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Test Utilization

Education & Training, General Information, Test Utilization

Thyroid Disease Awareness Month

Written by Yasel Fleitas Alvarez, Ph.D., Chemistry Clinical Advisor, Corewell Health Reference Laboratory West, Michigan Pathology Specialists.

This January we are celebrating the National Thyroid Awareness Month. In United States of America, it is estimated that approximately 20 million people have thyroid disease and most importantly, according to the American Thyroid Association (ATA) as many as 60% of people suffering from a thyroid disorder are not aware they have it.The thyroid is a butterfly shaped-gland located at the front of the neck that produces and release thyroid hormones (See Figure 1).

Figure 1. Thyroid Gland Anatomy and Histology

 

It regulates important physiological functions as:

    • Breathing
    • Heart rate
    • Energy production
    • Muscle strength
    • Body temperature
    • Weight
    • Mood

Thyroid disease can present in two main forms:

  1. Hypothyroidism (under functioning thyroid)
  2. Hyperthyroidism (over functioning thyroid)

Confirmation or exclusion of thyroid disease requires a clinical examination combined with biochemical determination of thyroid hormones (TH) and thyrotropin (TSH)concentrations.

In this blog we discuss the best practices for ordering thyroid function tests for the initial screening of thyroid disease at Corewell Health.
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Compliance & Safety, Referral/Sendouts, Test Utilization

Reminder: Send Out Referral Testing Notice

As a reminder, referral testing, tests that are sent to another laboratory to perform, is dependent on the weather. Inclement weather can affect both the turnaround time of testing, and the testing capabilities of the organization. Our referral testing is dependent on outside transportation facilities (such as FedEx and UPS). When those organizations face challenges in weather, our testing capabilities must remain flexible. 

If there is inclement weather in and around Memphis, TN (the main FedEx hub), there may be delays and cancellations of testing. We will try our best to communicate these changes as soon as possible via our blog: https://lab.spectrumhealth.org/

For any questions or concerns please “Contact Us” via the link above. 

Test Utilization

Influenza Testing Recommendation (December 2023)

Influenza cases numbers are currently increasing throughout West Michigan. Influenza prevalence guides the most appropriate testing approach and sufficient prevalence has now been reached for influenza rapid antigen or point of care testing (e.g. Sofia instrument) to have improved performance. The use of point of care testing as a screening method during high prevalence reduces both the cost to the patient and turn-around-time as compared to lab-based molecular methods. Point of care tests generally have high analytical specificity, but lack the sensitivity of nucleic acid amplification methods (e.g. PCR). For this reason, PCR testing is still recommended for hospitalized patients and for outpatients with a negative result if influenza is still suspected and if the result will impact clinical decision making.

Low influenza prevalence High influenza prevalence
Recommended order Influenza PCR  Influenza Point of Care Testing
or
Influenza PCR 

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Test Utilization

Test Update: Chlamydia Culture Discontinued

Effective September 13, 2023, Corewell Health Laboratory will discontinue the Chlamydia Culture orderable. For patients 14 years of age and older, please order Chlamydia PCR.

• This specimen can be either a swab (genital, rectal, or throat) or a urine sample.
• The collection container is the STD-Multi-Collection Kit.
• For more information please visit: Chlamydia PCR

For patients that are under 14 years of age, a “Reference Miscellaneous Test” [LAB 848], must be ordered.

• This specimen can be either a swab (genital, rectal, or throat) or a urine sample.
• The collection container is the Aptima
• For more information please visit: APTIMA Chlamydia, NAAT, ThinPrep, Swab, Urine

As a reminder, PCR testing is also preferred for gonorrhea, when the specimen types are compatible. Continue Reading

Referral/Sendouts, Test Utilization

Test Update: COVID-19 Total Antibody Discontinued

Effective August 30, 2023, the COVID-19 Total Antibody test, which includes the qualitative detection of spike and nucleocapsid antibodies against COVID-19, will be discontinued as an orderable test at Corewell Health West Laboratories. Symptomatic patients suspected to have acute COVID-19 infection should be tested using a molecular assay.

To aid in the clinical diagnosis of multisystem inflammatory syndrome in children or adults (MIS-C or MIS-A), the COVID-19 IgG, Qualitative by CIA will be available as a send out test. This test is a qualitative detection of IgG antibodies against the nucleocapsid protein of COVID-19 that develop in response to natural infection with COVID-19. This test is performed on Monday, Wednesday, and Fridays, and reported within 1-5 days. Continue Reading

Education & Training, General Information, Immunochemistry, Test Utilization

Webinar: Optimizing Care of the Respiratory Patient – The Role of Specific IgE Testing

It’s the season of sunshine and blooms which also means it can be a season of sneezing, itching, and a lot of trouble getting a good breath in for some.

⇒Are you prepared to meet the needs of your patients that may be suffering from some of these symptoms?
⇒Are you well versed in the difference between a sensitivity and a clinical allergy and how you can differentiate between the two?
⇒Do you know the resources we have at Corewell Health to assist in these determinations? Continue Reading

Test Utilization

Test Update: Pathologist Reviews

The test Pathologist Review Peripheral Smear [LAB7550] will become a lab only orderable in the near future. Effective, Monday, May 1, 2023, all provider ordered pathology smear reviews on outpatients will be cancelled by the hematopathologist.  If a pathologist interpretation of the blood smear is still desired, please order a Pathology Consult [LAB1230850], ask for a “general pathology consult” and indicate your question for the pathologist who will be interpreting the blood.

For Corewell Health West Epic Providers (Epic Hyperspace, Epic Community Connect and Epic Care Link) a tip sheet is available for ordering in Epic. If you cannot access the tip sheet or have further questions, please use the contact us link above.

TEST INFORMATION:

Pathology Consult [LAB1230850]

Pathologist Review Peripheral Smear (lab only orderable) [LAB7550]