CAPcast from the College of American Pathologists

Clinical decision support systems are IT-based tools that compile patient- and context-specific data, presenting this to providers at the point-of-care and clinical decision making. These systems are an excellent means for pathologists to influence laboratory test-ordering practices and to foster appropriate test use. However, the optimal methods to design, implement and maintain CDSS are not well...

This year’s CAP20 virtual event will feature a book club discussion on Bad Blood: Secrets and Lies in a Silicon Valley Startup, John Carreyrou’s award-winning account of the rise and fall of the lab testing company Theranos and its controversial founder, Elizabeth Holmes. Dr. Paul Valenstein will facilitate the discussion. In this CAPcast interview, Dr. Valenstein discusses the book in terms of th...

Laboratories must report cumulative antimicrobial sensitivity information to the medical staff at least annually under accreditation requirements from both the CAP and the Joint Commission. Despite requirements to do this at the institutional level, there is no national reporting or convenient way for the institution to monitor trends or compare rates recorded by other laboratories, explains Dr. R...

Careful morphologic review of blood smears is a crucial first step in the diagnostic workup of an abnormal WBC differential, explains Dr. Olga Pozdnyakova in this CAPcast interview. Dr. Pozdnyakova, along with Dr. Kyle Bradley, will be teaching a course on this topic at CAP20, which will be held virtually Oct. 10-14. For more information and to register: https://www.capannualmeeting.org.

Patients with cirrhosis are frequently transfused with platelets and plasma, yet the optimal role of these blood products may be poorly understood by ordering providers. It is important for pathologists to evaluate the available evidence supporting or refuting the use of these blood products in this population and be able to have conversations with gastroenterology colleagues about optimizing the...

Recent U.S. physician workforce counts have understated by about 40% the number of actively practicing pathologists, CAP members outline in an article published recently in the Journal of the American Medical Association Network Open (“Re-evaluation of the US Pathologist Workforce Strength": https://capatholo.gy/3eBugLM). In this CAPcast interview, two CAP member leaders—past president Stanley Rob...

In a laboratory setting with fast-paced changes and heavy demands on staff, day-to-day communication across departments is challenging, yet paramount to resource sharing and real-time problem solving. To improve communication across departments, the laboratory at Seattle Children’s Hospital has been using daily huddles for several years, explains Dr. Joe Rutledge in this CAPcast. Daily huddles hav...

Pathologists need to be aware of upcoming Medicare cuts due to changes to evaluation and management payment and coding, which were finalized in November 2019, explains Dr. Jonathan Myles in this CAPcast. In this interview, Dr. Myles will provide an overview of the current state of the efforts to prevent Medicare cuts to pathologists due to changes to evaluation and management (E/M) payment and cod...

In early 2020, the CAP introduced its first Autopsy Protocol for Adult Decedents, explains Dr. Jody Hooper, Director of Autopsy Service at Johns Hopkins Hospital and Associate Professor of Pathology, in this CAPcast. Dr. Hooper was the chair of the CAP’s Autopsy Committee until recently and was instrumental in creating this protocol. The protocol is available on CAP.org: https://capatholo.gy/2zvUS...

As we move into the next phase of the pandemic, laboratories are ramping up efforts to implement SARS-CoV-2 antibody testing to identify individuals who may have been infected with SARS-CoV-2 in the past. In this CAPcast, Dr. Daniel Rhoads, Section Head of Microbiology at the Cleveland Clinic and Dr. Elitza Theel, Director of Infectious Disease Serology from Mayo Clinic explain the clinical use of...

One investigational treatment being explored for COVID-19 is the use of convalescent plasma or CCP collected from individuals who have recovered from COVID-19. CCP that contains antibodies to severe acute respiratory syndrome coronavirus 2 or SARS-CoV-2 (the virus that causes COVID-19) is being studied for administration to patients with COVID-19. Use of convalescent plasma has been studied in out...

Most biorepositories have not traditionally paid attention to the financial aspects of their operations, which has led to problems in the long-term sustainability of some academic, government and commercial biobanking operations, explains Dr. Jim Vaught, editor-in-chief of the journal Biopreservation and Biobanking, in this CAPcast. Dr. Vaught has studied the challenges involved in the economics a...

