Abstract:
Objectives:To analyze the economic impact of testing for activated protein C resistance (APC-R) due to factor V Leiden (FVL) mutation with APC-R with reflexive FVL genotyping (algorithmic approach) or genotyping alone. Methods:OptumLabs Data Warehouse (OLDW) data were used to assess testing approaches. Insurance claims for APC-R and FVL in 2013 were compared with the Mayo Clinic database. Centers for Medicare & Medicaid Services diagnostic fee schedules were used to assign costs. Results:Of 19.3 million OLDW-covered individuals, 74,242 (0.385%) received 75,608 tests: APC-R, 2,265 (2.9%); FVL genotyping, 70,619 (90.1%); and both APC-R and FVL, 2,724 (7.0%). In total, 1,317 tests were performed at Mayo Clinic: APC-R with reflex FVL (1,256; 95.4%) and FVL alone (61; 4.6%). Costs per evaluated individual and per total population (person/year) in OLDW and algorithmic approach were $83.77 vs $36.38 and $0.32 vs $0.14, respectively. Conclusions:The cost-optimized algorithmic approach reduces health care costs.
journal_name
Am J Clin Patholjournal_title
American journal of clinical pathologyauthors
Perez Botero J,Majerus JA,Strege AK,Johnson RD,Chen D,Pruthi RKdoi
10.1093/ajcp/aqx033subject
Has Abstractpub_date
2017-06-01 00:00:00pages
604-610issue
6eissn
0002-9173issn
1943-7722pii
3784502journal_volume
147pub_type
杂志文章abstract::The resources needed to operate a clinical chemistry laboratory are known only as rough approximations. In order to gather more information about these resources, a 13-page questionnaire was completed by 50 pathology departments of which 38 departments provided adequate information about their clinical chemistry secti...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/78.6.839
更新日期:1982-12-01 00:00:00
abstract::Examination of kidneys of ten patients with uremia and severe hypertension treated by chronic intermittent hemodialysis revealed a deposition of glycogen within interstitial cells of the renal medulla. This is unlike any described renal distribution of glycogen. Electron microscopic studies performed in one case demon...
journal_title:American journal of clinical pathology
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更新日期:1979-09-01 00:00:00
abstract::We studied the antigen expression profiles of 19 anaplastic large cell lymphoma (ALCL) cases by multiparameter flow cytometry. The neoplastic cells expressed CD45, HLA-DR, and CD30 in all cases. At least 1 T cell-associated antigen was expressed in each case (CD2, 12/17 [71%]; CD4, 12/19 [63%]; CD3, 6/19 [32%]; CD7, 6...
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abstract::Hemizygous TP53 gene deletion is the most important adverse risk factor in chronic lymphocytic leukemia (CLL), but its relationship with p53 protein expression is unclear. We investigated 110 CLL cases and correlated nuclear p53 protein immunoreactivity with TP53 gene deletion status and other CLL-associated genetic r...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1309/AJCPEPX1C7HHFELK
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journal_title:American journal of clinical pathology
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abstract::In this study, I have estimated the percentage of tumor by visual estimate in 447 prostatectomy specimens from American Veterans Affairs patients and related this measurement to overall survival. Although percentage of tumor was significantly related to the serum prostate-specific antigen level, tumor stage, and Gleas...
journal_title:American journal of clinical pathology
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abstract::The most common differentiated renal tumor of early childhood is the congenital mesoblastic neophroma. Well-differentiated forms of Wilms' tumor may present a difficult differential diagnosis from these benign neoplasms. The cases of two patients found to have well-differentiated renal neoplasms after being treated fo...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
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abstract::This investigation was designed to improve reference information and to evaluate the influences of sample distribution and age on the derived reference intervals. Specimens from 127 men were collected after a 12- to 14-hour fast and analyzed by 60 different laboratory procedures. Differences in the reference intervals...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/79.5.574
更新日期:1983-05-01 00:00:00
abstract::Mantle cell lymphoma (MCL) expresses pan-B-cell antigens and is usually CD5+/CD10-/CD23-/FMC7+. In this study, we evaluated 52 patients with confirmed diagnoses of MCL and identified variant immunophenotypes in 21 patients (19/48 classical and 2/4 variant MCLs), including CD5- in 6 (12%) of 52, CD10+ in 4 (8%) of 50, ...
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abstract::Platelet volume measurements have been used to differentiate consumptive and hypoplastic thrombocytopenia. Since thrombocytopenia is a frequent complication of neonatal sepsis, the authors explored the utility of correlating mean platelet volume (MVP) and platelet distribution width (PDW) with bacteremia. In a sample ...
journal_title:American journal of clinical pathology
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更新日期:1990-03-01 00:00:00
abstract::Recently, strains of Streptococcus pneumoniae with greatly increased resistance to penicillin (minimal inhibitory concentrations or MICs, 1--8 microgram/ml) were recovered in cultures of blood from patients in South Africa and from one in Minnesota who had serious pneumococcal infections. The authors undertook a study...
journal_title:American journal of clinical pathology
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journal_title:American journal of clinical pathology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1309/AJCP8VE7AWBZCVQT
更新日期:2009-11-01 00:00:00
abstract::Platelet-derived growth factors (PDGFs) exert their biologic function by binding to 3 different tyrosine kinase receptor isoforms. Especially the PDGF-alpha alpha receptor binds PDGF proteins with high specificity, which results in growth stimulation. The expression of the receptor and its ligand was studied in human ...
journal_title:American journal of clinical pathology
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abstract::To evaluate the diagnostic utility of flow cytometry (FCM) as compared to cytology, DNA and RNA content of cells were measured in 233 samples of cerebrospinal fluid (CSF) from 147 patients with solid tumors or lymphomas and 17 controls with nonmalignant disorders. All control specimens were normal. Twenty-eight sample...
journal_title:American journal of clinical pathology
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更新日期:1987-11-01 00:00:00
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journal_title:American journal of clinical pathology
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journal_title:American journal of clinical pathology
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doi:10.1093/ajcp/112.2.204
更新日期:1999-08-01 00:00:00
abstract::A clinically and histopathologically well-documented case of malignant carcinoid tumor (with carcinoid syndrome) is described. The presence of numerous psammoma bodies in metastatic carcinoid tumor deposits, confirmed by histochemical and ultrastructural analyses, represents a heretofore unreported finding. ...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/81.3.372
更新日期:1984-03-01 00:00:00
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journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/76.3.305
更新日期:1981-09-01 00:00:00
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journal_title:American journal of clinical pathology
pub_type: 杂志文章
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更新日期:2008-04-01 00:00:00
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journal_title:American journal of clinical pathology
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doi:
更新日期:1983-10-01 00:00:00
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journal_title:American journal of clinical pathology
pub_type: 杂志文章
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更新日期:1990-12-01 00:00:00
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journal_title:American journal of clinical pathology
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更新日期:2005-03-01 00:00:00
abstract::Statin is a 57 kDa nuclear protein exclusively found in noncycling cells. Its expression in hematolymphoid cells had not been examined previously. The authors studied statin immunoreactivity in nonneoplastic lymphoid tissues from 26 lymph nodes, 3 tonsils, and 2 spleens. Statin was detected primarily in small lymphoid...
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pub_type: 杂志文章
doi:10.1093/ajcp/75.6.840
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journal_title:American journal of clinical pathology
pub_type: 杂志文章
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更新日期:2016-04-01 00:00:00
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journal_title:American journal of clinical pathology
pub_type: 杂志文章,评审
doi:
更新日期:1994-04-01 00:00:00