1301
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Retrouvey M, Grajo JR, Awan O, Catanzano T, Cheong LHA, Mankoff D, Burdette JH, Mendiratta-Lala M, Spalluto LB, Bronen RA, DeBenedectis CM. Transitioning From Radiology Training to Academic Faculty: The Importance of Mentorship. Curr Probl Diagn Radiol 2019; 49:219-223. [PMID: 30904346 DOI: 10.1067/j.cpradiol.2019.02.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 02/25/2019] [Indexed: 11/22/2022]
Abstract
Transitioning from radiology residency to academic faculty presents many challenges. In this review, we discuss the importance of introspection and mentorship to successfully navigate this process. Key points include alignment of goals with those of the institution, formation of a mentorship program, and periodic reassessment of career goals. These tips and tools can help make the transition from residency to academic faculty more seamless.
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Affiliation(s)
- Michele Retrouvey
- Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Joseph R Grajo
- Department of Radiology, University of Florida College of Medicine, Gainesville, FL
| | - Omer Awan
- Department of Radiology, Temple University Hospital, Philadelphia, PA
| | - Tara Catanzano
- Department of Radiology, University of Massachusetts Medical School-Baystate, Springfield, MA
| | | | - David Mankoff
- Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA
| | | | | | - Lucy B Spalluto
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN; Veteran's Health Administration-Tennessee Valley Healthcare System Geriatric Research, Education Clinical Center, Nashville, TN
| | - Richard A Bronen
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT
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1302
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Aitken CA, Siebers AG, Matthijsse SM, Jansen EEL, Bekkers RLM, Becker JH, Ter Harmsel B, Roovers JPWR, van Kemenade FJ, de Kok IMCM. Management and treatment of cervical intraepithelial neoplasia in the Netherlands after referral for colposcopy. Acta Obstet Gynecol Scand 2019; 98:737-746. [PMID: 30687935 PMCID: PMC6593855 DOI: 10.1111/aogs.13547] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 12/17/2018] [Accepted: 01/07/2019] [Indexed: 01/09/2023]
Abstract
Introduction The aim of this study was to describe trends in the diagnosis and treatment of women referred from the national screening program with cervical intraepithelial neoplasia (CIN) in the Netherlands, and to compare these trends with national guidelines and identify potential areas for improvement for the new primary high‐risk HPV screening program. Material and methods We conducted a population‐based cohort study using data from the Dutch pathology archive. Women aged 29‐63 years who took part in the Dutch cervical screening program between 1 January 2005 and 31 December 2014 were selected. Three referral groups were identified: direct referrals and those referred after either one (first indirect referrals) or two (second indirect referrals) repeat cytology tests, totaling 85 239 referrals for colposcopy. The most invasive management technique and the most severe diagnosis of each screening episode was identified. Rates of management techniques were calculated separately by referral type, highest CIN diagnosis and age group. Results In all, 85.1% of CIN 3 lesions were treated with excision (either large excision or hysterectomy) and 26.4% of CIN 1 lesions were treated with large excision. Rates of overtreatment (CIN 1 or less) in see‐and‐treat management were higher for indirect referrals than for direct referrals and increased with age. Large excision rates increased with CIN diagnosis severity. Conclusions Despite guideline recommendations not to treat, CIN 1 lesions were treated in just over 25% of cases and approximately 15% of CIN 3 lesions were possibly undertreated. Given the expected increase in CIN detection in the new primary high‐risk HPV screening program, reduction in CIN 1 treatment and CIN 2 treatment in younger women is needed to avoid an increase in potential harm.
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Affiliation(s)
- Clare A Aitken
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Albert G Siebers
- PALGA, the nationwide network and registry of histo- and cytopathology in the Netherlands, Houton, the Netherlands.,Department of Pathology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Suzette M Matthijsse
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands.,BresMed Health Solutions, Utrecht, the Netherlands
| | - Erik E L Jansen
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Ruud L M Bekkers
- Department of Gynecology, Catharina Hospital Eindhoven, Eindhoven, the Netherlands.,Department of Gynecology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jeroen H Becker
- Department of Obstetrics and Gynecology, St. Antonius Hospital Nieuwegein, Nieuwegein, the Netherlands
| | - Bram Ter Harmsel
- Department of Gynecology, Roosevelt Kliniek, Leiden, the Netherlands
| | - Jan-Paul W R Roovers
- Bergman Clinics (Gynecology), Amsterdam, Amsterdam, the Netherlands.,Department of Obstetrics and Gynecology, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Folkert J van Kemenade
- Department of Pathology, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Inge M C M de Kok
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
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1303
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Kragel PJ, Hoffman RD, Kaul KL. Position Paper From the Association of Pathology Chairs: Surgical Pathology Residency Training. Acad Pathol 2019; 6:2374289518824054. [PMID: 30783619 PMCID: PMC6365987 DOI: 10.1177/2374289518824054] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 12/10/2018] [Indexed: 11/16/2022] Open
Abstract
Training in surgical pathology specimen dissection and microscopic diagnosis is an integral part of pathology residency training, as surgical pathology is one of the defining activities of most pathologists. The Accreditation Council for Graduate Medical Education and the American Board of Pathology policies delineate guidelines and requirements for residency training. Both the ACGME and ABP require that residents are ready for “independent practice” upon completion of training (ACGME) and for board eligibility (ABP). This position paper, developed through a consensus process involving the Association of Pathology Chairs, including the Program Directors and Graduate Medical Education committee, expands on these guidelines and the importance of gross dissection as a part of training.
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Affiliation(s)
- Peter J Kragel
- Department of Pathology and Laboratory Medicine, East Carolina University Brody School of Medicine, Greenville, NC, USA
| | - Robert D Hoffman
- Department of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Karen L Kaul
- Department of Pathology and Laboratory Medicine, Northshore University Health System, Evanston, IL, USA
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1304
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Kaushik N, Kim MJ, Kaushik NK, Myung JK, Choi MY, Kang JH, Cha HJ, Kim CS, Nam SY, Lee SJ. Low dose radiation regulates BRAF-induced thyroid cellular dysfunction and transformation. Cell Commun Signal 2019; 17:12. [PMID: 30760304 PMCID: PMC6373124 DOI: 10.1186/s12964-019-0322-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 01/21/2019] [Indexed: 12/15/2022] Open
Abstract
Background The existence of differentiated thyroid cells is critical to respond radioactive iodide treatment strategy in thyroid cancer, and loss of the differentiated phenotype is a trademark of iodide-refractive thyroid disease. While high-dose therapy has been beneficial to several cancer patients, many studies have indicated this clinical benefit was limited to patients having BRAF mutation. BRAF-targeted paired box gene-8 (PAX8), a thyroid-specific transcription factor, generally dysregulated in BRAF-mutated thyroid cancer. Methods In this study, thyroid iodine-metabolizing gene levels were detected in BRAF-transformed thyroid cells after low and high dose of ionizing radiation. Also, an mRNA-targeted approach was used to figure out the underlying mechanism of low (0.01Gyx10 or 0.1Gy) and high (2Gy) radiation function on thyroid cancer cells after BRAFV600E mutation. Results Low dose radiation (LDR)-induced PAX8 upregulation restores not only BRAF-suppressive sodium/iodide symporter (NIS) expression, one of the major protein necessary for iodine uptake in healthy thyroid, on plasma membrane but also regulate other thyroid metabolizing genes levels. Importantly, LDR-induced PAX8 results in decreased cellular transformation in BRAF-mutated thyroid cells. Conclusion The present findings provide evidence that LDR-induced PAX8 acts as an important regulator for suppression of thyroid carcinogenesis through novel STAT3/miR-330-5p pathway in thyroid cancers. Electronic supplementary material The online version of this article (10.1186/s12964-019-0322-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Neha Kaushik
- Department of Life Science, Research Institute for Natural Sciences, Hanyang University, Seoul, 04763, Republic of Korea
| | - Min-Jung Kim
- Laboratory of Radiation Exposure and Therapeutics, National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul, South Korea
| | - Nagendra Kumar Kaushik
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Department of Electrical and Biological Physics, Kwangwoon University, Seoul, 01897, Republic of Korea
| | - Jae Kyung Myung
- Department of Radiation Pathology, Korea Cancer Center Hospital, Seoul, South Korea
| | - Mi-Young Choi
- Department of Life Science, Research Institute for Natural Sciences, Hanyang University, Seoul, 04763, Republic of Korea
| | - Jae-Hyeok Kang
- Department of Life Science, Research Institute for Natural Sciences, Hanyang University, Seoul, 04763, Republic of Korea
| | - Hyuk-Jin Cha
- College of Pharmacy, Seoul National University, Seoul, South Korea
| | - Cha-Soon Kim
- Department of Preventive Medicine, College of Medicine, Dongguk University, Gyeongju, 38066, Korea
| | - Seon-Young Nam
- Radiation Health Institute, Korea Hydro and Nuclear Power Co. Ltd, Seoul, South Korea.
| | - Su-Jae Lee
- Department of Life Science, Research Institute for Natural Sciences, Hanyang University, Seoul, 04763, Republic of Korea. .,Laboratory of Molecular Biochemistry, Department of Life Science, Hanyang University, 17 Haengdang-Dong, Seongdong-Ku, Seoul, 04763, South Korea.
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1305
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Greenblatt HK, Greenblatt DJ. Designer Benzodiazepines: A Review of Published Data and Public Health Significance. Clin Pharmacol Drug Dev 2019; 8:266-269. [PMID: 30730611 DOI: 10.1002/cpdd.667] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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1306
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Identification of a pathogenic mutation in a Chinese pedigree with polycystic kidney disease. Mol Med Rep 2019; 19:2671-2679. [PMID: 30720121 PMCID: PMC6423614 DOI: 10.3892/mmr.2019.9921] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 12/18/2018] [Indexed: 12/16/2022] Open
Abstract
Polycystic kidney disease (PKD) is a life-threatening inherited disease with a morbidity of 1:500–1,000 worldwide. Numerous progressively enlarging cysts are observed in the bilateral kidneys of patients with PKD, inducing structural damage and loss of kidney function. The present study analyzed one family with PKD. Whole exome sequencing of the proband was performed to detect the pathogenic gene present in the family. Candidate gene segments for lineal consanguinity in the family were amplified by nest polymerase chain reaction, followed by Sanger sequencing. One novel duplication variant (NM_001009944.2:c.9359dupA:p.Y3120_E3121delinsX) and one missense mutation (c.G9022A:p.V3008M) were detected in PKD1. Additionally, the pathogenic substitutions in PKD1 published from the dataset were analyzed. Following analysis and confirmation, the duplication variant NM_001009944.2:c.9359dupA:p.Y3120_E3121delinsX in PKD1, within the polycystin-1, lipoxygenase, α-toxin domain, was considered to be the pathogenic factor in the examined family with autosomal dominant PKD. Additionally, based on the analysis of 4,805 pathogenic substitutions in PKD1 within various regions, the presence of the missense mutation in the N-terminal domain of polycystin-1 may present high pathogenicity in ADPKD.
