Combined Pathology-Driven Algorithmic Testing and Integrated Reporting for Bone Marrow Examination.

Context.--The College of American Pathologists published guideline recommending bone marrow synoptic reporting for hematologic neoplasms. Objective.--To evaluate the impact of pathology-driven algorithmic testing (PDAT) with integrated reporting for bone marrow examination on test utilization, abili...

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Published in:Archives of Pathology & Laboratory Medicine Vol. 143; no. 6; pp. 732 - 738
Main Authors: Pearson, Lauren N., Miller, Jill M., Lunde, John H., Bryant, Ronald J., Lewis, Michael R., Tang, Mary E.
Format: forms protocol research tables/charts Journal Article
Published: College of American Pathologists Jun2019
Online Access:View this record in EBSCOhost
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      dt: Jun2019
      vid: 143
      iid: 6
      pid: 2550
      pub: College of American Pathologists
      place: Northfield, Illinois
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        136682436
        136682436
        136682436
        10.5858/arpa.2018-0161-OA
        136682436
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        atl: Combined Pathology-Driven Algorithmic Testing and Integrated Reporting for Bone Marrow Examination.
      aug:
        au:
          Pearson, Lauren N.
          Miller, Jill M.
          Lunde, John H.
          Bryant, Ronald J.
          Lewis, Michael R.
          Tang, Mary E.
        affil: Department of Pathology and ARUP Laboratories, University of Utah, Salt Lake City
      sug:
        subj:
          Bone Marrow Examination Utilization
          Algorithms
          Pathology, Clinical
          Hematologic Neoplasms Diagnosis
          Hematologic Neoplasms Pathology
          World Health Organization
          Pathologists Psychosocial Factors
          Job Satisfaction
          Human
          Record Review
          Surveys
          Treatment Errors
          Hematologic Neoplasms Prognosis
      ab: Context.--The College of American Pathologists published guideline recommending bone marrow synoptic reporting for hematologic neoplasms. Objective.--To evaluate the impact of pathology-driven algorithmic testing (PDAT) with integrated reporting for bone marrow examination on test utilization, ability to render a specific World Health Organization diagnosis, and clinician satisfaction 1 year after implementation. Design.--We reviewed the hematopathology reports, integrated synoptic reports, and ancillary test results generated during a 12-month period. The initial diagnosis from the hematopathology report was compared with the final diagnosis on the integrated synoptic reports. Test utilization data were compared with a previous year in which ancillary testing was ordered at clinician discretion. Clinicians were anonymously surveyed to assess their satisfaction with PDAT and integrated reporting. Results.--Integrated reporting resulted in a World Health Organization diagnosis for 80 of 85 cases (94%) compared with 54 (64%) for the hematopathology report alone. Unnecessary testing decreased from 45% pre-PDAT (124 of 274 cases) to 0.7% PDAT (2 of 268 cases), and PDAT resulted in fewer omissions of necessary tests. Clinicians preferred PDAT and valued integrated reporting for a variety of reasons, including the ease of finding relevant prognostic information. Conclusions.--Pathology-driven algorithmic testing with integrated reporting improves the pathologist's ability to render a specific World Health Organization diagnosis and improves test utilization. Clinicians prefer PDAT to clinician-ordered testing. This is the first study to examine how synoptic reporting can modify hematologic diagnoses.
      pubtype: Academic Journal
      doctype:
        forms
        protocol
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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