Data-Driven Iterative Refinement of Bone Marrow Testing Protocols Leads to Progressive Improvement in Cytogenetic and Molecular Test Utilization.
Objectives: To determine the effect of iterative refinement of standard ordering protocols on test utilization and results for bone marrow biopsy specimens.Methods: Eighteen months of test utilization and result data were used to revise the protocols that determine cytogenetic and molecular test sel...
| Publicado en: | American Journal of Clinical Pathology Vol. 146; no. 5; pp. 585 - 594 |
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| Autores principales: | , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Oxford University Press / USA
Nov2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=120294151&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 120294151 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00029173 2RW jtl: American Journal of Clinical Pathology issn: 00029173 maglogo: N pubinfo: dt: Nov2016 vid: 146 iid: 5 pid: 10398 pub: Oxford University Press / USA artinfo: ui: 120294151 120294151 NLM27769956 120294151 10.1093/ajcp/aqw180 NLM27769956 120294151 ppf: 585 ppct: 9 formats: tig: atl: Data-Driven Iterative Refinement of Bone Marrow Testing Protocols Leads to Progressive Improvement in Cytogenetic and Molecular Test Utilization. aug: au: Seegmiller, Adam C. Kim, Annette S. Mosse, Claudio A. Shaver, Aaron C. Thompson, Mary Ann Shaoying Li Head, David R. Zutter, Mary M. Li, Shaoying affil: Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, TN sug: subj: Practice Guidelines Bone Marrow Pathology Bone Marrow Neoplasms Diagnosis Medical Practice, Evidence-Based Pathology, Molecular Statistics and Numerical Data Hematology Costs and Cost Analysis Bone Marrow Neoplasms Pathology Genetics Statistics and Numerical Data Genetics Economics Human Pathology, Molecular Economics Bone Marrow Neoplasms Biopsy Pathology Validation Studies Comparative Studies Evaluation Research Multicenter Studies ab: Objectives: To determine the effect of iterative refinement of standard ordering protocols on test utilization and results for bone marrow biopsy specimens.Methods: Eighteen months of test utilization and result data were used to revise the protocols that determine cytogenetic and molecular test selection on bone marrow specimens and then compared with data obtained following protocol revision.Results: Revision of protocols resulted in reduction in total tests and associated charges, due to a decrease in tests both concordant and discordant with the protocols. These reductions only occurred in diseases for which revisions were made and were limited to cases in which reflex testing was performed. There was an increase in the fraction of positive tests, which was also limited to reflex testing.Conclusions: Data-driven iterative revision of protocols further improves test utilization and performance, while reducing cost. Analysis of testing data can be used to continuously improve test ordering decisions. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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