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1307
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Ouellette SB. Landscape of granted US patents in personalized diagnostics for oncology from 2014 to 2018. Expert Opin Ther Pat 2019; 29:191-198. [PMID: 30712415 DOI: 10.1080/13543776.2019.1575809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Personalized diagnostic testing (PDx) is a key component of the precision medicine toolkit and has shown the most development in cancer applications. Recent changes in the regulatory and legal landscapes regarding PDx development and commercialization have brought uncertainties to both intellectual property strategies and business model development. While the regulatory and legal uncertainties have been well-documented, there has been little reported analysis of the recent patent landscape and movement of IP into the PDx market. Areas covered: This article provides a snapshot landscape analysis of cancer-associated PDx US granted patents from 2014 to 2018, with a focus on claim types, biomarkers, and associated detection strategies, and assignee-specific IP portfolio analyses. Expert opinion: Patent-driven research is commonplace in the legal world for performing patentability, clearance, and validity analyses. The results from this review show that patent-driven analysis is also insightful for understanding strategies to build IP portfolios around biomarker and detection platforms, identifying partners and competitors, and driving PDx technologies into the market. This information is an important source of business intelligence and can provide companies or investors with valuable information for making strategic decisions in developing and commercializing PDx technologies.
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Affiliation(s)
- Steven B Ouellette
- a Biotechnology & Pharmaceuticals Group , Global Prior Art, Inc , Boston , MA , USA
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1308
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Naugler C, Church DL. Clinical laboratory utilization management and improved healthcare performance. Crit Rev Clin Lab Sci 2019. [DOI: 10.1080/10408363.2018.1526164] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Christopher Naugler
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Canada
- Department of Family Medicine, University of Calgary, Calgary, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Canada
| | - Deirdre L. Church
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Canada
- Department of Medicine, University of Calgary, Calgary, Canada
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1309
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Diaz MM, Ojukwu K, Padilla J, Steed K, Schmalz N, Tullis A, Mageno A, McCleve J, White E, Stark ME, Morton DA, Seastrand G, Ray G, Lassetter J, Wilson-Ashworth HA, Wisco JJ. Who is the Teacher and Who is the Student? The Dual Service- and Engaged-Learning Pedagogical Model of Anatomy Academy. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2019; 6:2382120519883271. [PMID: 31673628 PMCID: PMC6806115 DOI: 10.1177/2382120519883271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 09/27/2019] [Indexed: 06/10/2023]
Abstract
Anatomy Academy is a simultaneous service-learning experience for preprofessional school undergraduate students and preclinical professional students acting as classroom paraprofessional teachers (Mentors), and engaged-learning experience for fourth to sixth grade elementary school children (Students). Using didactic and kinesthetic active learning teaching strategies in small-group classroom environments, Mentors taught anatomy, physiology, and nutrition concepts to Students. In this study of the program's early years (2012-2014), overall objectives of improving Mentors' pedagogical confidence; and Students' science interest, science knowledge, and exercise self-efficacy were assessed. Mentors showed (89% response of 595 surveyed) improvement in content delivery (P < .001), student engagement (P < .001), classroom management (P < .001), and professionalism (P = .0001). Postprogram Mentor reflections were categorized into 7 major themes that demonstrated personal growth through the service-learning opportunity: (1) realization of an ability to make a difference in the world now; (2) acknowledgment of the importance of listening in teaching; (3) recognition that lives can and will change with "a little love"; (4) insight into the effectiveness of guiding Students through material rather than lecturing; (5) awareness of the value of respect in the learning environment; (6) cognizance of the power of individualized attention to motivate Students; and (7) reflection of one's own personal growth through the open influence of Students. Students showed (88% response of 1259 surveyed) improvement in science knowledge (P = .014) and exercise self-efficacy (P = .038), but not science interest (P = .371). Thus, while Students are learning more science and becoming more aware of their health, we need to be more overt in our presence as scientists in the educational arena.
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Affiliation(s)
- Molly M Diaz
- David Geffen School of Medicine,
University of California, Los Angeles, Los Angeles, CA, USA
- Jonathan and Karin Fielding School of
Public Health, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Pediatrics, Pritzker
School of Medicine, The University of Chicago, Chicago, IL, USA
| | - Kenechukwu Ojukwu
- David Geffen School of Medicine,
University of California, Los Angeles, Los Angeles, CA, USA
- Department of Public Policy, Meyer and
Renee Luskin School of Public Affairs, University of California, Los Angeles, Los
Angeles, CA, USA
- Department of Pathology, Harbor-UCLA
Medical Center, Torrance CA, USA
| | - Jessica Padilla
- Department of Public Policy, Meyer and
Renee Luskin School of Public Affairs, University of California, Los Angeles, Los
Angeles, CA, USA
| | - Kevin Steed
- Department of Physiology and
Developmental Biology, Neuroscience Center, Brigham Young University, Provo, UT,
USA
- Department of Biomedical Education,
College of Osteopathic Medicine, California Health Sciences University, Clovis, CA,
USA
| | - Naomi Schmalz
- Division of Integrative Anatomy,
Department of Pathology & Laboratory Medicine, David Geffen School of Medicine,
University of California, Los Angeles, Los Angeles, CA, USA
- Department of Anatomy and Cell Biology,
Indiana University School of Medicine, Indianapolis, IN, USA
| | - Autumn Tullis
- Department of Physiology and
Developmental Biology, Neuroscience Center, Brigham Young University, Provo, UT,
USA
| | - Alex Mageno
- Department of Physiology and
Developmental Biology, Neuroscience Center, Brigham Young University, Provo, UT,
USA
| | - Jeff McCleve
- Department of Biology, Utah Valley
University, Orem, UT, USA
| | - Erik White
- Department of Biology, Utah Valley
University, Orem, UT, USA
| | - M Elena Stark
- Division of Integrative Anatomy,
Department of Pathology & Laboratory Medicine, David Geffen School of Medicine,
University of California, Los Angeles, Los Angeles, CA, USA
| | - David A Morton
- Department of Neurobiology and
Anatomy, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Gary Seastrand
- Center for the Improvement of Teacher
Education and Schooling (CITES), McKay School of Education, Brigham Young
University, Provo, UT, USA
| | - Gaye Ray
- College of Nursing, Brigham Young
University, Provo, UT, USA
| | - Jane Lassetter
- College of Nursing, Brigham Young
University, Provo, UT, USA
| | | | - Jonathan J Wisco
- Department of Physiology and
Developmental Biology, Neuroscience Center, Brigham Young University, Provo, UT,
USA
- Division of Integrative Anatomy,
Department of Pathology & Laboratory Medicine, David Geffen School of Medicine,
University of California, Los Angeles, Los Angeles, CA, USA
- Department of Neurobiology and
Anatomy, University of Utah School of Medicine, Salt Lake City, UT, USA
- Laboratory for Translational Anatomy
of Degenerative Diseases and Developmental Disorders (TAD4), Department of Anatomy
and Neurobiology, Boston University School of Medicine, Boston, MA, USA
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1310
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Nohr EW, Wright JR. Discordance of Twin Placentas for Multifocal Eosinophilic/T-cell Chorionic Vasculitis. Pediatr Dev Pathol 2019; 22:40-44. [PMID: 29914285 DOI: 10.1177/1093526618783256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Eosinophilic/T-cell chorionic vasculitis (ETCV) is an idiopathic placental lesion characterized by chorionic vasculitis composed predominantly of eosinophils and CD3+ T lymphocytes. It usually presents as a unifocal lesion, but a subset have multifocal involvement. We report 4 Di-Di and 2 Di-Mo twins sharing fused placental discs with discordant circulatory involvement by multifocal ETCV. The findings are difficult to explain by sampling alone. The limitation of ETCV to 1 fetus's vascular territory in monozygotic twin pregnancies is difficult to explain but could provide insights into the fetal immune system and the etiology of ETCV.
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Affiliation(s)
- Erik W Nohr
- 1 Department of Pathology & Laboratory Medicine, University of Calgary/Calgary Laboratory Services, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - James R Wright
- 1 Department of Pathology & Laboratory Medicine, University of Calgary/Calgary Laboratory Services, Alberta Children's Hospital, Calgary, Alberta, Canada
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1311
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Buja LM, Barth RF, Krueger GR, Brodsky SV, Hunter RL. The Importance of the Autopsy in Medicine: Perspectives of Pathology Colleagues. Acad Pathol 2019; 6:2374289519834041. [PMID: 30886893 PMCID: PMC6410379 DOI: 10.1177/2374289519834041] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 01/12/2019] [Accepted: 01/18/2019] [Indexed: 12/17/2022] Open
Abstract
This article presents a perspective on the importance of the autopsy in medical practice and science based on experiences of the authors as physician-scientists involved in autopsy practice. Our perspectives are presented on the seminal contributions of the autopsy in the areas of cardiovascular disease, including congenital heart disease, atherosclerosis, coronary artery disease, and myocardial infarction, and infectious disease, including tuberculosis and viral infections. On the positive side of the future of the autopsy, we discuss the tremendous opportunities for important research to be done by application of advanced molecular biological techniques to formalin-fixed, paraffin-embedded tissue blocks obtained at autopsy. We also note with concern the countervailing forces impacting the influence of pathology in education and clinical practice at our academic medical centers, which also present impediments to increasing autopsy rates. Our challenge as academic pathologists, whose careers have been molded by involvement in the autopsy, is to counter these trends. The challenges are great but the benefits for medicine and society are enormous.
