Browsing Tag

Internal Medicine

Test Utilization

Influenza Testing Update: April 2024

This winter, West Michigan influenza infections peaked in February 2024 and significantly declined throughout March and April 2024. Now with a low prevalence of circulating influenza, using the most sensitive diagnostic test is recommended in order to obtain accurate and actionable results. Influenza antigen testing (e.g. Sofia instrument) is no longer appropriate at this time and Influenza PCR testing should be ordered when clinically indicated.

 

Low Influenza
Prevalence
High Influenza
Prevalence
Recommended Order Influenza PCR (LAB3255) Influenza antigen testing (e.g. Sofia instrument)
or
Influenza PCR (LAB3255)

More detailed information can be found as published by the CDC:

Algorithm to assist in the interpretation of influenza testing results and clinical decision-making during periods when influenza viruses are NOT circulating in the community, and in previous lab newsletters: Influenza Diagnosis and Test Utilization

Chemistry, Referral/Sendouts

Hepatitis A IgG Antibody Discontinued

Effective Thursday, April 18, 2024, Corewell Health Laboratory will discontinue the send out test Hepatitis A IgG Antibody, Serum (Mayo Test ID: HAIGG). This test has been made obsolete by Mayo Clinic Laboratories. We recommend to our healthcare providers the following in-house testing:

1.Hepatitis A Total Antibody (LAB1230596): intended for the clinical laboratory diagnosis of acute or past hepatitis A virus infection in persons with signs or symptoms of hepatitis and in persons at increased risk for hepatitis A infection, to identify HAV susceptible individuals and to determine the presence of an antibody response to HAV in vaccine recipients.

2.Hepatitis A Antibody, IgM (LAB7980): intended for use as an aid in the laboratory diagnosis of an acute or recently acquired hepatitis A virus infection.

Continue Reading

Compliance & Safety, Cytology, General Information

Resolved: HPV Error 3/17/2024

This issue is resolved. It was identified as an issue within Corewell Health Epic Preference Lists. If you are still encountering issues, please reach out to Service Now. This post will be archived in 7 days.

Due to an error from our system changes that happened on Sunday, March 17, 2024, the HPV reflex on the Pap testing orderable is not reflexing appropriately based on ASCCP Guidelines.

The Cytology Laboratory (Corewell Health Reference Laboratory West) and our Digital Services teams are aware of the error and working on a solution to correct the missed HPVs that were processed this week.  As the correction may cause a slight delay in HPV results, please hold add-on requests for HPV until Friday (3/29).  If you are concerned about an HPV being missed after this date (3/29/24), please fill out an Add-On form and fax to the number on the form (Note: Pap Specimens are held for 30 days).

We apologize for any inconvenience and confusion. If you have any further questions or concerns, please use the contact us link above.

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

 

Continue Reading

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 

Continue Reading