Abstract:
OBJECTIVES:Many nonpathologists and some pathologists consider utilization review essential to laboratory quality improvement, but (1) confusion surrounding the definition of "appropriate" laboratory utilization, (2) the reliance on manual chart review, and (3) a lack of leadership have contributed to its unstandardized implementation. How the solutions to these barriers have evolved since the 1950s is described. METHODS:A systematic literature review is used. RESULTS:Current literature largely defines inappropriate laboratory utilization as any test order in violation of a guideline produced by a government or professional society. Audits performed without manual chart review (ie, database query) have dramatically increased since the mid-1990s. Most utilization audits do not involve any author with a pathology or laboratory medicine affiliation. CONCLUSIONS:Literature consensus defining "inappropriate" utilization combined with the adoption of database technology has removed key obstacles to utilization reviews. Leadership is needed to unify and benchmark laboratory utilization.
journal_name
Am J Clin Patholjournal_title
American journal of clinical pathologyauthors
Hauser RG,Shirts BHdoi
10.1309/AJCPX1HIEM4KLGNUsubject
Has Abstractpub_date
2014-06-01 00:00:00pages
774-83issue
6eissn
0002-9173issn
1943-7722pii
AJCPX1HIEM4KLGNUjournal_volume
141pub_type
杂志文章,评审abstract:Objectives:Approximately 15% of breast cancers show equivocal human epidermal growth factor receptor 2 (HER2) results on HER2 immunohistochemistry (IHC) and are reflexed for fluorescence in situ hybridization (FISH). However, some cases remain equivocal. In this study, we evaluated these double-equivocal cases by using...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/aqw211
更新日期:2017-01-01 00:00:00
abstract::To improve the positive predictive value (PPV) for high-risk human papillomavirus (HR-HPV) in primary screening, DNA ploidy was measured on the same liquid-based sample by image cytometry in 984 cases showing discrepancies between cytology and HR-HPV testing. Of the conflicting results, 14.5% corresponded to a cytolog...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1309/6NXC-V9XD-YM87-8FAE
更新日期:2002-11-01 00:00:00
abstract::Neoplastic transformation of epithelial cell sis commonly associated with altered synthesis of mucin glycoproteins. Few studies have been performed on the correlation between MUC 1 expression and pancreatic carcinoma using immunohistochemical methods. We compared the patterns of MUC 1 expression in normal pancreatic t...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/112.5.635
更新日期:1999-11-01 00:00:00
abstract::In the thymus, the relationship between lymphofollicular hyperplasia and mucosa-associated lymphoid tissue (MALT)-type lymphoma is uncertain. We analyzed 14 cases with a diagnosis of thymic follicular hyperplasia in patients with connective tissue disease (n = 2), myasthenia gravis (n = 11), or both (n = 1). In 11 cas...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1309/G3AC-P7K8-2JNK-8C3U
更新日期:2002-01-01 00:00:00
abstract::Gastric intraepithelial neoplasia (IEN; formerly dysplasia) is an advanced precancerous lesion. Lesions indefinite for IEN mimic the IEN phenotype but lack some morphologic attributes of IEN. Indefinite for IEN lesions may arise in native foveolae (atypical foveolar hyperproliferation [aFH]) or intestinalized glands (...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1309/AJCPEU41HTGXSJDQ
更新日期:2012-05-01 00:00:00
abstract::We studied the presence of surfactant protein A (Sp-A) immunoreactivity and messenger RNA in 62 normal and abnormal breast samples. Sections were immunostained with polyclonal anti-Sp-A antibody. The association between Sp-A immunoreactivity and histologic grade of 32 invasive ductal carcinomas was assessed by 3 patho...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1309/DU7F-XYP8-1DF6-WM9E
更新日期:2001-11-01 00:00:00
abstract::Two hundred forty-three patients who had pathologically verified primary osteosarcomas of bone, treated at The University of Texas System Cancer Center, M. D. Anderson Hospital and Tumor Institute over a 24-year period, form the basis of this study. These cases provide a basis for comparison of those patients currentl...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/67.5.427
更新日期:1977-05-01 00:00:00