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Affiliation(s)
- Louis Maximilian Buja
- Department of Pathology and Laboratory Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Rolf F. Barth
- Department of Pathology, The Ohio State University, Columbus, OH, USA
| | - Gerhard R. Krueger
- Department of Pathology and Laboratory Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Sergey V. Brodsky
- Department of Pathology, The Ohio State University, Columbus, OH, USA
| | - Robert L. Hunter
- Department of Pathology and Laboratory Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
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1312
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Thomas RE, Thomas BC. A Systematic Review of Studies of the STOPP/START 2015 and American Geriatric Society Beers 2015 Criteria in Patients ≥ 65 Years. Curr Aging Sci 2019; 12:121-154. [PMID: 31096900 DOI: 10.2174/1874609812666190516093742] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 02/07/2019] [Accepted: 04/20/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Polypharmacy remains problematic for individuals ≥65. OBJECTIVE To summarise the percentages of patients meeting 2015 STOPP criteria for Potentially Inappropriate Prescriptions (PIPs), 2015 Beers criteria for Potentially Inappropriate Medications (PIMs), and START criteria Potential Prescribing Omissions (PPOs). METHODS Searches conducted on 2 January 2019 in Medline, Embase, and PubMed identified 562 studies and 62 studies were retained for review. Data were abstracted independently. RESULTS 62 studies (n=1,854,698) included two RCTs and 60 non-randomised studies. For thirty STOPP/START studies (n=1,245,974) average percentages for ≥1 PIP weighted by study size were 42.8% for 1,242,010 community patients and 51.8% for 3,964 hospitalised patients. For nineteen Beers studies (n = 595,811) the average percentages for ≥1 PIM were 58% for 593,389 community patients and 55.5% for 2,422 hospitalised patients. For thirteen studies (n=12,913) assessing both STOPP/START and Beers criteria the average percentages for ≥1 STOPP PIP were 33.9% and Beers PIMs 46.8% for 8,238 community patients, and for ≥ 1 STOPP PIP were 42.4% and for ≥1 Beers PIM 60.5% for 4,675 hospitalised patients. Only ten studies assessed changes over time and eight found positive changes. CONCLUSION PIP/PIM/PPO rates are high in community and hospitalised patients in many countries. RCTs are needed for interventions to: reduce new/existing PIPs/PIMs/PPO prescriptions, reduce prescriptions causing adverse effects, and enable regulatory authorities to monitor and reduce inappropriate prescriptions in real time. Substantial differences between Beers and STOPP/START assessments need to be investigated whether they are due to the criteria, differential medication availability between countries, or data availability to assess the criteria.
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Affiliation(s)
- Roger E Thomas
- Department of Family Medicine, Faculty of Medicine, Health Sciences Centre, 3330 Hospital Drive NW, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
| | - Bennett C Thomas
- Independent Researcher, 1604 21 Avenue, NW, Calgary, Alberta, T2M1M1, Canada
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1313
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Hoffman RD, Kragel PJ, Kaul KL. Position Paper From the Association of Pathology Chairs: Assessing Autopsy Competency in Pathology Residency Training. Acad Pathol 2019; 6:2374289518824057. [PMID: 30783620 PMCID: PMC6365994 DOI: 10.1177/2374289518824057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 12/10/2018] [Indexed: 11/25/2022] Open
Abstract
Declining numbers of hospital autopsies performed in US pathology residency training programs and perceived declining practice of autopsy by many pathologists has caused stakeholder organizations to reassess the role of autopsy training in pathology residency. A working group convened by the stakeholder organizations has delivered the results of a detailed study of current practice of autopsy education in US pathology programs, along with recommendations for the future of autopsy education. Accepting the report of the Working Group, the Association of Pathology Chairs here publishes its position paper on the proposed recommendations.
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Affiliation(s)
- Robert D. Hoffman
- Department of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Peter J. Kragel
- Department of Pathology and Laboratory Medicine, East Carolina University Brody School of Medicine, Greenville, NC, USA
| | - Karen L. Kaul
- Department of Pathology and Laboratory Medicine, Northshore University Health System, Evanston, IL, USA
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1314
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Narasimhalu T, Olson KA. Educational Case: Noninfectious Esophagitis. Acad Pathol 2019; 6:2374289519893087. [PMID: 35155740 PMCID: PMC8819812 DOI: 10.1177/2374289519893087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 09/23/2019] [Accepted: 11/02/2019] [Indexed: 11/17/2022] Open
Abstract
The following fictional case is intended as a learning tool within the Pathology
Competencies for Medical Education (PCME), a set of national standards for teaching
pathology. These are divided into three basic competencies: Disease Mechanisms and
Processes, Organ System Pathology, and Diagnostic Medicine and Therapeutic Pathology.
For additional information, and a full list of learning objectives for all three
competencies, seehttp://journals.sagepub.com/doi/10.1177/2374289517715040.1
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Affiliation(s)
- Tara Narasimhalu
- Department of Pathology and Laboratory Medicine, University of California
Davis School of Medicine, Sacramento, CA, USA
- Tara Narasimhalu, Department of Pathology and
Laboratory Medicine, University of California Davis School of Medicine, 4400 V St,
Sacramento, CA 95817, USA.
| | - Kristin A. Olson
- Department of Pathology and Laboratory Medicine, University of California
Davis School of Medicine, Sacramento, CA, USA
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1315
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Aslan D. Which Skills are Needed and How They Should be Gained by Laboratory Medicine Professionals for Successful ISO 15189 Accreditation. EJIFCC 2018; 29:264-273. [PMID: 30574036 PMCID: PMC6295584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Clinical laboratories worldwide are accredited according to the "ISO standard, 15189:2012: Medical Laboratories-Requirements for Quality and Competence." Seeking accreditation has many challenges. Success requires the right competencies and knowledge and the right technical expert and trainer to lead the laboratory through the process. The right competencies and knowledge typcially are beyond the core knowledge, skills and attitudes gained during education of laboratory professionals. The main objective of this paper is to discuss what competencies, knowledge and expertise are essential for laboratories to meet accreditation challenges and gain ISO 15189:2012 accreditation.
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Affiliation(s)
- Diler Aslan
- Department of Medical Biochemistry, Medical Faculty, Pamukkale University, Denizli, Turkey
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1316
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Jain R, Rao B. Health care facility vulnerability in developing nations: strengthening health care policy-making and implementation. J Public Health (Oxf) 2018. [DOI: 10.1007/s10389-018-0911-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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1317
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Gross DJ, Kennedy M, Kothari T, Scamurra DO, Wilkerson ML, Crawford JM, Cohen MB. The Role of the Pathologist in Population Health. Arch Pathol Lab Med 2018; 143:610-620. [PMID: 30398912 DOI: 10.5858/arpa.2018-0223-cp] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
CONTEXT.— As part of its value-based care initiative, the College of American Pathologists has pursued research to better understand the role pathologists can have in population health. OBJECTIVES.— To answer the following questions: (1) what is the impact of population health and population health management on pathologists; (2) what roles are pathologists playing in population health management; (3) is population health something that pathologists in both larger and smaller settings can engage in; (4) are pathologists in a position to analyze laboratory data for population health, and, if so, what are the key information sources those pathologists must access; and (5) what steps can a pathologist take to become involved in population health? DESIGN.— We conducted 10 semistructured interviews with pathologists and other medical laboratory leaders who have been active in population health. These interviews were supplemented with a review of the medical literature. RESULTS.— Pathologists have demonstrated that laboratory data can provide unique value-added contributions to improving the health of populations. These contributions are not limited to pathologists in large, integrated settings. However, pathologists need to be proactive to contribute to health systems' population health efforts and may need to both enhance their own skills and the quality of their data to maximize the value of their contributions. CONCLUSIONS.— Although not necessarily a definitive summary of the roles that pathologists are playing in population health, this article identifies some of the promising and innovative activities occurring among pathologists and laboratorians.
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Affiliation(s)
| | | | | | | | | | | | - Michael B Cohen
- From the Policy Roundtable, College of American Pathologists, Washington, DC (Dr Gross); Clinical Informatics, College of American Pathologists, Northfield, Illinois (Ms Kennedy); the Department of Pathology and Laboratory Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Lake Success, New York (Drs Kothari and Crawford); Eastern Great Lakes Pathology, Amherst, New York (Dr Scamurra); the Division of Laboratory Medicine, Geisinger Medical Laboratories, Danville, Pennsylvania (Dr Wilkerson); and the Department of Pathology, Wake Forest School of Medicine, Winston-Salem, North Carolina (Dr Cohen)
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1318
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Kinnear B, Warm EJ, Hauer KE. Twelve tips to maximize the value of a clinical competency committee in postgraduate medical education. MEDICAL TEACHER 2018; 40:1110-1115. [PMID: 29944025 DOI: 10.1080/0142159x.2018.1474191] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Medical education has shifted to a competency-based paradigm, leading to calls for improved learner assessment methods and validity evidence for how assessment data are interpreted. Clinical competency committees (CCCs) use the collective input of multiple people to improve the validity and reliability of decisions made and actions taken based on assessment data. Significant heterogeneity in CCC structure and function exists across postgraduate medical education programs and specialties, and while there is no "one-size-fits-all" approach, there are ways to maximize value for learners and programs. This paper collates available evidence and the authors' experiences to provide practical tips on CCC purpose, membership, processes, and outputs. These tips can benefit programs looking to start a CCC and those that are improving their current CCC processes.
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Affiliation(s)
- Benjamin Kinnear
- a Internal Medicine and Pediatrics , University of Cincinnati College of Medicine , Cincinnati , OH , USA
| | - Eric J Warm
- b Richard W. Vilter Professor of Medicine , University of Cincinnati College of Medicine , Cincinnati , OH , USA
| | - Karen E Hauer
- c Medicine , University of California, San Francisco School of Medicine , San Francisco , CA , USA
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1319
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Sanders CD, Leigh MW, Chao KC, Weck KE, King I, Wolf WE, Campbell DJ, Knowles MR, Zariwala MA, Shapiro AJ. The prevalence of the defining features of primary ciliary dyskinesia within a cri du chat syndrome cohort. Pediatr Pulmonol 2018; 53:1565-1573. [PMID: 30238669 DOI: 10.1002/ppul.24159] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 08/06/2018] [Indexed: 11/09/2022]
Abstract
BACKGROUND Primary ciliary dyskinesia (PCD) and cri du chat syndrome (CdCS) are distinct disorders that can co-occur due to a common genetic locus on chromosome 5p. Chronic respiratory symptoms associated with PCD can occur in CdCS and are typically attributed to hypotonia, dysphagia, and aspiration. The prevalence of PCD among individuals with CdCS is not known. METHODS An online survey assessing common features of PCD was distributed to members of the 5P Minus Society, a cri du chat patient advocacy group. Respondents who met criteria for elevated risk of PCD (at least 3 symptoms or other features highly suggestive of PCD) were offered PCD genetic testing. RESULTS For the 123 respondents (median age 10.1 years with IQR 5.5-17.3 years; from 33 U.S. states and 10 other countries) chronic respiratory symptoms associated with PCD were prevalent, including unexplained neonatal respiratory distress, year-round nasal congestion beginning in infancy, and year-round, wet cough beginning in infancy in 35%, 32%, and 20% of respondents, respectively. Fifteen respondents (12%) met criteria for elevated risk for PCD and completed genetic analysis; however, none were diagnostic for PCD. A PCD clinical center evaluated an additional subject with CdCS who met criteria for likely PCD and had negative genetics, but had diagnostic electron microscopy of the respiratory cilia (missing outer dynein arms). CONCLUSION Clinicians should be aware of the genetic connection between CdCS and PCD. Non-informative genetic testing does not rule out PCD. CdCS patients with chronic respiratory symptoms may benefit from referral to specialized PCD diagnostic centers.
