Octavia Peck Palmer, PhD, FADLM, BS, is division director for clinical chemistry and associate professor of pathology at the University of Pittsburgh School of Medicine and past president of the Association for Diagnostics & Laboratory Medicine (ADLM).
At ADLM’s 2026 annual meeting in July, Peck Palmer spoke with Today’s Clinical Lab about the conference’s “Meeting of the Minds” theme, whether pressure remains from the Food and Drug Administration (FDA) over laboratory-developed tests (LDTs), and the evolving role of mass spectrometry in diagnostics. This interview has been lightly edited for clarity.
How do you think the main theme of ADLM 2026 reflects against the clinical lab industry as a whole?
Peck Palmer: I think the “Meeting of the Minds” theme was appropriate because I was able to meet with my colleagues who I've known for years but also some new individuals who are joining my network. They bring me insights, from women’s health and preeclampsia to infectious disease and newer technology, that I can use. At the end of the day, for clinical labs to demonstrate value, they must be less transactional. That means that when physicians interact with the laboratory, they’re not only getting a result—they're getting an interpretation. They're getting information that helps them manage the care of their patients. ADLM is a true meeting of the minds, where we're exchanging ideas to be more integrative in our hospitals, our labs, and even in the way we develop testing. Labs need to interact with and understand what the community needs—it's not a one-size-fits-all approach—and ensure that their actions are reflect the disease trajectory.
Courtesy: Octavia Peck Palmer
When you were president of ADLM, there was a lot of industry pressure from the now vacated FDA rule on LDTs. Is that pressure gone in 2026?
Peck Palmer: There is a sigh of relief from labs, and I feel it, too. But in the back of our minds, laboratory professionals agree that the fight over LDTs is not over. The question remains about what oversight really needs to be in place for laboratory-developed tests and who actually has the authority to regulate them. I think I can speak for labs when I say that we are not putting out tests that we don't have accurate information on. We apply the same rigor to a laboratory-developed test that we do to an FDA-approved test. And the key here is that, many times, for the patient population we're serving with an LDT, there isn’t an economic or financial incentive for a larger in vitro diagnostics company to pursue that diagnostic. That’s part of demonstrating the lab's value. Lab professionals are trained to validate and perform an LDT. It’s nice not having that proposed FDA LDT authority looming over us, but labs must be cognizant that we still need to determine who's going to have that authority.
There seems to be growing interest in clinical labs with mass spectrometry. What do you think of the technology?
Peck Palmer: Mass spectrometry is very important for measuring hormones and being able to quantify very small concentrations in individuals. Let's take testosterone as an example. Very small changes in testosterone levels in both babies and women may not be picked up by an immunoassay. So, being able to quantify those minute changes using mass spec is important. Additionally, consider drug measurements. Labs don't want to inadvertently label someone fentanyl-positive because of a false-positive immunoassay. Gas chromatography or liquid chromatography–mass spectrometry can confirm those results and measure the metabolite or the parent drug itself, so the lab can ensure that person gets the appropriate therapeutic monitoring they need, or identify illicit drug use. Mass spec is also useful for assessing differentiated thyroid cancer to help detect the presence or absence of thyroglobulin following surgery, radiation, or chemotherapy. That really takes the worry off not only the physicians, knowing that they removed all of the malignancy, but also the patients, so they can go on living their lives. Mass spectrometry is important for labs as a complement for immunoassays.
