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March 2014

Newsbytes, 3/14

March 2014—Digital imaging going strong but weaknesses persist: In his CAP ’13 presentation on digital imaging last fall, John H. Sinard, MD, PhD, asked attendees if they use digital still photography in anatomic pathology. “Most of the people in the room raised their hands,” says Dr. Sinard, who is professor of pathology, director of pathology informatics, and associate director of anatomic pathology at the Yale School of Medicine. In contrast, “very few hands went up” in response to a similar query regarding whole slide imaging.

Clinical Pathology Selected Abstracts, 3/14

March 2014—Transfusion-associated hyperkalemic cardiac arrest in pediatric patients: Hyperkalemic cardiac arrest is a potential complication in pediatric patients undergoing rapid massive transfusion. Identifying patients at particular risk for this reaction is critical for determining the best strategies to prevent transfusion-associated hyperkalemic cardiac arrest (TAHCA). Concerns arise over the use of older blood in at-risk pediatric patients. The authors examined the case reports and studies related to transfusion-associated cardiac arrest in a pediatric population.

Laboratory automation possibilities give lift to labs

March 2014—Tracks, modules, rules, consolidations, connections. Marketers of lab automation systems and workcells are busy turning out and fine-tuning what labs of all sizes need in the face of staff shortages, belt-tightening, growing workloads, and the need to implement a new set of best practices as payment shifts from volume-based to value-based. “Automation systems that provide answers to these challenges will help fulfill the original promise of laboratory automation and become the new standards of automation innovation,” says Jeremy Kiger, marketing manager for lab automation and IT, Roche Diagnostics.

No ifs, ands, or buts on IHC assay validation

March 2014—Like Gypsy Rose Lee, tests and their true nature reveal themselves bit by bit. For immunohistochemistry, this unhurried disclosure has meant evolving ideas of whether these tests must indeed be validated and, if so, then how, exactly. The discussion recently culminated in a new CAP guideline for laboratories.

How a Maryland lab met fixed-budget test

March 2014—Maryland may be one of the smallest states in the nation, but its new effort to reduce spending on hospital services could have a big impact on patient care and health care costs. In January, after a three-year, 10-site pilot program, most of the state’s hospitals decided to move to a system under which “the hospitals are given a fixed budget and asked to manage the care of the patients they serve within that budget,” says Maryland Hospital Association president and CEO Carmela Coyle.

MicroRNA markers show staying power

March 2014—Not many components of human cell biology have been discovered and immediately dubbed “junk.” But micro-RNAs, small noncoding RNA molecules first identified in 1993, fall into that category. Like Hans Christian Andersen’s Ugly Duckling, microRNAs began their life after discovery with people scoffing at them. People even laughed at researchers who thought microRNAs held promise in diagnosing cancer.

Anatomic Pathology Selected Abstracts, 3/14

March 2014—Use of morphological parameters of LN in stereotactic 11-gauge vacuum-assisted needle core biopsy: Management of lobular in situ neoplasia when diagnosed on core biopsy remains controversial. The authors conducted a study to investigate the association between morphological parameters of lobular in situ neoplasia (LN) on vacuum-assisted needle core biopsy (VANCB) and the presence of malignancy (ductal carcinoma in situ, pleomorphic lobular carcinoma in situ, or invasive carcinoma) at surgical excision. The study included 14 pathology departments in Italy.

Guidance aims for safer use of lab data in EHRs

March 2014—A wide-ranging set of recommended health information technology safety practices recently issued by the Department of Health and Human Services is likely to accentuate the essential role that pathologists and laboratory leaders play in minimizing the adverse consequences of health IT.

From the President’s Desk: Turning data into care—lead the way, 3/14

March 2014—Implementation of meaningful use and related federal regulations has spurred widespread adoption of the electronic health record, and that’s a game-changer. Every one of us will need to have competence in clinical informatics, to varying degrees.

How high-tech approach may reshape the autopsy

March 2014—Boosters of so-called virtual autopsy say it has the potential to revolutionize the practice of forensic pathology and could help increase the share of U.S. deaths subject to medical autopsy. The technique involves the use of computed tomography, magnetic resonance imaging, and three-dimensional surface scanning technology to help resolve tricky forensic questions such as whether a woman was killed with a hammer or a bicycle wrench.