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Affiliation(s)
- Catherine D Sanders
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Margaret W Leigh
- Department of Pediatrics, University of North Carolina, Marsico Lung Institute, Chapel Hill, North Carolina
| | - Kay C Chao
- Department of Pathology and Laboratory Medicine, University of North Carolina, Marsico Lung Institute, Chapel Hill, North Carolina
| | - Karen E Weck
- Department of Pathology and Laboratory Medicine, University of North Carolina, Marsico Lung Institute, Chapel Hill, North Carolina
| | - Ian King
- Laboratory Medicine Program, University Health Network, Toronto, Ontario
| | - Whitney E Wolf
- Department of Medicine, University of North Carolina, Marsico Lung Institute, Chapel Hill, North Carolina
| | - Dennis J Campbell
- Department of Leadership and Teacher Education, University of South Alabama, Mobile, Alabama
| | - Michael R Knowles
- Department of Medicine, University of North Carolina, Marsico Lung Institute, Chapel Hill, North Carolina
| | - Maimoona A Zariwala
- Department of Pathology and Laboratory Medicine, University of North Carolina, Marsico Lung Institute, Chapel Hill, North Carolina
| | - Adam J Shapiro
- Department of Pediatrics, Division of Pediatric Respiratory Medicine, McGill University Health Centre Research Institute, Montreal, Quebec
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1320
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Quality assurance of genetic laboratories and the EBTNA practice certification, a simple standardization assurance system for a laboratory network. EUROBIOTECH JOURNAL 2018. [DOI: 10.2478/ebtj-2018-0052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Abstract
Analytical laboratory results greatly influence medical diagnosis, about 70% of medical decisions are based on laboratory results. Quality assurance and quality control are designed to detect and correct errors in a laboratory’s analytical process to ensure both the reliability and accuracy of test results. Unreliable performance can result in misdiagnosis and delayed treatment. Furthermore, improved quality guarantees increased productivity at a lower cost. Quality assurance programmes include internal quality control, external quality assessment, proficiency surveillance and standardization. It is necessary to try to ensure compliance with the requirements of the standards at all levels of the process. The sources of these standards are the International Standards Organization (ISO), national standards bodies, guidelines from professional organisations, accreditation bodies and governmental regulations. Laboratory networks increase the performance of laboratories in support of diagnostic screening programme. It is essential that genetic laboratories of a network have procedures underpinned by a robust quality assurance system to minimize errors and to reassure the clinicians and the patients that international standards are being met. This article provides an overview of the bases of quality assurance and its importance in genetic tests and it reports the EBTNA quality assurance system which is a clear and simple system available for access to adequate standardization of a genetic laboratory’s network.
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1321
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Bailey DN, Cohen S, Gotlieb A, Lipscomb MF, Sanfilippo F. What Advice Current Pathology Chairs Seek From Former Chairs. Acad Pathol 2018; 5:2374289518807397. [PMID: 30364779 PMCID: PMC6198385 DOI: 10.1177/2374289518807397] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 08/13/2018] [Accepted: 09/24/2018] [Indexed: 11/15/2022] Open
Abstract
The 2018 Association of Pathology Chairs annual meeting included a panel discussion of Association of Pathology Chairs senior fellows (former chairs of academic departments of pathology who have remained active in Association of Pathology Chairs) about the type of advice that current (sitting) pathology chairs ask them. To inform the panel discussion, information was obtained from the senior fellows by e-mail and subsequent conference call. Of the 33 respondents, 24 (73%) had provided consultation advice (9, <5; 11, 5-10; 2, 10-20; and 2, >20). Most (>75%) of the consultations were provided face-to-face and outside the framework of Association of Pathology Chairs, with 70% of those seeking advice being well known by the consultant(s). Of the senior fellows providing advice, 71% had themselves sought consultation from former pathology chairs and 75% from nonpathology chairs. Modest correlation was found between the number of consultations senior fellows sought when they were chairs and the number of consultations they subsequently provided. The most frequent topics of consultation were strategic planning, balancing the missions, setting department priorities, recruitment of faculty and staff, conflict management, issues specific to new chairs, and resource (money/space) issues. Those who had provided such advice the longest and to the most people indicated that there was no significant change in the type of questions asked over time. Former department chairs can be a valuable source of counseling for current chairs, and organizations of department chairs should consider formalizing the use of these individuals as consultants to sitting chairs.
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Affiliation(s)
- David N Bailey
- Department of Pathology, University of California, San Diego, La Jolla, CA, USA
| | - Stanley Cohen
- Department of Pathology and Laboratory Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Avrum Gotlieb
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Mary F Lipscomb
- Department of Pathology, University of New Mexico, Albuquerque, NM, USA
| | - Fred Sanfilippo
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA
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1322
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Guido M, Alves VAF, Balabaud C, Bathal PS, Bioulac-Sage P, Colombari R, Crawford JM, Dhillon AP, Ferrell LD, Gill RM, Hytiroglou P, Nakanuma Y, Paradis V, Quaglia A, Rautou PE, Theise ND, Thung S, Tsui WMS, Sempoux C, Snover D, van Leeuwen DJ. Histology of portal vascular changes associated with idiopathic non-cirrhotic portal hypertension: nomenclature and definition. Histopathology 2018; 74:219-226. [DOI: 10.1111/his.13738] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 06/07/2018] [Accepted: 08/18/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Maria Guido
- Department of Medicine-DIMED; Pathology Unit; University of Padova; Padova Italy
| | - Venancio A F Alves
- Department of Pathology; University of Sao Paulo School of Medicine; Sao Paulo Brazil
| | | | - Prithi S Bathal
- Department of Pathology; University of Melbourne; Melbourne Vic. Australia
| | - Paulette Bioulac-Sage
- Department of Pathology; CHU Bordeaux, and Inserm U1053; Bordeaux University; Bordeaux France
| | | | - James M Crawford
- Department of Pathology and Laboratory Medicine; Donald and Barbara School of Medicine at Hofstra/Northwell; New York NY USA
| | - Amar P Dhillon
- Department of Cellular Pathology; UCL Medical School; London UK
| | - Linda D Ferrell
- Department of Pathology; University of California; San Francisco CA USA
| | - Ryan M Gill
- Department of Pathology; University of California; San Francisco CA USA
| | - Prodromos Hytiroglou
- Department of Pathology; Aristotle University Medical School; Thessaloniki Greece
| | - Yasuni Nakanuma
- Department of Diagnostic Pathology; Shizuoka Cancer Centre; Shizuoka Japan
| | | | - Alberto Quaglia
- Institute of Liver Studies; King's College Hospital and King's College; London UK
| | - Pierre E Rautou
- Department of Hepatology; Hopital Beaujon; University of Paris; Paris France
| | - Neil D Theise
- Department of Pathology; New York University School of Medicine; New York NY USA
| | - Swan Thung
- Department of Pathology; Icahn School of Medicine at Mount Sinai; New York NY USA
| | | | - Christine Sempoux
- Service of Clinical Pathology; Lausanne University Hospital; Institute of Pathology; Lausanne Switzerland
| | - Dale Snover
- Department of Pathology; Fairview Southdale Hospital; Edina MN USA
| | - Dirk J van Leeuwen
- Section of Gastroenterology and Hepatology; Geisel School of Medicine at Dartmouth College; Hanover NH USA
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1323
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Mrak RE, Parslow TG, Ducatman BS. Benchmarking Subspecialty Practice in Academic Anatomic Pathology: The 2017 Association of Pathology Chairs Survey. Acad Pathol 2018; 5:2374289518798556. [PMID: 30327790 PMCID: PMC6178122 DOI: 10.1177/2374289518798556] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 07/26/2018] [Accepted: 08/01/2018] [Indexed: 12/03/2022] Open
Abstract
Assessment of physician workloads has become increasingly important in modern academic
physician practice, where it is commonly used to allocate resources among departments, to
determine staffing, and to set the compensation of individual physicians. The physician
work relative value unit system is a frequently used metric in this regard. However, the
application of this system to the practice of pathology has proven problematic. One area
of uncertainty is the validity of using work relative value unit norms that were derived
from general surgical pathology practice to assess the various subspecialties within
anatomic pathology. Here, we used data from the 2017 Association of Pathology Chairs
practice survey to assess salary and work relative value unit data for single-subspecialty
practitioners in US academic pathology departments in the prior year (2016). Five
subspecialties were evaluated: dermatopathology, gastrointestinal pathology,
hematopathology/hematology, renal pathology, and neuropathology. Data for general surgical
pathologists and cytopathologists were included for comparison. For this analysis, survey
data were available for 168 practitioners in 43 US academic departments of pathology.
Salary ranges varied little among subspecialties, with the exception of dermatopathology,
where salaries were higher. In contrast, work relative value unit productivity varied
widely among different subspecialties, with median values differing as much as 4- to
7-fold between subspecialties. These results suggest that the use of a single overall work
relative value unit standard is not appropriate for specialty- or subspecialty-based
anatomic pathology practice, and that either the benchmark norms should be tailored to
individual practice patterns, or an alternative system of workload measurement should be
developed.
