(3-7) Algorithmic testing protocols have been successful in improving test utilization (8-10) and may be able to improve the completeness of the BM evaluation and therefore improve patient care.
The pathologists in hematopathology and cytogenetics sought and received approval from laboratory compliance personnel to offer algorithmic testing. We developed a strategy to triage BM samples into 1 of 8 testing algorithms, referred to as tracks, based on clinical history and initial peripheral blood and BM findings (see supplemental digital content at www.archivesofpathology.org in the June 2019 table of contents).
Pathology-driven algorithmic testing with IR ensures that our patients receive an appropriate BM examination with an integrated diagnosis.
Pathology-driven algorithmic testing improves compliance with recommendations for testing.
Pathology-driven algorithmic testing with IR may be used as an educational tool for medical students, pathology residents, hematopathology fellows, and hematology/oncology fellows.
Pathology-driven algorithmic testing with IR is the standard of care at our institution.
To evaluate local ordering practices and determine the potential use of algorithmic testing, we performed a retrospective review of 918 HFE clinical test results from January 6, 2015, to January 4, 2016, which included a detailed clinical chart review of 98 patients.
Our proposed intervention is a single "one-button order" (Figure 2) that activates appropriate algorithmic testing. Initial studies for transferrin saturation would be followed by genetic testing only when transferrin saturation levels were above 45%.