Emergency assistance programs recently enacted by Congress have created more than $350 billion in financial aid for small businesses during the COVID-19 national emergency and economic downturn. Many of these programs for small businesses, which are defined as those with 500 or fewer employees, are applicable to pathologists and their laboratories. The CAP is urging its members to consider applyin...

In the wake of the outbreak of COVID-19, clinical laboratories have shown an unwavering commitment to the patients they serve by ramping up efforts to deploy COVID-19 testing. The CAP is committed to supporting your efforts and is happy to announce COV2, a new proficiency testing (PT) program for the detection of SARS-CoV-2 by nucleic acid amplification testing. The new PT program’s material is no...

As U.S. laboratories expand their testing capabilities, many pathologists are eager to share lessons learned from their own experiences. In this CAPcast interview, Dr. Richard Scanlan discusses his experiences bringing COVID-19 testing online at his institution, including some lessons learned. Dr. Scanlan is the medical director of the Oregon Health and Sciences University Hospital laboratory in P...

Seattle experienced the COVID-19 pandemic’s first wave in the United States. UW Medicine’s Geoffrey Baird, MD, PhD, acting chair of Laboratory Medicine was at the forefront, confronting significant challenges related to diagnosing patients with this virus. In this CAPcast, Dr. Baird discusses lessons learned from testing and personnel challenges when ramping up testing capacity. In addition, Dr. S...

Patients treated with opioids for noncancer chronic pain are known to exhibit aberrant drug behaviors. The urine drug screen or UDS complements behavior monitoring as an objective means to assess patient compliance. UDS results can impact decisions related to a patient’s treatment, including discontinuation of opioid therapy or removal of the patient from the treatment program, explains Barbarajea...

Technology continues to move at a fast pace, and many tools are available to streamline practice. However, the busy pathologist may not have time to seek out and keep pace with all the latest developments and technologies, explains Raul S. Gonzalez, MD, FCAP, in this CAPcast interview. Dr. Gonzalez is one of the instructors of a CAP20 course on this topic. Register and learn more about CAP20, whic...

Fluid samples are one of the most commonly-encountered samples in cytopathology, and may show a range of benign, inflammatory, and neoplastic disease processes. A structured approach to these samples is important, according to Xiaoyin "Sara" Jiang, MD, FCAP, who will be teaching a course on this topic at CAP20, which will be held virtually this year on Oct. 10-14. In this CAPcast, Dr. Jiang discus...

Drug testing is critical to patient care, whether it’s for compliance to prescribed medications, identification of drugs in the immediate overdose setting, or exposure to toxins that may cause long term deleterious effects, such as lead. But there’s an important resources to help pathologists address these challenges--the second edition of Clinical Toxicology Testing: A Guide for Laboratory Profes...

The novel coronavirus, 2019-nCoV or COVID-19, is rooted in Wuhan, China but has since arrived in the United States, stoking fears of a global pandemic. In this CAPcast interview, Dr. Michael Mina, Associate Medical Director of Clinical Microbiology and Molecular Virology at Brigham and Women’s Hospital’s Department of Pathology in Boston, discusses the current outlook of the virus and what patholo...

Determining obsolescence for clinical tests in each setting requires discussion between laboratory staff and clinicians, influenced by reimbursement determinations, explains Dr. Robert Dufour in this CAPcast. Dr. Dufour led the development of a Clinical Pathology Improvement Program (CPIP) course on this topic (https://capatholo.gy/39Alig1).

The advent of new molecularly targeted treatment strategies for patients with advanced colorectal cancer places anatomic and molecular pathologists as key players in the delivery of care for this large patient population. Specifically, advanced colorectal cancer encompasses patients presenting with Stage IV cancer, or those who experience a cancer recurrence, explains Dr. Joseph Willis in a new CA...

Surprise billing continues to be a priority for Congress in Washington, DC. In this CAPcast, Dr. David Gang and Dr. Matthew Foster--two leaders with the CAP’s Federal and State Affairs Committee--discuss their recent trips to Capitol Hill to meet with their legislators on surprise billing. Also interviewed is Michael Hurlbut, CAP Assistant Director, Legislation & Political Action, who will provide...

The Atlas of Fundamental Infectious Diseases Histopathology: A Guide for Daily Practice contains real-world, practical information on commonly encountered infectious diseases for all levels of pathologists, from trainees to attendings. In this CAPcast, editor Dr. Bobbi Pritt discusses how the book is designed to be a valuable resource for pathologists, including using algorithms to help study patt...