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Affiliation(s)
- Robert E Mrak
- Department of Pathology, University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA
| | - Tristram G Parslow
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Barbara S Ducatman
- Department of Pathology, Oakland University William Beaumont School of Medicine, Rochester, MI, USA.,Beaumont Health, Royal Oak, MI, USA
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1324
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Weinstein RS. On being a pathologist: a pathway to pathology practice; the added value of supplemental vocational training and mentoring in college and medical school. Hum Pathol 2018; 82:10-19. [PMID: 30267777 DOI: 10.1016/j.humpath.2018.08.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 08/17/2018] [Accepted: 08/26/2018] [Indexed: 11/25/2022]
Abstract
Traditionally, vocational training and liberal arts (and premedical) curricula have been separate education tracks. This personal profile describes a program that evolved from the partial fusion of vocational training and a premedical education track. My personal health issue, visual impairment, which presumably resulted as a complication of congenital toxoplasmosis, hampered my ability to read in grammar school and necessitated my placement in remedial reading classes until eighth grade. My father created an independent home-based vocational training program that ran in parallel to my traditional school education all the way through college. In this case study, I provide an overview of this hybrid education program, which we refer to as the Vocational Training/Medical College Curriculum of the Future (VTMC). This term implies that the education of a student from K-12 school through medical college is a continuum. I find it useful to conceptualize a single education continuum beginning with vocational training and ending with medical education, with a large overlap area in the middle. In this paper, I describe a set of my work experiences that leveraged and reinforced my didactic education experiences. Mentors who supported aspects of the VTMC program have included a college president, a US Congressman, a Nobel Laureate, and a Massachusetts General Hospital leader in academic pathology. Elements of this innovative VTMC program have been used in K-12 public schools and in nonmedical graduate school programs.
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Affiliation(s)
- Ronald S Weinstein
- Department of Pathology College of Medicine, The University of Arizona, Tucson, AZ 85724.
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1325
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Duddy C, Wong G. Explaining variations in test ordering in primary care: protocol for a realist review. BMJ Open 2018; 8:e023117. [PMID: 30209159 PMCID: PMC6144329 DOI: 10.1136/bmjopen-2018-023117] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 06/29/2018] [Accepted: 08/10/2018] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Studies have demonstrated the existence of significant variation in test-ordering patterns in both primary and secondary care, for a wide variety of tests and across many health systems. Inconsistent practice could be explained by differing degrees of underuse and overuse of tests for diagnosis or monitoring. Underuse of appropriate tests may result in delayed or missed diagnoses; overuse may be an early step that can trigger a cascade of unnecessary intervention, as well as being a source of harm in itself. METHODS AND ANALYSIS This realist review will seek to improve our understanding of how and why variation in laboratory test ordering comes about. A realist review is a theory-driven systematic review informed by a realist philosophy of science, seeking to produce useful theory that explains observed outcomes, in terms of relationships between important contexts and generative mechanisms.An initial explanatory theory will be developed in consultation with a stakeholder group and this 'programme theory' will be tested and refined against available secondary evidence, gathered via an iterative and purposive search process. This data will be analysed and synthesised according to realist principles, to produce a refined 'programme theory', explaining the contexts in which primary care doctors fail to order 'necessary' tests and/or order 'unnecessary' tests, and the mechanisms underlying these decisions. ETHICS AND DISSEMINATION Ethical approval is not required for this review. A complete and transparent report will be produced in line with the RAMESES standards. The theory developed will be used to inform recommendations for the development of interventions designed to minimise 'inappropriate' testing. Our dissemination strategy will be informed by our stakeholders. A variety of outputs will be tailored to ensure relevance to policy-makers, primary care and pathology practitioners, and patients. PROSPERO REGISTRATION NUMBER CRD42018091986.
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Affiliation(s)
- Claire Duddy
- Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, Oxford, UK
| | - Geoffrey Wong
- Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, Oxford, UK
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1326
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Kim K, Lee YM. Understanding uncertainty in medicine: concepts and implications in medical education. KOREAN JOURNAL OF MEDICAL EDUCATION 2018; 30:181-188. [PMID: 30180505 PMCID: PMC6127608 DOI: 10.3946/kjme.2018.92] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 06/27/2018] [Accepted: 07/05/2018] [Indexed: 05/30/2023]
Abstract
In an era of high technology and low trust, acknowledging and coping with uncertainty is more crucial than ever. Medical uncertainty has been considered an innate feature of medicine and medical practice. An intolerance to uncertainty increases physicians' stress and the effects of burnout and may be a potential threat to patient safety. Understanding medical uncertainty and acquiring proper coping strategies has been regarded to be a core clinical competency for medical graduates and trainees. Integrating intuition and logic and creating a culture that acknowledges medical uncertainty could be suggested ways to teach medical uncertainty. In this article, the authors describe the concepts of medical uncertainty, its influences on physicians and on medical students toward medical decision making, the role of tolerance/intolerance to uncertainty, and proposed strategies to improve coping with medical uncertainty.
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Affiliation(s)
- Kangmoon Kim
- Department of Medical Education, Korea University College of Medicine, Seoul, Korea
| | - Young-Mee Lee
- Department of Medical Education, Korea University College of Medicine, Seoul, Korea
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1327
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Rodd C, Sokoro A, Lix LM, Thorlacius L, Moffatt M, Slater J, Bohm E. Increased rates of 25-hydroxy vitamin D testing: Dissecting a modern epidemic. Clin Biochem 2018; 59:56-61. [DOI: 10.1016/j.clinbiochem.2018.07.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 06/23/2018] [Accepted: 07/12/2018] [Indexed: 11/28/2022]
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1328
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Davis GG, Winters GL, Fyfe BS, Hooper JE, Iezzoni JC, Johnson RL, Markwood PS, Naritoku WY, Nashelsky M, Sampson BA, Steinberg JJ, Stubbs JR, Timmons C, Hoffman RD. Report and Recommendations of the Association of Pathology Chairs' Autopsy Working Group. Acad Pathol 2018; 5:2374289518793988. [PMID: 30186954 PMCID: PMC6117865 DOI: 10.1177/2374289518793988] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 07/11/2018] [Accepted: 07/16/2018] [Indexed: 11/17/2022] Open
Abstract
Autopsy has been a foundation of pathology training for many years, but hospital autopsy rates are notoriously low. At the 2014 meeting of the Association of Pathology Chairs, some pathologists suggested removing autopsy from the training curriculum of pathology residents to provide additional months for training in newer disciplines, such as molecular genetics and informatics. At the same time, the American Board of Pathology received complaints that newly hired pathologists recently certified in anatomic pathology are unable to perform an autopsy when called upon to do so. In response to a call to abolish autopsy from pathology training on the one hand and for more rigorous autopsy training on the other, the Association of Pathology Chairs formed the Autopsy Working Group to examine the role of autopsy in pathology residency training. After 2 years of research and deliberation, the Autopsy Working Group recommends the following:Autopsy should remain a component of anatomic pathology training.A training program must have an autopsy service director with defined responsibilities, including accountability to the program director to record every autopsy performed by every resident.Specific entrustable activities should be defined that a resident must master in order to be deemed competent in autopsy practice, as well as criteria for gaining the trust to perform the tasks without direct supervision.Technical standardization of autopsy performance and reporting must be improved.The current minimum number of 50 autopsies should not be reduced until the changes recommended above have been implemented.
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Affiliation(s)
- Gregory G Davis
- Forensic Division, Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Gayle L Winters
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Billie S Fyfe
- UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Jody E Hooper
- Department of Pathology, The Johns Hopkins University, Baltimore, MD, USA
| | - Julia C Iezzoni
- Department of Pathology, University of Virginia School of Medicine, Charlottesville, VA, USA
| | | | | | - Wesley Y Naritoku
- Department of Pathology and Laboratory Medicine, USC/LAC+USC Medical Center, Los Angeles, CA, USA
| | - Marcus Nashelsky
- Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, USA
| | - Barbara A Sampson
- City of New York Office of Chief Medical Examiner, New York, NY, USA
| | - Jacob J Steinberg
- Department of Pathology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - James R Stubbs
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Charles Timmons
- Department of Pathology and Laboratory Medicine, University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA
| | - Robert D Hoffman
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, TN, USA
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1329
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Affiliation(s)
- Georga Cooke
- Primary Care Clinical Unit, Faculty of Medicine, University of Queensland, Herston, Queensland, Australia
| | - Ben Mitchell
- Primary Care Clinical Unit, Faculty of Medicine, University of Queensland, Herston, Queensland, Australia
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1330
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Larson RS. A Path to Better-Quality mHealth Apps. JMIR Mhealth Uhealth 2018; 6:e10414. [PMID: 30061091 PMCID: PMC6090170 DOI: 10.2196/10414] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 05/10/2018] [Accepted: 06/16/2018] [Indexed: 12/13/2022] Open
Abstract
The rapid growth of mobile health (mHealth) apps has resulted in confusion among health care providers and the public about which products rely on evidence-based medicine. Only a small subset of mHealth apps are regulated by the US Food and Drug Administration. The system similar to that used to accredit and certify laboratory testing under the Clinical Laboratory Improvement Amendment offers a potential model for ensuring basic standards of quality and safety for mHealth apps. With these products expanding into the realm of diagnosis and treatment, physicians and consumers are in a strong position to demand oversight that delivers safe and high-quality mHealth apps.
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Affiliation(s)
- Richard S Larson
- School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
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1331
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Zatloukal K, Stumptner C, Kungl P, Mueller H. Biobanks in personalized medicine. EXPERT REVIEW OF PRECISION MEDICINE AND DRUG DEVELOPMENT 2018. [DOI: 10.1080/23808993.2018.1493921] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Kurt Zatloukal
- Diagnostic and Research Center for Molecular BioMedicine, Medical University of Graz, Graz, Austria
| | - Cornelia Stumptner
- Diagnostic and Research Center for Molecular BioMedicine, Medical University of Graz, Graz, Austria
| | - Penelope Kungl
- Diagnostic and Research Center for Molecular BioMedicine, Medical University of Graz, Graz, Austria
| | - Heimo Mueller
- Diagnostic and Research Center for Molecular BioMedicine, Medical University of Graz, Graz, Austria
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1332
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Ehlers A, Dyson RL, Hodgson CK, Davis SR, Krasowski MD. Impact of Daylight Saving Time on the Clinical Laboratory. Acad Pathol 2018; 5:2374289518784222. [PMID: 30023429 PMCID: PMC6047237 DOI: 10.1177/2374289518784222] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 05/20/2018] [Accepted: 05/24/2018] [Indexed: 12/15/2022] Open
Abstract
Daylight saving time is a practice in some countries and local regions to set clocks forward (typically 1 hour) during the longer days of summer and back again in autumn. Time changes resulting from daylight saving time have the potential to impact clinical laboratory instruments, computer interfaces, and information systems. We analyzed turnaround time data for an academic medical center clinical laboratories (chemistry, hematology, blood gas analyzer, and transfusion medicine), examining how turnaround time was impacted by the daylight saving time shifts in 2017. We also determined whether the daylight saving time shift on November 5, 2017 (“fall back” by 1 hour) resulted in any “absurd” time combinations such as a receipt time occurring “before” a normally later time such as final result. We also describe challenges resulting from daylight saving time changes over a 5-year period. The only significant impact on turnaround time was for clinical chemistry samples during the autumn daylight saving time change, but the overall impact was low. Four instances of absurd time combinations occurred in the autumn time change with only a transfusion medicine example resulting in an interface error (a Type and Screen resulted “before” receipt in laboratory). Over a 5-year period, other daylight saving time impacts included problems of reestablishing interface to instruments, inadvertent discrepancies in manual time changes at different points of the core laboratory automation line, and time change errors in instruments with older operating systems lacking patches that updated daylight saving time rules after 2007. Clinical laboratories should be aware that rare problems may occur due to issues with daylight saving time changes.
