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Family Medicine

Chemistry

Anion Gap Reference Range Update

Effective February 7, 2024, at 7:30 AM, Corewell Health West Laboratories will go live with a new reference range for the calculated Anion Gap (AG). The AG reference range will be adjusted to align with recent reference range studies.

The following will be the new normal reference ranges for AG:

Anion Gap: 5 – 14 mmol/L

 

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Immunochemistry, Main lab

Update in Testing Platform – Immunochemistry

As of January 26, 2024, for the following tests, the testing platform has changed from EliA Fluorescence Enzyme Immunoassay (FEIA) from Thermofisher to Multiplex Flow Immunoassay from Biorad. Please review the lab catalog for any changes to collection information or reference ranges.

• Anti-dsDNA Antibody
• Cyclic Citrullinated Peptide (CCP) Antibody
• Celiac Antibody Cascade
• Tissue Transglutaminase Antibody
• Gliadin Antibodies Continue Reading

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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General Information

Outpatient Lab Draw Site Updates

Effective Monday, October 2, 2023, the Outpatient Lab Draw Sites in Kent, Ottawa, and Muskegon counties (excluding the Zeeland Hospital and Gerber Hospital sites) will begin a new process for walk-in patients.

Registration staff will begin informing the patient of their wait times based on the scheduling template available for that site for that day. This will allow the patient to make an informed decision on whether to wait, come back at a later time, or schedule an appointment time that works best for them. Patients choosing to schedule, may schedule for any available sites, times and dates in MyChart, or they may schedule with the registrar for the next 24-48 hours.  (Note: lab staff does not have the ability to schedule patients.)

Additionally, at this time, Blodgett Outpatient Lab is temporarily closed until further notice. Sites closest to Blodgett are the Integrated Care Campus at 426 Michigan St NE, 4100 Lake Drive, and Integrated Care Campus at 2750 East Beltline, or patients may visit Find a Doctor | Corewell Health to find a lab location nearest to them.

 

Microbiology

Test Update: Influenza Rapid and RSV Rapid Tests Discontinued

Effective October 3, 2023, Corewell Health Laboratories will discontinue the Influenza Rapid and Respiratory Syncytial Virus (RSV) Rapid tests. These antigen tests are less sensitive than the nucleic acid amplification tests (NAAT; such as PCR) that are now the standard of care for diagnosing these respiratory viruses. Specimen collection remains unchanged with PCR testing available for nasopharyngeal and nasal swabs collected in a universal transport media (UTM) tube.

Discontinued:

• Influenza (Flu) A/B Rapid – Epic Code: LAB9240
• Influenza (Flu) A/B Rapid, Influenza A/B PCR if Negative – Epic Code: LAB2111530
• Respiratory Syncytial Virus (RSV) Rapid – Epic Code: LAB495

Replace with:

• Influenza (Flu) A/B PCR – Epic Code: LAB3255
• COVID-19, Influenza A/B, RSV PCR – Epic Code: LAB1230746

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