September 2023—A casual comment made in a routine exchange in an Avera McKennan Hospital laboratory sparked a five-year campaign to bring down the urine culture contamination rate. “I feel like all I do is report contaminated cultures,” a microbiology technologist said in 2016.
Read More »In urinalysis, reflex algorithms and other efficiencies
March 2023—Urinalysis was at the heart of a Feb. 7 discussion between CAP TODAY publisher Bob McGonnagle; Ron Jackups Jr., MD, PhD, of Washington University School of Medicine; and Jason Anderson of Sysmex America. “There’s a lot of room to explore what the optimal parameters are to use with the best specificity and sensitivity for a reflex to the sediment analysis or the culture,” Anderson said. Here’s what he and Dr. Jackups said about reflex testing, automation, and middleware.
Read More »In fee schedule, an increase to pathology clinical labor rates
December 2022—The Centers for Medicare and Medicaid Services published on Nov. 1 its final 2023 Medicare physician fee schedule with payment rates and new policies set to take effect next year.
Read More »Urinalysis: Efficiency, utility, and the ‘movement in the field’
December 2021—Four experts met on an Oct. 12 call to talk with CAP TODAY about urinalysis—the newest platforms, what labs need, labor solutions. CAP TODAY publisher Bob McGonnagle asked the questions. Providing their perspectives were Matthew Rhyner, PhD, MBA, Beckman Coulter; Jason Anderson, MPH, MT(ASCP), Sysmex America; Megan Nakashima, MD, Cleveland Clinic; and Keri Donaldson, MD, MSCE, Solvd Health and Penn State. Here’s what they had to say.
Read More »Problems, solutions at core of UTI, C. diff modules
April 2021—Urinary tract infections and Clostridioides (Clostridium) difficile testing are the topics of two of the modules released recently in the CAP Test Ordering Program. The Laboratory Workup for Urinary Tract Infections module became available online in January, and C. difficile Testing in October 2020 (www.cap.org/member-resources/test-ordering-program). The program is free to CAP members.
Read More »Fewer urine cultures — series of changes add up
November 2020—Five years after putting in place a urine reflex algorithm at Barnes-Jewish Hospital in St. Louis, and many tweaks later, Melanie Yarbrough, PhD, D(ABMM), D(ABCC), has tips to share on how to increase the odds for success in reducing the number of urine cultures.
Read More »Targeting microbiology lab efficiency with AI
August 2020—Bringing an automated culture plate reading system into the Hennepin County Medical Center microbiology laboratory was never a question of if but when. “We need artificial intelligence to help us with active decision-making processes in the lab,” says Glen Hansen, PhD.
Read More »Bladder cancer detection and surveillance: How urine cell-free DNA stacks up against cytology
June 2019—A high-throughput sequencing panel was found to be more than 90 percent sensitive in detecting urinary tumor DNA in early-stage bladder cancer and in post-treatment surveillance. The approach, reported in April in Cancer Discovery, overcomes some of the challenges urinary cell-free DNA analysis poses, said one of its developers, and is far more sensitive than cytology and cystoscopy.
Read More »Urinalysis instrumentation: All eyes on standardized, scalable, integrated solutions
December 2018—On page 36 begins our urinalysis instrumentation product guide. The companies whose analyzers are profiled talked to CAP TODAY writer Valerie Neff Newitt
Read More »Automation, standardization lead the way in urinalysis
December 2017—Smaller-scale technology and standardization are just some of what laboratories need, and it’s where the companies that make urinalysis analyzers are in part focusing their work. CAP Today spoke with three of the five whose analyzers are profiled on the following pages.
Read More »Missed UTIs? ‘Enhanced cultures’ suggest so
August 2016—The long-held belief that urine is sterile is facing a serious challenge from new research combining sequencing techniques and an enhanced urine culturing protocol to uncover an array of uropathogens hitherto unseen in microbiology laboratories.
Read More »Cytopathology in Focus: Paris System: a new paradigm for urinary cytology
May 2016—The Paris System Working Group has proposed and published a standardized reporting system that redefines the primary purpose of urinary cytology: the detection of high-grade urothelial carcinoma (HGUC).1 A program to address standardization of urine cytology reporting was conceived at the 18th International Congress of Cytology in Paris in May 2013 where a number of people of like interest assembled and formed the Paris System Working Group.
Read More »Urine preanalytics guideline effort highlights data need
February 2016—When it comes to recommended practices for preanalytic handling of urine specimens for the microbiology lab, Alice S. Weissfeld, PhD, D(ABMM), has a blunt and colorful take: “I call it ‘running our lab based on urban legend.’”
Read More »Leveraging urinalysis for value-based health care
November 2015—Tim Skelton, MD, PhD, knows a fair amount about how to enhance the clinical value of urinalysis. It’s a subject that, as medical director of the core laboratory and laboratory informatics at Lahey Hospital and Medical Center in Burlington, Mass., he’s been focused on for the past three years. But he didn’t exactly set out to become an expert in that particular area. He was mainly trying to figure out why his laboratory was experiencing repeated urinalysis quality assurance failures.
Read More »Lab studies new steps in urine and anemia screening
August 2015—Despite the demonstrated value of implementing reflex testing algorithms to improve patient care and avert wasteful spending, the road from conceptual understanding to plan-in-action can be rocky. A pathologist at one academic medical center recently talked about his experience with reflex testing algorithms in the areas of urine screening and preoperative anemia screening. His story illustrates the barriers to change as well as the enviable outcomes that could potentially be achieved.
Read More »For CKD, work is on to refine and find biomarkers
July 2015—Getting the upper hand on chronic kidney disease requires taking maximum advantageof existing CKD biomarker capabilities. It also means discovering new markers, though the trick is finding those that can expand treatment options. Some believe fibroblast growth factor-23 has the potential to fit that bill, with one researcher calling it “among the most exciting new targets in chronic kidney disease.”
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 »In urinalysis, automated microscopy making the difference
March 2014—Traditional urinalysis is messy. It’s tedious. It’s prone to variability. It’s nicknamed the “ugly stepchild” of the laboratory. Many are quick to note that it’s just a screening tool—with an emphasis on “just.” But in recent years, urinalysis has been quietly tiptoeing into a new era.
Read More »To reduce UTIs, one lab takes a long, wide look
June 2013—Lance Peterson, MD, wasn’t expecting to be surprised. But the numbers were dramatic enough to startle even him.
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