Browsing Tag

Pediatrics

Compliance & Safety, Education & Training, General Information, Referral/Sendouts

Chlamydia and Gonococcus Testing on Pediatric Patients

Spectrum Health Regional Laboratory is not validated to perform Chlamydia and Gonococcus testing on pediatric patients under the age of 14 years old. Testing for these patients must be sent to a reference laboratory. Please order a Reference Miscellaneous Test (#LAB848) and indicate complete test name when ordering. 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, 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

Immunochemistry, Test Utilization

Utility of specific IgE (sIgE) testing to foods and food allergen components

The diagnostic evaluation of allergic disease occurs in the context of a patient’s complete clinical presentation. Important factors include, age, clinical signs and symptoms, relevant allergen exposures, and the performance characteristics (sensitivity, specificity, and predictive values) of the allergy tests themselves. Allergy tests yield information about sensitization to allergens, which is not always equivalent to allergic hypersensitivity (i.e., sensitivity); thus, interpretation in the context of clinical history is essential for accurate diagnosis. Continue Reading

Hematology, Test Utilization

Pathologist Review – Reason for Review

Pathologist review of peripheral blood smear (#8367) will have an additional required field to complete upon ordering. We are striving to improve our test utilization, inter-provider communication, and accurate and timely result reporting. Providers will see a choice of the top 10 to 15 reasons for review, including such reasons as “anemia evaluation” and “look for blasts”. An option for “other, see comment” is available for any free text comments to the pathologist.

This change is anticipated to begin for all electronic ordering of this test on February 4, 2016

Any questions concerning these changes may be directed to Dr. Jennifer Stumph, Director of Hematology.

Chemistry, Referral/Sendouts, Test Utilization

Appropriate Thyroglobulin Tumor Marker and Anti-Thyroperoxidase Ordering Practices

Thyroid Peroxidase Antibody (anti-TPO), Blood Level (Test #8524 )
This is the recommended test for the evaluation of Autoimmune Thyroiditis

Thyroglobulin, Tumor Marker, Serum (Test #3069)
It is only indicated for monitoring of thyroid cancer treatment.
This result is reported with an Anti-Tg result to assess for possible interference.
This test should NOT be ordered for associated anti-Tg result provided by reference laboratory.

Thyroglobulin Antibody (anti-Tg) Test
Historically ordered with anti-TPO for evaluation of possible autoimmune thyroiditis.
The literature shows that anti-TPO, alone, has better sensitivity and specificity with only 5% of cases of Autoimmune thyroiditis with anti-TPO negative, anti-Tg positive.
Since 2/2011, requests for anti-Tg have been cancelled per Laboratory Communication: Memo Thyroglobulin Antibody 2/2011

Spectrum Health Regional Laboratory Experience February 2015 – March 2016 (13 months):
357 patients with both Anti-TPO and Anti-Tg results.
*Anti-Tg results were due to concomitantly ordered Thyroglobulin TM requests.
250 patients had positive Anti-TPO and/or Anti-Tg level
193 patients had both positive Anti-TPO and Anti-Tg level
56 patients had positive Anti-TPO and negative Anti-Tg level
1 patient had a negative Anti-TPO and positive Anti-Tg levels

Based on these results, and what is reported in the literature, we are confident of our current practices and strongly request discontinuation of Thyroglobulin TM requests for the associated Anti-Tg result

Caturegli P, De Remigis A, Rose NR. Hashimoto thyroiditis: clinical and diagnostic criteria. Autoimmun Rev. 2014 Apr-May;13(4-5):391-7