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Devices, decisions: POC glucose in the critically ill

January 2018—Using point-of-care glucose meters in critically ill patients can feel like tiptoeing through a regulatory minefield. Perhaps your preferred meter hasn’t been cleared by the FDA for use in this population. Or maybe you’re not sure which assay performance requirements should be regulating the performance of your meters. Or perhaps you’re still trying to define “critically ill.”

Lab needs driving coagulation analyzer market

January 2018—Customer wish lists help to define every generation of coagulation analyzers, test menus, and related technologies. That’s evident in the recent and upcoming launches and the ongoing work of the companies whose analyzers are profiled in this issue in the 2018 coagulation analyzer product guide.

AABB seeks comments on form to streamline transfusion adverse reaction reporting

January 2018—The AABB is seeking comments by March 30 on its common transfusion reaction reporting form, the seven pages of which are presented online at The fillable PDF form is intended to be used by hospitals and blood centers to communicate information about transfusion reactions to the blood supplier, particularly when there are multiple suppliers to the hospital transfusion service.

Cytopathology in focus: A right and a wrong way to use CAP educational kits

January 2018—The CAP Cytopathology Committee constructs educational and interlaboratory comparison kits that are distributed regularly to cytotechnologists, cytopathologists, and pathologists who want continuing education in cytopathology. The purpose of the kits is to make it possible for those who screen and diagnose cytology slides to maintain and update their skills. However, the Cytopathology Committee has been made aware that the kits have been employed for purposes other than education. We address here the potentially detrimental uses to which some laboratories are putting these educational kits and advise laboratories to use them only as they were intended.

Cytopathology in focus: Pap proficiency testing: what’s permitted, what’s not

January 2018—Annual proficiency testing is mandated for all cytotechnologists and pathologists who sign out Pap tests. CAP staff frequently receive questions about the PT rules or hear of situations in which there was confusion about the rules, a few of which we will highlight here.

Cytopathology in focus: HPV vaccines: the decade in review

January 2018—Diane Harper, MD, MPH, and Leslie DeMars, MD, provide an extensive review of the efficacy of available FDA-approved HPV vaccines in different age groups and describe immunogenicity findings in particular (Gynecol Oncol. 2017;146:196–204). The World Health Organization and the Centers for Disease Control and Prevention recommend a two-dose vaccine for younger children due to high rates of seroconversion and antibody titers in this age group. Girls age 15 and older should continue to get three doses.

Hopes, fears as users switch to new troponin

December 2017—The questions that arise over the use of highly sensitive cardiac troponin are as riveting as, if less historically fraught than, the Jefferson-Hamilton debates over the shape of their newborn country. Who should lead—the states or a strong central government? Cardiologists or the emergency department? What cutoffs represent the right balance between admissions, referrals, and sending patients home? And will Lin-Manuel Miranda ever write a smash musical about this cardiac assay?

In hemostasis, two hot-button testing issues

December 2017—Having validation data to support the use of age-adjusted D-dimer cutoffs with the D-dimer assay your laboratory uses is a must, and know well the limitations of point-of-care prothrombin time/INR testing. That advice and more was shared in a “Hot Topics in Hemostasis” session at CAP17, presented by Russell Higgins, MD, and Karen Moser, MD.

‘Connectathon’ opens door to interoperability in digital pathology

December 2017—With the FDA having approved whole slide imaging for primary diagnosis this year, one obstacle to full acceptance of digital pathology remains: lack of interoperability. To topple that barrier, the Digital Pathology Association, the CAP through its Digital Pathology Committee, and DICOM Working Group 26 convened in October, during the Pathology Visions conference, the first Connect­athon for digital pathology.

HbA1c shows its mettle in predicting diabetes risk

December 2017—The longitudinal Framingham Heart Study, which first identified the concept of risk factors and made serum LDL cholesterol a household name, could help increase the celebrity status of HbA1c, with the Oct. 26 publication of a new study in Diabetes Care. International and national organizations since 2010 have recognized HbA1c as a valid way to diagnose abnormalities in glycemia and diabetes mellitus. But there has been less consensus on its use as a screen for elevated diabetes risk.