March 2017—The language of blood banking experts, as they talk about irradiators, transfers easily to a car dealership. How reliable are the newer models? Are you willing to replace it every 10 years or so? Do you keep running it until it dies? What parts are likely to burn out? What will repairs run? And then the word “terrorism” pops up.
March 2017—Perhaps unusually for news about clinical diagnostics research, an article in the Feb. 7 issue of JAMA created a mild stir with findings that HbA1c results in patients with sickle cell trait, the most common hemoglobin variant in the U.S., may systematically underestimate past glycemia (Lacy ME, et al. 317:507–515).
March 2017—Something about having the letters “DNA” in a test’s name may make the test seem like the last word, the key to a black-and-white, definitive diagnosis. That connotation has been problematic for cell-free DNA sequencing used for noninvasive prenatal testing, because the test is not intended or designed for diagnosis, but only for screening. It’s for that reason, in fact, that some maternal-fetal medicine specialists and clinical geneticists prefer to use the term “noninvasive prenatal screening,” with the acronym NIPS.
March 2017—True, hemophilia is no longer commonly known as the “royal disease” (as it was when several generations of European rulers suffered from it). But in a January webinar, Dorothy M. Adcock, MD, gave some royally important suggestions regarding the laboratory diagnosis of hemophilia A and B.
March 2017—Anchor. Central pillar. Cornerstone. It would be hard to find a weighty synonym for “linchpin” that hasn’t been used to describe HbA1c’s role in diabetes diagnosis and management since 2010, when the assay was recognized by key standard-setting organizations as the equal of fasting glucose and oral glucose tolerance testing in diabetes and prediabetes testing.
March 2017—Testing for latent Mycobacterium tuberculosis infection and active tuberculosis disease remained relatively unchanged for many years. Screening for latent infection depended on an initial positive tuberculin skin test, and evidence for active TB required a positive culture for M. tuberculosis complex. New tests altered this picture in the past five years. For diagnosis of latent infection, interferon-gamma release assays have taken a major role. And nucleic acid amplification testing is becoming a mainstay for establishing a diagnosis of TB.
March 2017—Keep eyes wide open to everything and describe everything because there might be a number of different factors playing into a patient’s disease. That was the reminder Robert M. Najarian, MD, opened with last fall in his CAP16 presentation on common patterns of liver injury.
March 2017—Crystal Sands, MBA, MT(ASCP)SM, manager of quality, regulatory, and safety at NorDx Laboratories in Scarborough, Me., has a new favorite product, and she’s not shy about saying so. “Oh my gosh, I’ll be playing with it for a long time,” she says. “Every time I use it, I find different ways to slice and dice.”
February 2017—NGS has taken its NBS, or next big step: a newly published joint consensus guideline on how to interpret and report sequence variants in cancer. With these 20 pages of best practices for making next-generation sequencing a regular part of cancer diagnostics, the field is moving, essentially, from frontier town to gated community.
February 2017—It doesn’t happen often. But from time to time, says Gene Finley, MD, director of medical oncology at Allegheny Health Network in western Pennsylvania, a patient who is at death’s door will make such a dramatic recovery with therapy that clinicians refer to it as a “Lazarus effect.”