CHICAGO – GE Healthcare 's (Waukesha, Wisconsin) William Clarke, MD, told Wednesday's plenary session audience at the American Association for Clinical Chemistry 's (AACC; Washington) annual meeting and clinical expo that in vivo imaging companies such as GE need to work together with in vitro diagnostics (IVD) companies to determine which patients should be tested with MRI, positron emission tomography (PET) and computed tomography (CT).

The goal would be to hold down healthcare costs, limit unnecessary imaging – but at the same time catch disease earlier in those determined through new in vitro diagnostic tests to be most likely to have a particular disease, said Clarke, executive vice president and chief technology and medical officer at GE Healthcare.

“Here's where we need to work together,” he said, noting that through joint initiatives companies like GE and clinical chemistry companies and the entire lab industry need to set standards “so we can go together to the health policy experts and [our] colleagues.”

“We need to figure out how to bring them together,” Clarke said, with the basic question being, “Who to order what tests on the road to better healthcare?”

One disease state of interest, he pointed out, might be in what is projected to be dramatically increasing incidence of Alzheimer's disease with the aging baby boomer population.

Here, the first question might be, who would want to know they have a predisposition or likelihood of getting Alzheimer's – or even a clear diagnosis – when there is no known cure?

But Clarke said the reason to plan for such diagnostic tests now is “there are a number of anti-amyloid [plaque] drugs” about to enter clinical trials.

Another example would be IVD tests that could help determine which smokers need to get a PET scan to check for lung cancer. Of long-term smokers, about 20% actually develop lung cancer. Up until now, the prognosis for those diagnosed with lung cancer has not been good, but new literature is expected to be published showing that if lung cancer can be detected at its very beginnings, the patient may have hope.

And the need is great because, according to Clarke, there are 3.1 billion smokers worldwide, with 44 million of those smokers in the U.S. alone.

“That's why we need you guys to come up with a test to determine who's likely to get cancer, whether it be sputum, blood [whatever],” he said.

Clarke noted that just the previous week, GE Healthcare had signed an agreement with a university to conduct a trial using multiple agents to differentiate both lung cancer and prostate cancer in scans. “We have to increase the pre-[scan] probability,” of determining which patients are likely to have disease in an effort to both improve patient care and save money.”

He added, “IVD and imaging are central to better health,” saying he would argue that increasingly, the two are converging.

However, there's “still a problem” with the scenario of providing additional decision-making information as it relates to general practitioner physicians, who often must evaluate information about each patient he or she sees in a given day in a matter of minutes.

“When does more information become less knowledge?” Clarke, who said he still practices medicine part-time, asked. He said that “everybody talks about the knowledge solution,” but when does additional knowledge become too much information for a general physician to process efficiently and accurately?

Using the process of making crystals as an analogy, Clarke said, “We are at risk of giving our clinical colleagues so much information that they are super-saturated,” pointing out that crystals fall apart and can't be brought back together in a super-saturated state.

“The system can't deal with it . . . and I would say that we are about at that point,” he said.

GE Healthcare's parent company, General Electric (GE; Fairfield, Connecticut) in April 2004 completed its $9.5 billion deal to acquire life sciences company Amersham (Little Chalfont, UK) to form GE Healthcare, which was previously known as GE Medical Systems.

At the time, GE Healthcare chairman Sir William Castell, formerly chief executive of Amersham, lauded the deal by saying, “We are ready to become the world's best diagnostic company.”

Earlier this month, industrial conglomerate Siemens (Munich, Germany) said it had agreed to acquire Bayer Diagnostics (Tarrytown, New York), the diagnostic unit of Bayer AG (Leverkusen, Germany), for $5.3 billion (Medical Device Daily, July 6, 2006).

Dr. Klaus Kleinfeld, president and CEO of Siemens, said the acquisition of Bayer is part of the company's strategy “to create the healthcare industry's first integrated diagnostics company by combining imaging diagnostics, laboratory diagnostics and clinical IT value chain under one roof.”

Siemens' acquisition of Bayer Diagnostics also was expected to provide a strong complementary fit to its purchase of Diagnostic Products Corp. (Los Angeles) (MDD, April 28, 2006).