Home >> Tag Archives: Letters

Tag Archives: Letters

Letters

September 2023—I read with interest “In anatomic pathology labs, a balancing act” (August 2023). Some of the roundtable participants highlighted an area of next-generation-sequencing–based diagnostics that is a blind spot for pathologists, molecular biology tool manufacturers, and laboratory information system vendors—namely how to reduce the fractional cost of performing NGS-based analysis. On the topic of gene panels, the participants offered that the workflows are complex, reimbursement is relatively low, and startup costs are high—all true statements. However, I was struck that they evaluated the cost structure only in the setting of tissue oncology, with the implication being that the fully loaded cost of the diagnostic must be borne by the degree and level of oncology-based sequencing.

Read More »

Letters

May 2023—As members of the CAP Transfusion, Apheresis, and Cellular Therapy Committee, we wish to offer comments to the readers of CAP TODAY in response to the article, “Case review reveals latest on overtransfusion” (March 2023). The article reported on a single publication of retrospective reviews of transfusions given in 2012–2018 in 15 community hospitals (Jadwin DF, et al. Jt Comm J Qual Patient Saf. 2023;49[1]:42–52), based on approximately 100 encounters with transfusions per institution. The retrospective character of this work as well as its applied methodology raise several important questions regarding the true value of any conclusions and their generalizability. Interpretation of the presented data requires a thorough and unbiased discussion, as some numbers are significantly out of observed ranges elsewhere. For example, by the authors’ methodology, less than 10 percent of encounters had fully appropriate RBC transfusions.  

Read More »

Letters

April 2023—There have been several recent articles in CAP TODAY regarding the use of whole blood and prehospital transfusion. The general tenor of the reporting has supported these novel practices. We would like to suggest an alternative perspective.  

Read More »

Letters

January 2023—The CAP president’s column, “The visible pathologist” (CAP TODAY, November 2022), struck a chord that has been reverberating through our specialty for many years when a medical student who expressed an interest in pathology was asked, “Why don’t you want to be a real doctor?” You put it in terms of “disappearing” as judged by our role in the case of patients.

Read More »

Letters

October 2022—I read with great interest your article “Transgender care, in and beyond the lab” (July 2022). In the article Gabrielle Winston-McPherson, PhD, talks about her desire to improve health outcomes, identify problems in the preanalytical process, develop training material, assemble data and information prior to implementation, address informatics challenges, and ensure proper allocation of limited resources—all of which is laudable and appears to align perfectly with our mission as pathologists. The writer reminds readers that the topic has landed in the middle of court cases, state laws, and policy debates, with “words like ‘controversial,’ ‘issue,’ ‘politics,’ ‘traditional family values,’ and ‘beliefs’ awkwardly mixed in with medical realities.”

Read More »

Letters

June 2022—The CAP issued a statement on April 5 in support of the ADVANCE study, which hopes to end discriminatory practices based on sexual identity and/or sexual orientation in donor risk assessments and deferral periods for blood donation. Originally, the FDA instituted such discriminatory criteria on the assumption that potential donors who are gay and bisexual men who have sex with men are at an increased risk of transmission of communicable diseases, such as human immunodeficiency virus. If the results of the ADVANCE study prove this antiquated idea false, the FDA will hopefully amend the official guidance on donor eligibility for blood donation.

Read More »

Letters

February 2022—The CDC published on Nov. 5, 2021 a report indicating that immunocompromised persons receiving SARS-CoV-2 mRNA vaccines should receive three doses and a booster (MMWR Morb Mortal Wkly Rep. 2021;70[44]:1553–1559). The following n-of-1 observational study suggests that an immunocompromised nonresponder to mRNA vaccine may indeed respond to a second series of SARS-CoV-2 mRNA vaccine.

Read More »

Letters

June 2020—I enjoyed the recent roundtable on billing and reimbursement (April 2020), along with the product guide on billing software. As we all know, since that time COVID-19 has taken center stage. Here are some thoughts and predictions to bring your readers up to date. Never before has a nation turned off a large percentage of its health care system overnight. This change has caused a train wreck-like boxcar effect that is rippling through medical billing operations for laboratories and pathology groups.

Read More »

Letters

November 2019—We read with interest the case described by Vormittag-Nocito, et al., of metastatic bladder adenocarcinoma with associated molecular pathology findings (September 2019). However, we would like to point out what we believe to be an important update related to the significance of FGFR3 alterations in urothelial carcinoma. When referring to TP53 and FGFR3 alterations in urothelial carcinoma, the authors write that “no targeted therapy or prognostic implications can be made about these mutations at this time.”

Read More »

Letters, 11/14

November 2014—We read with great interest the two recent articles by William Check, PhD, highlighting primary HPV testing proposals (June and September 2014). Additional related information not covered in the two CAP TODAY articles should be brought to readers’ attention.