abstract::Eosinophils are normally absent from the urine. Their presence has been associated with a variety of clinical conditions affecting the kidney or urinary tract. The authors examined the clinical significance and eosinophils, in particular, for acute interstitial nephritis. ...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/88.4.520
更新日期:1987-10-01 00:00:00
abstract:Objectives:To analyze interobserver reproducibility and compare practice patterns between academic and community settings of Lower Anogenital Squamous Terminology (LAST). Methods:In total, 132 anal biopsy slides were revised as well as p16 immunostains. Results:LAST was used in 49% of cases (academic center, 68%; sat...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/aqx044
更新日期:2017-07-01 00:00:00
abstract::Thirty drugs used primarily in critical care and hospital settings were tested in vitro to observe interference on glucose measurements with 6 hand-held glucose meters and a portable glucose analyzer. Paired differences of glucose measurements between drug-spiked samples and unspiked control samples were calculated to...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1309/QAW1-X5XW-BVRQ-5LKQ
更新日期:2000-01-01 00:00:00
abstract::Following normalization of blood glucose levels, a marked change in the MCV and in the calculated hematocrit was observed in five patients with transient severe hyperglycemia. The addition of varied concentrations of glucose to blood samples from healthy volunteers and from patients with microcytic, macrocytic, and no...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/77.5.561
更新日期:1982-05-01 00:00:00
abstract:OBJECTIVES:B-lymphoblastic leukemia (B-LBL) arising in patients with chronic lymphocytic leukemia (CLL) is exceedingly rare and poorly characterized. METHODS:We describe four patients with CLL and concurrent or subsequent B-LBL diagnosed by morphologic, immunophenotypic, cytogenetic, and molecular analysis and reviewe...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1309/AJCPXE5VMONMVLZ0
更新日期:2015-08-01 00:00:00
abstract::To study the usefulness of calretinin as an immunohistochemistry marker in the diagnosis of cardiac myxoma (CM) and the origin of myxoma cells, we examined 24 CMs and 9 fetal hearts with immunohistochemical methods on formalin-fixed paraffin-embedded tissues. We compared 24 CMs with 10 mural thrombi, 6 jaw myxomas, an...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1309/NR6G-T872-F090-LBRW
更新日期:2000-11-01 00:00:00
abstract::A number of variables thought to affect measurement of prothrombin time (PT) and partial thromboplastin time (PTT) were examined in an effort to determine more precisely their effects on these measurements. On the basis of these studies, it is proposed that blood specimens be anticoagulated with one part 3.8% (w./v.) ...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/64.5.591
更新日期:1975-11-01 00:00:00
abstract::A case of metastatic squamous cell carcinoma to bone was studied using immunoperoxidase methods for Factor VIII-related antigen, producing positive staining in the tumor cells. Electron microscopy proved the squamous nature of the tumor, and, subsequently, a pulmonary primary tumor was found. Testing of additional tum...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/81.1.117
更新日期:1984-01-01 00:00:00
abstract::The Society for Hematopathology and European Association for Haematopathology workshop, from October 27 to 29, 2011, in Los Angeles, CA, exhibited many exemplary skin biopsy specimens with interesting inflammatory changes mimicking features of cutaneous lymphoma. This article reviews features observed in cutaneous lym...
journal_title:American journal of clinical pathology
pub_type: 共识发展会议,杂志文章
doi:10.1309/AJCPX4BXTP2QBRKO
更新日期:2013-04-01 00:00:00
abstract::A murine monoclonal antibody (MAb 12C3) that is specific to human ovarian carcinomas was generated by immunizing mice with a human ovarian germinoma cell line (JOHYC-2). The antigen distribution that was defined by MAb 12C3 in normal and malignant human tissues was analyzed by immunohistochemistry on paraffin-embedded...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/103.3.288
更新日期:1995-03-01 00:00:00
abstract::The ATHENA (Addressing THE Need for Advanced HPV Diagnostics) HPV study evaluated the clinical usefulness of the cobas HPV Test (Roche Molecular Systems, Pleasanton, CA) for high-risk human papillomavirus (HR-HPV) testing (14 HR types) and individual HPV-16/HPV-18 genotyping in women undergoing routine cervical cytolo...