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Affiliation(s)
- Alexandra Ehlers
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Richard L Dyson
- Health Care Information Systems, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Christina K Hodgson
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Scott R Davis
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Matthew D Krasowski
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
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1333
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McGary CT. Educational Case: Medullary Thyroid Carcinoma. Acad Pathol 2018; 5:2374289518770173. [PMID: 29978015 PMCID: PMC6024339 DOI: 10.1177/2374289518770173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 02/08/2018] [Accepted: 02/16/2018] [Indexed: 11/18/2022] Open
Abstract
The following fictional case is intended as a learning tool within the Pathology Competencies for Medical Education (PCME), a set of national standards for teaching pathology. These are divided into three basic competencies: Disease Mechanisms and Processes, Organ System Pathology, and Diagnostic Medicine and Therapeutic Pathology. For additional information, and a full list of learning objectives for all three competencies, see http://journals.sagepub.com/doi/10.1177/2374289517715040.
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Affiliation(s)
- Carl T McGary
- Department of Biomedical Sciences, The University of Minnesota Medical School-Duluth, Duluth, MN, USA
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Abstract
Abstract
Laboratory services around the world are undergoing substantial consolidation and changes through mechanisms ranging from mergers, acquisitions and outsourcing, primarily based on expectations to improve efficiency, increasing volumes and reducing the cost per test. However, the relationship between volume and costs is not linear and numerous variables influence the end cost per test. In particular, the relationship between volumes and costs does not span the entire platter of clinical laboratories: high costs are associated with low volumes up to a threshold of 1 million test per year. Over this threshold, there is no linear association between volumes and costs, as laboratory organization rather than test volume more significantly affects the final costs. Currently, data on laboratory errors and associated diagnostic errors and risk for patient harm emphasize the need for a paradigmatic shift: from a focus on volumes and efficiency to a patient-centered vision restoring the nature of laboratory services as an integral part of the diagnostic and therapy process. Process and outcome quality indicators are effective tools to measure and improve laboratory services, by stimulating a competition based on intra- and extra-analytical performance specifications, intermediate outcomes and customer satisfaction. Rather than competing with economic value, clinical laboratories should adopt a strategy based on a set of harmonized quality indicators and performance specifications, active laboratory stewardship, and improved patient safety.
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Affiliation(s)
- Mario Plebani
- Dipartimento Strutturale Medicina di Laboratorio , Azienda Ospedale Università di Padova Via Giustiniani , 2 – 35128 Padova , Italy
- Department of Medicine-DIMED, Medical School , University of Padova , Padova , Italy
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1336
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Burns KH, Borowitz MJ, Carroll KC, Gocke CD, Hooper JE, Amukele T, Tobian AAR, Valentine A, Kahl R, Rodas-Eral V, Boitnott JK, Jackson JB, Sanfilippo F, Hruban RH. The Evolution of Earned, Transparent, and Quantifiable Faculty Salary Compensation: The Johns Hopkins Pathology Experience. Acad Pathol 2018; 5:2374289518777463. [PMID: 29978019 PMCID: PMC6024278 DOI: 10.1177/2374289518777463] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Revised: 03/24/2018] [Accepted: 04/12/2018] [Indexed: 11/23/2022] Open
Abstract
Faculty value equitable and transparent policies for determining salaries and expect
their compensation to compare favorably to the marketplace. Academic institutions use
compensation to recruit and retain talented faculty as well as to reward accomplishment.
Institutions are therefore working to decrease salary disparities that appear arbitrary or
reflect long-standing biases and to identify metrics for merit-based remuneration. Ours is
a large academic pathology department with 97 tenure-track faculty. Faculty salaries are
comprised of 3 parts (A + B + C). Part A is determined by the type of appointment and
years at rank; part B recognizes defined administrative, educational, or clinical roles;
and part C is a bonus to reward and incentivize activities that forward the missions of
the department and medical school. A policy for part C allocations was first codified and
approved by department faculty in 1993. It rewarded performance using a semiquantitative
scale, based on subjective evaluations of the department director (chair) in consultation
with deputy directors (vice chairs) and division directors. Faculty could not directly
calculate their part C, and distributions data were not widely disclosed. Over the last 2
years (2015-2017), we have implemented a more objective formula for quantifying an earned
part C, which is primarily designed to recognize scholarship in the form of research
productivity, educational excellence, and clinical quality improvement. Here, we share our
experience with this approach, reviewing part C calculations as made for individual
faculty members, providing a global view of the resulting allocations, and considering how
the process and outcomes reflect our values.
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Affiliation(s)
- Kathleen H Burns
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michael J Borowitz
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Karen C Carroll
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Christopher D Gocke
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jody E Hooper
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Timothy Amukele
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Aaron A R Tobian
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Allen Valentine
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Rob Kahl
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Vanessa Rodas-Eral
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - John K Boitnott
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - J Brooks Jackson
- Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA, USA
| | - Fred Sanfilippo
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA
| | - Ralph H Hruban
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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van Leeuwen DJ, Alves V, Balabaud C, Bhathal PS, Bioulac-Sage P, Colombari R, Crawford JM, Dhillon AP, Ferrell L, Gill RM, Guido M, Hytiroglou P, Nakanuma Y, Paradis V, Rautou PE, Sempoux C, Snover DC, Theise ND, Thung SN, Tsui WMS, Quaglia A, Liver Pathology Study Group TI. Acute-on-chronic liver failure 2018: a need for (urgent) liver biopsy? Expert Rev Gastroenterol Hepatol 2018; 12:565-573. [PMID: 29806950 DOI: 10.1080/17474124.2018.1481388] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
'Acute-on-Chronic-Liver Failure (ACLF)' entered hepatology practice by the end of the 20th century. Although we lack precise and universally agreed definitions, acute decompensation of chronic liver disease with jaundice and deranged clotting, multi-organ failure and high, short-term mortality are hallmarks of the syndrome. Timely recognition and and treatment, including urgent liver transplantation, may save the life of certain patients. The diagnosis and management are mostly based on clinical features, but some have suggested to incorporate histopathology (liver biopsy). This may add to the differentiation between acute and chronic disease, primary and concomitant etiologies, and identify prognostic determinants. Areas covered: A review of the literature on ACLF and the outcome of the discussions at a topical international meeting on specific histopathological aspects of diagnosis and prognosis of the syndrome. Expert commentary: There is a lack of standardized descriptions of histopathological features and there is limited prospective experience with the role of pathology of ACLF. It is important for the clinical hepatologist to understand the potential and limitations of (transjugular) liver biopsy in ACLF and for the pathologist to help address the clinical question and recognise the histopathological features that help to characterize ACLF, both in terms of diagnosis and prognosis.
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Affiliation(s)
- Dirk J van Leeuwen
- a Section of Gastroenterology and Hepatology , Geisel School of Medicine at Dartmouth College , Hanover , NH , USA.,b Section of Gastroenterology and Hepatology , Eastern Maine Medical Center , Bangor , ME , USA
| | - Venancio Alves
- c Department of Pathology , University of São Paulo School of Medicine , São Paulo , Brazil
| | | | - Prithi S Bhathal
- e Department of Pathology , University of Melbourne , Melbourne , Victoria , Australia
| | | | - Romano Colombari
- g Department of Pathology , Ospedale Fracastoro , Verona , Italy
| | - James M Crawford
- h Department of Pathology and Laboratory Medicine , Hofstra Northwell School of Medicine , Hempstead , NY , USA
| | - Amar P Dhillon
- i Department of Cellular Pathology , UCL Medical School , London , UK
| | - Linda Ferrell
- j Department of Pathology , University of California , San Francisco ; CA , USA
| | - Ryan M Gill
- j Department of Pathology , University of California , San Francisco ; CA , USA
| | - Maria Guido
- k Department of Medicine-DIMED, Pathology Unit , University of Padova , Padova , Italy
| | - Prodromos Hytiroglou
- l Department of Pathology , Aristotle University Medical School , Thessaloniki , Greece
| | - Yasuni Nakanuma
- m Department of Pathology , Fukui Saiseikai Hospital , Fukui , Japan
| | | | | | - Christine Sempoux
- p Pathologie Clinique , Institut Universitaire de Pathologie , Lausanne , Switzerland
| | - Dale C Snover
- q Department of Pathology , Fairview Southdale Hospital , Edina , MN , USA
| | - Neil D Theise
- r Department of Pathology , NYU-Langone Medical Center , NY , NY , USA
| | - Swan N Thung
- s Department of Pathology , Icahn School of Medicine at Mount Sinai , New York , NY , USA
| | - Wilson M S Tsui
- t Department of Pathology , Caritas Medical Centre , Hong Kong , China
| | - Alberto Quaglia
- u Institute of Liver Studies , King's College Hospital and King's College , London , England
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1338
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Wilcox RL, Adem PV, Afshinnekoo E, Atkinson JB, Burke LW, Cheung H, Dasgupta S, DeLaGarza J, Joseph L, LeGallo R, Lew M, Lockwood CM, Meiss A, Norman J, Markwood P, Rizvi H, Shane-Carson KP, Sobel ME, Suarez E, Tafe LJ, Wang J, Haspel RL. The Undergraduate Training in Genomics (UTRIG) Initiative: early & active training for physicians in the genomic medicine era. Per Med 2018; 15:199-208. [PMID: 29843583 DOI: 10.2217/pme-2017-0077] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Genomic medicine is transforming patient care. However, the speed of development has left a knowledge gap between discovery and effective implementation into clinical practice. Since 2010, the Training Residents in Genomics (TRIG) Working Group has found success in building a rigorous genomics curriculum with implementation tools aimed at pathology residents in postgraduate training years 1-4. Based on the TRIG model, the interprofessional Undergraduate Training in Genomics (UTRIG) Working Group was formed. Under the aegis of the Undergraduate Medical Educators Section of the Association of Pathology Chairs and representation from nine additional professional societies, UTRIG's collaborative goal is building medical student genomic literacy through development of a ready-to-use genomics curriculum. Key elements to the UTRIG curriculum are expert consensus-driven objectives, active learning methods, rigorous assessment and integration.
