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Test Utilization

Microbiology, Test Utilization

Helicobacter pylori Diagnosis – Serologic Testing is no Longer Recommended

Overview

Clinical guidelines no longer recommend serologic testing as a method for the diagnosis of H. pylori infection. Rather than IgG serology testing, other non-invasive testing methods such as H. pylori stool antigen and urea breath tests may be used to both diagnose and monitor response to therapy for H. pylori infection. In anticipation of an increase in stool antigen testing, currently a reference lab send-out test, Spectrum Health Regional Laboratory (SHRL) will be implementing this test as of October 29, 2018. By offering this test in-house, results will typically be available one day faster than present state. Continue Reading

Referral/Sendouts, Test Utilization

Anti-Thyroglobulin Orders Received in Conjunction with Thyroglobulin Tumor Marker Orders

Effective immediately, Anti-Thyroglobulin (Anti-TgAb) requests if received in conjunction with Thyroglobulin Tumor Marker (Tg-TM) requests, will be canceled. Tg-TM tests are sent to Mayo Medical Laboratory; where both Tg-TM and Anti-TgAb are performed and resulted as part of the Tg-TM order. This is a laboratory best practice as anti-thyroglobulin autoantibodies (Anti-TgAb), which occur in 15% to 30% of thyroid cancer patients, could lead to misleading Tg results (falsely positive or falsely negative).

Questions may be directed to Dr. David Alter, using the “Contact Us” link above.

Microbiology, Test Utilization

Influenza Epidemic Testing Recommendations 2018

Influenza is currently widespread throughout the nation at epidemic proportions. During influenza epidemics, clinical assessment predicts the presence of influenza infection virtually as well as laboratory testing. Therefore, it is no longer necessary to perform viral testing on ambulatory patients who present with illness consistent with influenza before beginning antiviral treatment. Antiviral treatment for Influenza should be started as soon as possible to have a beneficial effect.

Shortages of supplies and medications frequently occur during Influenza epidemics. However, diagnosis of specific viral respiratory infection remains important for hospitalized patients.

Please follow the current recommendations:

  • Limit availability of viral transport media at ambulatory sites.
  • Emergency departments are to limit viral respiratory testing to patients expected to be admitted.
  • Do not perform testing for test of cure.

Thank you for your support during this time. Please direct any questions to Laboratory Services via the “contact us” link above.

Immunochemistry, Test Utilization

Test Utilization: Cardiolipin Antibody Testing

Listed below are the Cardiolipin Antibody tests available in the Spectrum Health Regional Laboratory (SHRL) catalog. Please review the tests and the recommended test utilities.

Cardiolipin IgA testing should not be ordered unless the patient is negative for IgM and IgG. It should be restricted to very specific clinical scenarios for the evaluation of patients with suspected APS (Antiphospholipid Antibody Syndrome). Cardiolipin IgA requests will be reviewed for presence or absence of IgM/IgG testing.

Questions may be directed to Dr. David Alter by using the contact us link above.

General Information, Test Utilization

Discontinuation of Custom Reflexes

Effective November 5, 2017, Spectrum Health Regional Laboratory will no longer be able to support custom reflex orders. Only reflexes that are defined in our Mandatory and Optional Reflex Testing list will be supported. These reflexes have been approved by our Pathologists, PhD’s and the Spectrum Health Medical Executive Committee. On November 5th, we will be undergoing a system change to Epic and with our new Laboratory Information System (LIS), custom requests for reflexes will not be available. Continue Reading

Microbiology, Test Utilization

Spectrum Health Regional Laboratory Discontinues Influenza Rapid Antigen Testing

There has been a minor change to the influenza testing methods performed by the Spectrum Health Regional Laboratory (SHRL) to improve the accuracy and timeliness of patient results, while simplifying the ordering process for providers. In past years during respiratory illness season, the lab performed influenza rapid antigen testing due to its low cost and rapid turnaround time, with negative specimens reflexed to PCR for confirmatory testing. Approximately 85% of specimens tested by a rapid antigen method typically reflexed, with those patients charged for performing both tests. Continue Reading

Microbiology, Referral/Sendouts, Test Utilization

New Test: Streptococcus pneumoniae Urine Antigen

As of July 11, 2017, Spectrum Health Regional Laboratory will offer Streptococcus pneumoniae urine antigen testing. This testing is currently sent to Mayo Medical Laboratories. By bringing testing in-house, result turnaround time will be improved by 1 day, testing will be available 7 days per week (instead of Monday – Friday), and testing can be offered at a reduced charge to our patients. Continue Reading

Microbiology, Test Utilization

Test Name Change: Throat Culture Comprehensive

On June 27th, the name of the current order “Respiratory (non-sputum) Culture without Gram stain” will change to “Throat Culture Comprehensive.” All other specimen collection details and culture workup will remain the same. Given the fact that there are currently several similarly named tests, this change is being made to reduce confusion regarding test selection and to clarify acceptable specimen types. Continue Reading