March 2015—Turning points emerge in retrospect, but I’m ready to put a red pushpin at December 2013 on the evolutionary timeline for pathology graduate medical education. Twenty-four pathology education organizations came together that month for a workforce summit sponsored by the CAP, the American Society for Clinical Pathology, the Association of Pathology Chairs, and the United States and Canadian Academy of Pathology that would refine consensus on how to best shape the future of our specialty.
Read More »March 2015
How satisfied are physicians with labs? Study digs deep
March 2015—In the span of human history, seven years is nothing but an eye blink. But in technological terms, seven years might as well be a geologic epoch. Consider: Only since 2007 have we seen Netflix streaming services; Kindles, Nooks, and other e-readers; and the sweeping adoption of the iPhone.
Read More »Groups closing the gap in reference materials for sequencing assays
March 2015—It’s a truism in the clinical laboratory that your results are only as good as the reference standards available to QC your assay. For measuring small analytes like glucose that’s not a problem. However, in clinical laboratories the analyte in question increasingly is DNA. In the past five years, next-generation sequencing has been adopted to detect variants in small targeted regions of specific genes, which is useful in oncology and medical genetics. More ambitious applications of NGS—whole genome and whole exome sequencing—have recently begun to enter the clinical realm as well.
Read More »Genetic profiling vies with IHC in retune of CUP testing
March 2015—Tesla beats Camry. Online catalogs replace paper. Keurig edges out Chemex. Mobile trounces landline. When paradigms shift, the theory goes, we can only cling to the technology in the outbox for just so long. But that’s a theory that may not apply to diagnostic testing for cancer of unknown primary (CUP). Microarray-based gene expression profiling (GEP) has recently gained a foothold in the quest to identify origins and therapeutic targets for metastatic cancer, but traditional immunohistochemistry is not about to be sidelined.
Read More »With molecular MPN testing, think positive
March 2015—If molecular tests for myeloproliferative neoplasms ever decide to write their autobiography, they could easily do a riff on the business bestseller Getting to Yes. For myeloproliferative neoplasms, morphologic and clinical findings should guide molecular analysis, which can often be a helpful way to clinch the diagnosis, says Dr. David Czuchlewski (left), of TriCore Reference Laboratories, with Mohammad Vasef, MD, TriCore’s director of molecular diagnostics.
Read More »Pap test litigation—
Not backing off: CAP retains call for blinded review
March 2015—When the 11th Circuit U.S. Court of Appeals issued an opinion harshly criticizing the CAP’s guidelines on review of Pap tests last summer, many in the pathology community were stunned by the rebuke and wondered whether change was called for.
Read More »Paths to validating, using urine sediment analyzers
March 2015—Before Lahey Hospital and Medical Center’s clinical laboratory brought an automated urine sediment analyzer on board last November, it had been doing manual microscopy on positive dipstick specimens only. A review of that practice uncovered problems with quality, including patient misdiagnosis, says Tim Skelton, MD, PhD, medical director of the core laboratory and laboratory informatics at the tertiary care medical center in Burlington, Mass.
Read More »Q&A column, 3/15
Are red blood cell parameters (Hb, MCV, MCH, MCHC, and RDW), especially a normal MCV, a reliable screening tool for ruling out beta thalassemia trait? Is the sickle solubility test reliable in ruling out sickle cell disorder? The absence of coagulation of seminal fluid has been attributed to bilateral congenital absence of the vas deferens and seminal vesicles due to the absence of the coagulation substrate (fibrinogen-like precursor).
Read More »Hear me now? Another audition for speech recognition
March 2015—When Pete Fisher, MD, says his name aloud, the speech-recognition system he uses spits out the words “deep fissure” on the screen. And there are times when he says “note that” and “note fat” pops up instead. Despite the occasional hiccups, he loves the software and the freedom it affords him to do his work without being bound to a transcriptionist’s timetable.
Read More »Anatomic Pathology Selected Abstracts, 3/15
March 2015—Histopathologic spectrum of thecoma of the ovary: a report of 70 cases: The authors evaluated 70 cases of thecoma of the ovary to ascertain their histopathologic spectrum. The tumors occurred over a wide age range (average, 49.6 years). Presentation in the form of pelvic or abdominal pain was uncommon, but postmenopausal bleeding was relatively frequent.
Read More »Clinical Pathology Selected Abstracts, 3/15
March 2015—Chimeric antigen receptor T cells for sustained remissions in leukemia: Relapsed and refractory acute lymphoblastic leukemia is associated with a poor prognosis. T cells genetically modified to express chimeric antigen receptors targeted to cells expressing CD19 (CTL019) are a promising treatment strategy, with complete responses previously reported in two patients who had relapsed and refractory acute lymphoblastic leukemia (ALL).
Read More »Newsbytes, 3/15
March 2015—CMS to alter reporting period for meaningful use: The Centers for Medicare and Medicaid Services has announced that it intends to engage in rulemaking to shorten the reporting period for stage two meaningful use attestation this year from 365 to 90 days under the EHR incentive programs.
Read More »Molecular Pathology Selected Abstracts, 3/15
March 2015—Generation of allergen-specific human IgEs as standards in diagnostic allergy testing: Diagnostic allergy testing for patients with moderate to severe allergies is usually performed by an allergy specialist and can include skin prick and patch tests or blood tests.
Read More »Put It on the Board, 3/15
AMP outlines laboratory view on incidental findings: The American College of Medical Genetics and Genomics’ controversial 2013 recommendations on the reporting of incidental findings on select genes was the first attempt to address the matter in the clinical setting. But the ACMG’s recommendations pose significant challenges that labs undertaking next-generation sequencing must be prepared to address, said a special report written by an Association for Molecular Pathology working group.
Read More »Companies say their AP LIS is up to the job, and how
March 2015—From tracking charges in anatomic pathology and maintaining documentation to the changing classifications of some cancers, representatives of five companies tell CAP TODAY what their AP systems offer and what they’re working on to help labs.
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