journal_title:American journal of clinical pathology
pub_type: 临床试验,杂志文章
doi:10.1309/AJCPTUS5EXAS6DKZ
更新日期:2011-10-01 00:00:00
abstract::Reports of sex steroid receptor expression in chordoma suggest that these tumors may be responsive to hormone manipulation therapy. Immunohistochemical stains for estrogen receptor (ER)-alpha, ER-beta, progesterone receptor (PR), androgen receptor (AR), and cyclooxygenase 2 (COX-2), were performed on a tissue microarr...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1309/8T2NPHLK5X5WQ3E7
更新日期:2007-09-01 00:00:00
abstract::The Travenol Hem-O-Scan and the Instrumentation Laboratory (IL) system for determination of the oxygen dissociation curve and P50 values have been evaluated. Using the Hem-O-Scan, an oxygen dissociation curve and P50 value may be obtained on 2 microliter of blood in 40 min, though the pH is not measured. In the IL sys...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/75.3.395
更新日期:1981-03-01 00:00:00
abstract::We tested the hypothesis that extensively keratinized squamous intraepithelial lesions (SILs) are difficult to grade precisely by identifying 100 Papanicolaou smears with a keratinizing SIL that had been originally judged difficult to grade. Of these, 65 were confirmed as low-grade SIL (LSIL) or high-grade SIL (HSIL) ...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1309/RQBN-Y51J-CJTK-P9H5
更新日期:2001-01-01 00:00:00
abstract:Objectives:To evaluate the prevalence of potentially unnecessary repeat testing (PURT) and the associated economic burden for an inpatient population at a large academic medical facility. Methods:We evaluated all inpatient test orders during 2016 for PURT by comparing the intertest times to published recommendations. ...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/aqy020
更新日期:2018-05-31 00:00:00
abstract::In a case of secondary syphilis with gastric involvement, the clinical history and roentgenographic and gastroscopic examiniations initially suggested an infiltrative malignant neoplasm. However, macroscopic and histologic examination of the partial gastrectomy specimen demonstrated an erosive, inflammatory lesion. Su...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/63.6.895
更新日期:1975-06-01 00:00:00
abstract::We analyzed the diagnostic role of claudins in effusion cytology in 325 effusions, including 218 ovarian, 49 breast, 15 cervical or endometrial, 10 gastrointestinal, and 8 lung adenocarcinomas and 25 malignant mesotheliomas (MMs). Specimens were analyzed for claudin-1 and claudin-3 expression using immunohistochemical...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1309/V025QRN3R9CJGNPX
更新日期:2007-06-01 00:00:00
abstract::Three brands of blood collection tubes were studied for their influence on the prothrombin time (PT) and international sensitivity index (ISI) for 5 commercial thromboplastin reagents. With all reagents, PTs were shorter in Vacutainer (Becton Dickinson Vacutainer Systems, Plymouth, England) samples than in S-Monovette...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1309/NW194EAMD4WMEHJD
更新日期:2007-05-01 00:00:00
abstract::Two non-Hodgkin's lymphomas, one a follicular mixed cell type and the other a diffuse large cell type (Working Formulation), appeared 7 and 12 years, respectively, after the initial histopathologic diagnosis of Hodgkin's disease (nodular sclerosis) in an elderly male. The clinicopathologic implications of non-Hodgkin'...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/86.3.370
更新日期:1986-09-01 00:00:00
abstract:OBJECTIVES:To investigate the prognostic utility of multifocal extraprostatic extension (EPE) on biochemical recurrence after radical prostatectomy. METHODS:We conducted retrospective analysis of biochemical recurrence and prognostic pathologic variables in 673 men with stage pT3a/pT3b prostate cancer from 2000 to 201...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/aqz193
更新日期:2020-03-09 00:00:00
abstract::A 37-year-old intravenous drug abuser with acquired immune deficiency syndrome showed elevated activated partial thromboplastin time (APTT) and prothrombin time, normal thrombin time and fibrinogen, and borderline low platelet counts. The patient subsequently had a fracture of the left zygomatic arch, which did not pr...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/91.4.491
更新日期:1989-04-01 00:00:00
abstract::Using Venn diagrams derived from set theory, a mathematic model is presented that allows triple-label immunophenotypic analysis of cells based upon double-label measurements. Practical applications of this method are illustrated and discussed. Using this model, triple-label data concerning Leu-8 and Leu-9 (CD7) antige...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/92.1.73
更新日期:1989-07-01 00:00:00
abstract:OBJECTIVES:Acute myeloid leukemia with myelodysplasia-related changes (AML-MRC) is a heterogeneous disorder defined by morphologic, genetic, or clinical features. Genetic abnormalities associated with AML-MRC are often associated with adverse prognostic features, and many cases are preceded by a myelodysplastic syndrom...
journal_title:American journal of clinical pathology
pub_type: 杂志文章,评审
doi:10.1309/AJCP58RSMFRHLHHH
更新日期:2015-07-01 00:00:00