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November 2014

Put It on the Board, 11/14

November 2014—For Ebola cases, weighing broader, faster diagnostics: Amid initial confusion over Ebola-related safety protocols for health professionals providing direct patient care, laboratory professionals report hearing a consistent message from the CDC on proper specimen handling. The pressing question for laboratories is how best to approach testing with potential Ebola patients given the dual imperatives of preventing exposure and offering faster diagnostic answers.

Molecular Pathology Selected Abstracts, 11/14

November 2014—Whole exome sequencing of Merkel cell carcinoma demonstrates conserved retinoblastoma pathway dysregulation: Merkel cell carcinoma is a rare aggressive neuroendocrine malignancy of the skin that is associated with infection by Merkel cell polyomavirus. Viral integration into the human genome and subsequent expression of the large T antigen is thought to cause cell cycle dysregulation via binding and inactivation of the retinoblastoma tumor suppressor protein and is a key step in the development of Merkel cell carcinoma.

Newsbytes, 11/14

November 2014—Software expands on ‘what you see is what you get’; ONC unveils tool for sharing health information with patients; Portal gives patients direct access to lab test results; Xifin partners with SyTrue; GenoSpace awarded grant for developing biorepositories; NovoPath interfaces to Athenahealth EHR

Anatomic Pathology Selected Abstracts, 11/14

November 2014—Final trial report of sentinel-node biopsy versus nodal observation in melanoma: Sentinel-node biopsy, a minimally invasive procedure for regional melanoma staging, was evaluated in a phase three trial. The authors evaluated outcomes in 2,001 patients with primary cutaneous melanomas who were randomly assigned to undergo wide excision and nodal observation, with lymphadenectomy for nodal relapse (observational group), or wide excision and sentinel-node biopsy, with immediate lymphadenectomy for nodal metastases detected on biopsy (biopsy group).

Clinical Pathology Selected Abstracts, 11/14

November 2014—Combination of blood tests for fibrosis and cirrhosis to assess liver prognosis in CHC: Newer therapies for chronic hepatitis C are promising due to a high rate of sustained viral response and few side effects. Although these therapies are not yet readily available, investigators are considering the best way to evaluate and monitor response.

How LIS tweaks can enhance efficiency, patient safety

November 2014—So, you have a great idea that will improve laboratory workflow and reduce errors? Chances are the change will depend on automation of some sort, and will involve the LIS. But upgrades to laboratory information systems may not come fast enough, and the middleware may not be available to accomplish what you need. Then the question becomes how to customize the LIS to achieve your aims.

Is molecular AP testing in sync with guidelines?

November 2014—Molecular testing, on a steep growth curve in anatomic pathology, is increasingly providing decisive guidance for treatment of cancer patients. But while guidelines on clinical relevance and performance of common molecular tests are available and widely used in theory, to date there has been limited information on how well requests for molecular testing in AP laboratories are adhering to the guidelines.

CAP proposals on IHC, PQRS accepted for Medicare in ’15

November 2014—The Centers for Medicare and Medicaid Services on Oct. 31 published its 2015 Medicare physician fee schedule to set payment rates and policy for the next year, including the relative value units for existing and new Current Procedural Terminology codes. Several of the CAP’s recommendations and proposals were accepted for inclusion, such as three new quality measures designed for pathologists and eliminating G-codes to pay for immunohistochemistry services.

From chaos to order—and compassion—in autopsies

November 2014—Pathology resident Beth Ellen Frost, DO, has at times taken an uncommon step to put family members at ease when they are asked to consent, or have consented, to an autopsy for a loved one: She’s providing her cell phone number. Simple but purposeful, and it’s one part of a new initiative to improve the University of Kentucky HealthCare system’s autopsy process, which has other pathology staff handing out numbers too.

NGS informatics catching up to clinical demands

November 2014—When Birgit H. Funke, PhD, gave a talk earlier this year on incorporating bioinformatic tools and pipelines into medical NGS, at Molecular Medicine Tri-Con 2014, one of her slides showed the main bioinformatics activities needed to support sequencing. Among them were designing and building pipelines to manage genetic data, writing scripts for data analysis pipelines, and building custom applications.