Read More »

Letters

AMH immunoassays October 2018—In the article “Satisfaction high with new automated AMH assays” (June 2018), the focus seems to be on the presumed advantages of the Roche Elecsys and Beckman Coulter Access automated anti-müllerian hormone assays over manual AMH assays. The article reports that the main advantages of the automated platforms are less variability in AMH measurements, greater assay turnaround time, and greater assay cost-effectiveness.

Read More »

Letters

Burnout
September 2018—As a pre-med student, I am shadowing a pathologist mentor at a major cancer hospital to gain insight into the life of physicians. She introduced me to CAP TODAY. I write in response to “Frontline dispatches from the burnout battle,” by Karen Titus (June 2018), to share the thoughts of a novice who now knows that becoming a physician means learning the skill of resiliency as early as possible.

Read More »

Letters

July 2018—I was excited to see the article “Clearing the air for electronic cancer checklists” (May 2018) and would like to share what we at Sunquest are doing to contribute to adoption of the electronic cancer checklists. Sunquest is continually improving the PowerPath Synoptics tool set, which is included as part of our base system.

Read More »

Letters

June 2018—LCIS variants and DCIS: We write in response to the article by Karen Lusky regarding tips to distinguish DCIS from variant forms of LCIS (April 2018). A different question might be: Is it actually important to distinguish these two in situ proliferations?

Read More »

Letters, 4/18

April 2018—Let us bring back breast FNAB: The article “Standardized reporting for breast FNAB cytology” (January 2018) is a welcome account of some of the challenges associated with breast fine needle aspiration biopsy compared with core needle biopsy. The author expertly outlines the significance of a standardized approach to performance, interpretation, and reporting of the breast FNAB procedure. The article was a pleasant surprise because the topic of breast FNAB has not been the subject of much interest in our pathology community during the past several years.

Read More »

Letters, 11/17

Biotin pharmacokinetic study results: In Anne Paxton’s September 2016 article, “Beauty fad’s ugly downside: test interference,” I stated a commitment from Roche to reduce possible interferences, including biotin, and provide clear test labeling to ensure that physicians and laboratories can mitigate risk.

Read More »

Letters, 10/17

CAP TODAY provides valuable information that is important to guide the practice for many pathologists. However, an article published in the August 2017 issue, “Laboratory director duties clarified in 2017 checklist” by Anne Ford, has raised serious concerns among many pathologists, particularly members of the Chinese American Pathologists Association (CAPA).

Read More »

Letters, 9/17

September 2017—I write this after reading “Total joints in view: to tilt at or to toss” (July 2017). I just completed my 42nd year as a general pathologist in an acute care community hospital that had 100 beds in 1971 and now has close to 500. From about 1980 (before we went to “separate billing”) through 2014, I fought relentlessly to have and keep the policy that all tissue get a pathology exam. These exams are needed:

Read More »

Letters, 08/15

August 2015—Breast pathology study: I read the letter by Diane Schecter, MD (July 2015), and I respect her right to remind readers that the findings from the breast pathology study published in JAMA (Elmore JG, et al. 2015;313:1122–1132) are similar to results published nearly 25 years ago.

Read More »

Letters, 5/15

May 2015—Speech recognition: I found the article on speech recognition to be well reported and interesting (“Hear me now? Another audition for speech recognition,” March 2015). We implemented speech recognition at NorthShore University HealthSystem (as your writer reported) before I retired as director of the clinical pathology division. What William Watkin, MD, said in the article about our smooth implementation was so true.

Read More »

Letters, 4/14

April 2014—HER2 testing guideline update: Karen Titus’ article “New guideline takes on tough HER2 cases” (October 2013) nicely captures the deliberations behind the new HER2 testing guideline, issued by the American Society of Clinical Oncology and the CAP last October. But as her article makes clear, the new guideline leaves open a question—and I would like to suggest an answer. That answer is based on new studies of molecular diagnostics, to which my institution and several others are contributors, and my own experience as a practicing medical oncologist.

Read More »

Letters, 10/13

October 2013—A CAP-accredited, multi-department laboratory, with 25 well-trained employees. A full-time staff of four American Board of Pathology-certified pathologists, including one with cytopathology boards. A rigorous quality assurance program involving clinicians and pathologists. An integrated electronic medical record system. Constant communication between administrative, technical, and clinical staff.

Read More »

Letters, 9/13

We read with interest your article in the June issue, “To reduce UTIs, one lab takes a long, wide look.” We strongly agree that there is inappropriate prescribing of antibiotics for patients whose urine cultures are reported with organism identification and antibiotic susceptibilities but who do not have urinary tract infection. This is because many physicians send urine for culture inappropriately and then equate a positive result with infection; they believe that these laboratory tests are diagnostic for UTI.

Read More »

Letters, 4/13

April 2013—Remembering Lee VanBremen, PhD: I read with interest the reminiscences about former CAP executive vice president Lee VanBremen, PhD (February 2013, page 12). It was my good fortune to serve on the CAP Board of Governors while Dr. VanBremen was the EVP. It became immediately apparent that he was a gentleman, highly intelligent, quiet, and reserved.

Read More »
CAP TODAY
X