the German Industry Association for Optics, Photonics, Analytical and Medical Technologies, over 30 global market leaders, hidden champions and drivers of innovation in the laboratory industry put their heads together in the "Networked Laboratory Devices" working group and created the "Laboratory and Analytical Device Standard", or LADS for short. Unlike numerous other attempts to establish communication standards for laboratories, LADS is based on the advanced OPC UA standard and takes an agnostic approach to cover the variety of devices, systems and requirements in laboratories. In this context, "agnostic" refers to the generic design and display of potentially as-yet-unknown aspects of the flow of information or communication structures. For the first time, LADS allows for modular, scalable networking of heterogeneous laboratory structures, efficient data transfers and - currently unused - user, process and device-based data analysis (keywords: big data, predictive analytics, data science) - even taking normative requirements into consideration. This agnostic modelling makes LADS a future-proof communication solution for the laboratory industry, the likes of which the world has never seen.

Matched-pair comparison of radioembolization plus best supportive care versus best supportive care alone for chemotherapy refractory liver-dominant colorectal metastases.

PURPOSE: This study was designed to evaluate overall survival after radioembolization or best supportive care (BSC) in patients with chemotherapy-refractory liver-dominant metastatic colorectal cancer (mCRC). METHODS: This was a matched-pair comparison of patients who received radioembolization plus BSC or BSC alone for extensive liver disease. Twenty-nine patients who received radioembolization were retrospectively matched with a contemporary cohort of >500 patients who received BSC from 3 centers in Germany. Using clinical databases, patients were initially matched for prior treatments and tumor burden and then 29 patients were consecutively identified with two or more of four matching criteria: synchronous/metachronous metastases, tumor burden, increased ALP, and/or CEA >200 U/ml. Survival was calculated from date of progression before radioembolization or BSC by using Kaplan-Meier analysis. RESULTS: Of 29 patients in each study arm, 16 pairs (55.2%) matched for all four criteria, and 11 pairs (37.9%) matched three criteria. Patients in both groups had a similar performance status (Karnofsky index, median 80% [range, 60-100%]). Compared with BSC alone, radioembolization prolonged survival (median, 8.3 vs. 3.5 months; P < 0.001) with a hazard ratio of 0.3 (95% confidence interval, 0.16-0.55; P < 0.001) in a multivariate Cox proportional hazard model. Treatment-related adverse events following radioembolization included: grade 1-2 fatigue (n = 20, 69%), grade 1 abdominal pain/nausea (n = 14, 48.3%), and grade 2 gastrointestinal ulceration (n = 3, 10.3%). Three cases of grade 3 radiation-induced liver disease were symptomatically managed. CONCLUSIONS: Radioembolization offers a promising addition to BSC in treatment-refractory patients for whom there are limited options. Survival was prolonged and adverse events were generally mild-to-moderate in nature and manageable.