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Affiliation(s)
- Rebecca L Wilcox
- Department of Pathology and Laboratory Medicine and Department of Pediatrics, University of Vermont Medical Center, Larner College of Medicine, University of Vermont, Burlington, VT, 05401, USA
| | - Patricia V Adem
- Department of Pathology, New York Medical College School of Medicine, Valhalla, NY, 10595, USA
| | - Ebrahim Afshinnekoo
- Department of Pathology, New York Medical College School of Medicine, Valhalla, NY, 10595, USA
| | - James B Atkinson
- Department of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, TN, 37232, USA
| | - Leah W Burke
- Department of Pathology and Laboratory Medicine and Department of Pediatrics, University of Vermont Medical Center, Larner College of Medicine, University of Vermont, Burlington, VT, 05401, USA
| | - Hoiwan Cheung
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH/Geisel School of Medicine at Dartmouth, Hanover, NH, 03755, USA
| | - Shoumita Dasgupta
- Department of Medicine, Biomedical Genetics Section, Boston University School of Medicine, Boston, MA, 02118, USA
| | - Julia DeLaGarza
- Department of Pathology, New York Medical College School of Medicine, Valhalla, NY, 10595, USA
| | - Loren Joseph
- Department of Pathology, Beth Israel Deaconess Medical Center & Harvard Medical School, Boston, MA, 02115, USA
| | - Robin LeGallo
- Department of Pathology, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA
| | - Madelyn Lew
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA
| | - Christina M Lockwood
- Department of Laboratory Medicine, University of Washington School of Medicine, Seattle, WA, 98195, USA
| | - Alice Meiss
- Department of Pathology, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA
| | | | | | - Hasan Rizvi
- Institue of Health Sciences Education, Barts and the London School of Medicine and Dentistry, Queen Mary, University of London, London, E1 2AD, UK
| | - Kate P Shane-Carson
- Division of Human Genetics, Department of Internal Medicine, Ohio State University Comprehensive Cancer Center, Columbus, OH, 43210, USA
| | - Mark E Sobel
- American Society for Investigative Pathology, Rockville, MD, 20852, USA
| | - Eric Suarez
- Pathology Department, Uniformed Services University, Bethesda, MD, 20814, USA
| | - Laura J Tafe
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH/Geisel School of Medicine at Dartmouth, Hanover, NH, 03755, USA
| | - Jason Wang
- Department of Pathology, UT Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Richard L Haspel
- Department of Pathology, Beth Israel Deaconess Medical Center & Harvard Medical School, Boston, MA, 02115, USA
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1339
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Gao ZH. Chairing an academic pathology department: challenges and opportunities. J Clin Pathol 2018; 72:206-212. [PMID: 29705737 DOI: 10.1136/jclinpath-2017-204963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 02/08/2018] [Accepted: 04/10/2018] [Indexed: 11/04/2022]
Abstract
Understanding the heterogeneity of departmental structure, service model and job descriptions for different pathology chairs, this review highlights some common challenges and opportunities facing most pathology chairs in academic institutions. The review is divided into three sections: clinical service, academic development and administration. The views and insights from this review may provide guidance to new chairs and emerging leaders in pathology and other relevant specialties.
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Affiliation(s)
- Zu-Hua Gao
- Department of Pathology, McGill University, Montreal, Quebec, Canada
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1340
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Prayson RA. Pathology resident perspectives about early autopsy experiences. Ann Diagn Pathol 2018; 34:82-84. [PMID: 29661734 DOI: 10.1016/j.anndiagpath.2018.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 03/13/2018] [Indexed: 11/25/2022]
Abstract
The performance of autopsies remains an integral part of residency training in Anatomic Pathology. A number of medical schools no longer require an autopsy experience; therefore, a subset of pathology residents has never seen an autopsy performed prior to commencement of residency training. Although much as been written regarding student's perspectives on their medical school anatomy experiences, practically nothing has been written about resident perspectives on the autopsy experience. Surveys were sent to all Pathology resident trainees (n = 27) in a training program exploring resident perspectives on their early autopsy experiences. Of the 13 residents who completed the survey, ten indicated a discomfort level of 3 or 4 (Likert scale of 1-5 with 1 = no discomfort and 5 = very uncomfortable) associated with their first autopsy; the most commonly cited reasons included discomfort with odors/body fluids (n = 6), fear of making a mistake (n = 5), and uncertainty about what to do (n = 4). Six residents felt it would be worthwhile to engage in a discussion around the first autopsy experience to help process it. In summary, a subset of residents experience discomfort around their first autopsy experience. Sensitivity to and acknowledgement of this discomfort and an opportunity to vet feelings and concerns should be considered as part of Pathology residency education.
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Affiliation(s)
- Richard A Prayson
- Department of Anatomic Pathology, L25, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
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1341
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Rodriguez FH, Petersen J, Selvaratnam R, Mann P, Hoyne JB. Hurricanes: Are You Prepared? Lab Med 2018; 49:e18-e22. [PMID: 29481622 DOI: 10.1093/labmed/lmy001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Severe weather events such as hurricanes have the potential to cause significant disruption of laboratory operations. Comprehensive planning is essential to mitigate the impact of such events. The essential elements of a Hurricane Plan, based on our personal experiences, are detailed in this article.
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Affiliation(s)
| | | | | | - Peggy Mann
- University of Texas Medical Branch, Galveston, TX
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1342
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Borges Costa L, Esteche FF, Fernandes Augusto Filho R, Benevides Bomfim AL, Aguiar Mourão Ribeiro MT. Competências e Atividades Profissionais Confiáveis: novos paradigmas na elaboração de uma Matriz Curricular para Residência em Medicina de Família e Comunidade. REVISTA BRASILEIRA DE MEDICINA DE FAMÍLIA E COMUNIDADE 2018. [DOI: 10.5712/rbmfc13(40)1632] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Objetivo: Realizar uma revisão na literatura sobre Currículo Baseado em Competências que possa subsidiar a elaboração de uma Matriz para Programa de Residência em Medicina de Família e Comunidade de Fortaleza, Ceará. Métodos: Foi realizada revisão de literatura sobre o referencial teórico do ensino baseado em competências, selecionando artigos, diretrizes, documentos e modelos de currículos de escolas médicas e entidades nacionais e internacionais envolvidas com o ensino médico. Resultados: A revisão de literatura evidenciou dois principais modelos de currículo repetidamente citados nas referências consultadas: ACGME (Accreditation Council for Graduate Medical Education) Milestones e CanMEDS (Canadian Medical Education Directions for Specialists) Framework. O Currículo Baseado em Competências enfatiza o ensino centrado no aluno e utiliza abordagem baseada em resultados para a criação, implementação e avaliação de programas de educação médica, usando uma estrutura organizacional de competências mapeadas com atividades profissionais confiáveis, na forma de uma matriz. A avaliação é feita por meio de desempenho e resultados graduados em marcos de desenvolvimento. Para fins de elaboração de Matriz curricular própria, optou-se como modelo e referência a proposta do CanMEDS 2015 por este ser aprovado por 12 organizações médicas canadenses e atualmente usado como base curricular em dezenas de países, sendo o modelo mais amplamente aplicado no mundo. Conclusão: Espera-se que esta revisão sirva de ferramenta para que também outras Instituições de Ensino e seus respectivos Programas de Residência possam desenvolver seus próprios Currículos Baseados em Competências.
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1343
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Gibson B, Bracamonte E, Krupinski EA, Briehl MM, Barker GP, Weinstein JB, Weinstein RS. A "Pathology Explanation Clinic (PEC)" for Patient-Centered Laboratory Medicine Test Results. Acad Pathol 2018; 5:2374289518756306. [PMID: 29582001 PMCID: PMC5862367 DOI: 10.1177/2374289518756306] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 11/15/2017] [Accepted: 01/04/2018] [Indexed: 11/15/2022] Open
Abstract
This concept paper addresses communication issues arising between physicians and their patients. To facilitate the communication of essential diagnostic pathology information to patients, and address their questions and concerns, we propose that "Pathology Explanation Clinics" be created. The Pathology Explanation Clinics would provide a channel for direct communications between pathologists and patients. Pathologists would receive special training as "Certified Pathologist Navigators" in preparation for this role. The goal of Pathology Explanation Clinics would be to help fill gaps in communication of information contained in laboratory reports to patients, further explain its relevance, and improve patient understanding of the meaning of such information and its impact on their health and health-care choices. Effort would be made to ensure that Certified Pathologist Navigators work within the overall coordination of care by the health-care team.
