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Optimizing personalized bone marrow testing using an evidence-based, interdisciplinary team approach.

Seegmiller AC, Kim AS, Mosse CA, Levy MA, Thompson MA, Kressin MK, Jagasia MH, Strickland SA, Reddy NM, Marx ER, Sinkfield KJ, Pollard HN, Plummer WD, Dupont WD, Shultz EK, Dittus RS, Stead WW, Santoro SA, Zutter MM
Am J Clin Pathol. 2013 140 (5): 643-50

PMID: 24124142 · PMCID: PMC4159763 · DOI:10.1309/AJCP8CKE9NEINQFL

OBJECTIVES - To address the overuse of testing that complicates patient care, diminishes quality, and increases costs by implementing the diagnostic management team, a multidisciplinary system for the development and deployment of diagnostic testing guidelines for hematologic malignancies.

METHODS - The team created evidence-based standard ordering protocols (SOPs) for cytogenetic and molecular testing that were applied by pathologists to bone marrow biopsy specimens on adult patients. Testing on 780 biopsy specimens performed during the six months before SOP implementation was compared with 1,806 biopsy specimens performed during the subsequent 12 months.

RESULTS - After implementation, there were significant decreases in tests discordant with SOPs, omitted tests, and the estimated cost of testing to payers. The fraction of positive tests increased. Clinicians reported acceptance of the new procedures and perceived time savings.

CONCLUSIONS - This process is a model for optimizing complex and personalized diagnostic testing.

MeSH Terms (10)

Bone Marrow Bone Marrow Cells Clinical Protocols Evidence-Based Medicine Hematologic Neoplasms Humans Patient Care Team Practice Guidelines as Topic Precision Medicine Reproducibility of Results

Connections (9)

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