Obstetrics & Gynecology
The most conclusive evidence for using thyroid peroxidase antibody (TPO) is predictive in nature when evaluating possible subclinical hypothyroidism. If this test is positive, hypothyroidism occurs at a rate of 4.3% per year versus 2.6% per year when the antibody is negative. While this scenario does not cover all clinical indications for ordering TPO, there is no definitive evidence that repeat TPO testing provides additional information.1
Based on this information the ordering of TPO within Spectrum Health is being modified. If the test is ordered more than once on a patient, a screen will appear in EPIC indicating the following: “This test should typically only be resulted once per lifetime. The duplicate checking indicates that this patient has already had this testing performed. Please see chart review for results.” This is not a “hard stop” but providers will need to click “Continue” to proceed with the order.
As of November 25th 2019 the following tests for Herpes Simplex Virus (HSV) IgM antibody testing will be obsoleted.
Herpes IgM Antibody Screen – LAB3576
Herpes Simplex Panel – LAB1230539
Effective Wednesday, November 13, 2019, the new Mycoplasma genitalium (mgen) assay is now available using the Aptima target nucleic acid amplification test (NAAT) for the qualitative detection of ribosomal RNA (rRNA) from Mycoplasma genitalium to aid in the diagnosis of M. genitalium urogenital infections in male and female patients.
Effective November 5th, testing for Beta-2 Glycoprotein 1 antibodies (IgG and IgM, serum) will change from a reference send out test to Mayo Medical Laboratories to an in-house test available at Spectrum Health Laboratories. This testing is useful for evaluation of patients of suspected antiphospholipid antibody syndrome.
In addition, a new Antiphospholipid Antibody Syndrome Panel will be added which allows for appropriate and complete testing for antiphospholipid antibody syndrome. This panel includes:
Cardiolipin IgG and IgM Antibodies
Beta-2 Glycoprotein 1 IgG and IgM Antibodies
Effective September 1, 2019, the test Drug of Abuse Screen, Pain Clinic, Urine will be discontinued.
Earlier this year, Spectrum Health Regional Laboratory – Toxicology announced two new drug screen panels, Urine Drug Screen with Confirmation (23 Targets) and Urine Drug Screen with Confirmation (32 Targets) as replacement tests. For more information regarding these new tests please reference this post.
Effective immediately, the OB Magnesium (Mg) reference range has been updated from 1.6 to 2.5 mg/dL to 4.8 to 8.0 mg/dL, to reflect the correct therapeutic range for patients receiving magnesium sulfate therapy. The non-OB magnesium reference range is unchanged.
Please direct questions and inquiries to Dr. Jennifer Stumph via the Contact Us link above.
OB Magnesium, Blood Level – Epic code #LAB3400, Interface code #11703, CPT code #83735