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Affiliation(s)
- Blake Gibson
- Department of Pathology, College of Medicine-Tucson, The University of Arizona, Tucson, AZ, USA
| | - Erika Bracamonte
- Department of Pathology, College of Medicine-Tucson, The University of Arizona, Tucson, AZ, USA
| | - Elizabeth A Krupinski
- Arizona Telemedicine Program, The University of Arizona, Tucson, AZ, USA.,Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA, USA
| | - Margaret M Briehl
- Department of Pathology, College of Medicine-Tucson, The University of Arizona, Tucson, AZ, USA
| | - Gail P Barker
- Arizona Telemedicine Program, The University of Arizona, Tucson, AZ, USA.,Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | | | - Ronald S Weinstein
- Department of Pathology, College of Medicine-Tucson, The University of Arizona, Tucson, AZ, USA.,Arizona Telemedicine Program, The University of Arizona, Tucson, AZ, USA.,Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
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1344
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Jajosky RP, Jajosky AN, Kleven DT, Singh G. Fewer seniors from United States allopathic medical schools are filling pathology residency positions in the Main Residency Match, 2008-2017. Hum Pathol 2018; 73:26-32. [DOI: 10.1016/j.humpath.2017.11.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 11/02/2017] [Indexed: 11/25/2022]
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1345
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Rae G, Newman WP, McGoey R, Donthamsetty S, Karpinski AC, Green J. The histopathologic reliability of tissue taken from cadavers within the gross anatomy laboratory. ANATOMICAL SCIENCES EDUCATION 2018; 11:207-214. [PMID: 29024453 DOI: 10.1002/ase.1743] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 09/11/2017] [Accepted: 09/12/2017] [Indexed: 06/07/2023]
Abstract
The purpose of this study was to examine the histopathologic reliability of embalmed cadaveric tissue taken from the gross anatomy laboratory. Tissue samples from hearts, livers, lungs, and kidneys were collected after the medical students' dissection course was completed. All of the cadavers were embalmed in a formalin-based fixative solution. The tissue was processed, embedded in paraffin, sectioned at six micrometers, and stained with H&E. The microscope slides were evaluated by a board certified pathologist to determine whether the cellular components of the tissues were preserved at a high enough quality to allow for histopathologic diagnosis. There was a statistically significant relationship between ratings and organ groups. Across all organs, there was a smaller proportion of "poor" ratings. The lung group had the highest percentage of "poor" ratings (23.1%). The heart group had the least "poor" ratings (0.0%). The largest percentage of "satisfactory" ratings were in the lung group (52.8%), and the heart group contained the highest percentage of "good" ratings (58.5%) The lung group had the lowest percentage of "good" ratings (24.2%). These results indicate that heart tissue is more reliable than lung, kidney, or liver tissue when utilizing tissue from the gross anatomy laboratory for research and/or educational purposes. This information advises educators and researchers about the quality and histopathologic reliability of tissue samples obtained from the gross anatomy laboratory. Anat Sci Educ 11: 207-214. © 2017 American Association of Anatomists.
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Affiliation(s)
- Guenevere Rae
- Department of Cell Biology and Anatomy School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - William P Newman
- Department of Pathology School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Robin McGoey
- Department of Pathology School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | | | - Aryn C Karpinski
- School of Foundations, Leadership, and Administration, Kent State University, Kent, Ohio
| | - Jeffrey Green
- Department of Cell Biology and Anatomy School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana
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1346
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Mello-Carpes PB, Carpes FP. Improving physiology learning and understanding by adding outreach activities to the teaching: report of the IUPS and ADInstruments Teaching Workshop 2017. ADVANCES IN PHYSIOLOGY EDUCATION 2018; 42:159-161. [PMID: 29446314 DOI: 10.1152/advan.00148.2017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Pâmela B Mello-Carpes
- Physiology Research Group, Federal University of Pampa, Uruguaiana, Rio Grande do Sul, Brazil
| | - Felipe Pivetta Carpes
- Applied Neuromechanics Research Group, Federal University of Pampa, Uruguaiana, Rio Grande do Sul, Brazil
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1347
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Mukundu Nagesh N, Chiva Giurca B, Lishman S. Innovating undergraduate pathology education through public engagement. Virchows Arch 2018; 472:853-863. [PMID: 29488009 PMCID: PMC5978842 DOI: 10.1007/s00428-018-2299-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 01/08/2018] [Accepted: 01/11/2018] [Indexed: 11/29/2022]
Abstract
The trends in modern undergraduate medical education focus on a patient-centred approach through problem-based learning over the traditional modular curriculum. Integrating pathology into this style of learning has resulted in the dilution of core scientific principles which may have contributed to reduced understanding and interest in the subject. We aim to innovate pathology education by utilising National Pathology Week which is organised by the Royal College of Pathologists to develop the public engagement model which empowers students to learn pathology by teaching the public. Through this model, we hope to generate a greater interest in pathology at both undergraduate and postgraduate stages of education. We obtained funding from the Royal College of Pathologists to organise National Pathology Week at Exeter Medical School and the Royal Devon & Exeter Hospital. We involved 125 undergraduate student volunteers from health-related courses. We designed a curriculum aiming to educate both students and public on current topics such as cancer screening programmes, antibiotic resistance, diagnosis of inflammatory bowel disease and the role of pathologists. We hosted 15 pathologists, biomedical scientists and microbiologists to engage with students, share experiences and offer an insight into their careers. Through this project, we interacted with over 500 members of the public and 150 school students. The medical student volunteers developed a range of skills including competent use of microscopes to visualise pathology slides, effective communication with lay audiences to teach pathology and understanding of the clinical application of pathology. We believe the public engagement model of teaching undergraduate students has the potential to develop a greater interest in pathology whilst benefitting the wider community.
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Affiliation(s)
| | | | - Suzy Lishman
- Royal College of Pathologists, 21 Prescot St, 4th Floor, London, E1 8BB, UK
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1348
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Rubinstein M, Hirsch R, Bandyopadhyay K, Madison B, Taylor T, Ranne A, Linville M, Donaldson K, Lacbawan F, Cornish N. Effectiveness of Practices to Support Appropriate Laboratory Test Utilization: A Laboratory Medicine Best Practices Systematic Review and Meta-Analysis. Am J Clin Pathol 2018; 149:197-221. [PMID: 29471324 PMCID: PMC6016712 DOI: 10.1093/ajcp/aqx147] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Objectives To evaluate the effectiveness of practices used to support appropriate clinical laboratory test utilization. Methods This review followed the Centers for Disease Control and Prevention (CDC) Laboratory Medicine Best Practices A6 cycle method. Eligible studies assessed one of the following practices for effect on outcomes relating to over- or underutilization: computerized provider order entry (CPOE), clinical decision support systems/tools (CDSS/CDST), education, feedback, test review, reflex testing, laboratory test utilization (LTU) teams, and any combination of these practices. Eligible outcomes included intermediate, systems outcomes (eg, number of tests ordered/performed and cost of tests), as well as patient-related outcomes (eg, length of hospital stay, readmission rates, morbidity, and mortality). Results Eighty-three studies met inclusion criteria. Fifty-one of these studies could be meta-analyzed. Strength of evidence ratings for each practice ranged from high to insufficient. Conclusion Practice recommendations are made for CPOE (specifically, modifications to existing CPOE), reflex testing, and combined practices. No recommendation for or against could be made for CDSS/CDST, education, feedback, test review, and LTU. Findings from this review serve to inform guidance for future studies.
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Affiliation(s)
| | | | | | | | - Thomas Taylor
- Centers for Disease Control and Prevention, Atlanta, GA
| | - Anne Ranne
- Centers for Disease Control and Prevention, Atlanta, GA
| | | | | | | | - Nancy Cornish
- Centers for Disease Control and Prevention, Atlanta, GA
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1349
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Green R, Hogarth MA, Prystowsky MB, Rashidi HH. The Job Market Outlook for Residency Graduates: Clear Weather Ahead for the Butterflies? Arch Pathol Lab Med 2018; 142:435-438. [PMID: 29425072 DOI: 10.5858/arpa.2017-0540-ed] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | | | | | - Hooman H Rashidi
- From the Department of Pathology and Laboratory of Medicine, University of California, Davis, Sacramento (Drs Green and Rashidi); the Division of Biomedical Informatics, Department of Medicine, University of California, San Diego Health, San Diego (Dr Hogarth); and the Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York (Dr Prystowsky)
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1350
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McCall SJ, Branton PA, Blanc VM, Dry SM, Gastier-Foster JM, Harrison JH, Jewell SD, Dash RC, Obeng RC, Rose J, Mateski DL, Liubinskas A, Robb JA, Ramirez NC, Shea K. The College of American Pathologists Biorepository Accreditation Program: Results from the First 5 Years. Biopreserv Biobank 2018; 16:16-22. [PMID: 29394087 PMCID: PMC5824654 DOI: 10.1089/bio.2017.0108] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The College of American Pathologists (CAP) developed the Biorepository Accreditation Program (BAP) in 2012. This program integrates best practices from the International Society for Biological and Environmental Biorepositories, the National Cancer Institute, the Organisation for Economic Cooperation and Development, the Center for Medicare and Medicaid Services, and the CAP Laboratory Accreditation Program. The goal of this elective program is to provide requirements for standardization in biorepository processes that will result in high-quality specimens that can be used to support research, drug discovery, and personalized medicine. CAP uses a peer inspection model to ensure the inspectors have proper expertise and to promote educational efforts through information sharing. Lead inspectors are comprised of pathologists, PhDs, and managers of biorepositories and they are often supported by CAP staff inspectors. Accreditation is a 3-year continuous cycle of quality with a peer inspection occurring at the start of year 1 and a self-inspection and CAP desk assessment at the start of year 2 and 3. At this time 53 biorepositories are fully CAP BAP accredited and 13 are in the process of obtaining accreditation. There are currently 273 established standards with requirement lists customized based on the scope of activities performed by a biorepository. A total of 90 inspections were completed between May 2012 and December 2016. Sixty-one were initial inspections and 29 were reinspections. A total of 527 deficiencies were identified in the areas of Equipment/Instrumentation (22%), Information Technology (18%), Specimen Handling and QC (15%), Quality Management (16%), Personnel (11%), Safety (10%), Facilities (6%), and Regulatory (2%). Assessment of common deficiencies identifies areas of focus for continuous improvement and educational opportunities. Overall success of the program is high based on the current enrollment of 66 biorepositories, anecdotal participant feedback and increasing national recognition of the BAP in federal documents.
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Affiliation(s)
- Shannon J. McCall
- Department of Pathology, Duke University Health System, Durham, North Carolina
| | - Philip A. Branton
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Victoria M. Blanc
- Central Biorepository, University of Michigan Medical School, Ann Arbor, Michigan
| | - Sarah M. Dry
- Department of Pathology and Laboratory Medicine, UCLA Medical Center, David Geffen School of Medicine, Los Angeles, California
| | - Julie M. Gastier-Foster
- Department of Pathology, Nationwide Childrens' Hospital and The Ohio State University, Columbus, Ohio
| | - James H. Harrison
- Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia
- Department of Pathology, University of Virginia, Charlottesville, Virginia
| | - Scott D. Jewell
- Program for Biospecimen Science, Van Andel Research Institute, Grand Rapids, Michigan
| | - Rajesh C. Dash
- Department of Pathology, Duke University Health System, Durham, North Carolina
| | | | - Joan Rose
- College of American Pathologists, Northfield, Illinois
| | | | | | - James A. Robb
- Consulting Pathologist and Former CAP Governor, Boca Raton, Florida
| | - Nilsa C. Ramirez
- Department of Pathology, Nationwide Childrens' Hospital and The Ohio State University, Columbus, Ohio
| | - Kathi Shea
- Brooks Life Science Systems, Indianapolis, Indiana
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