Leukocyte Alkaline Phosphatase Stain (LAP)
Optimizing Laboratory Testing for Hematologic
So why do we need to discuss this topic? The big picture is that we need to understand and react to three large drivers in health care. The first driver is quality of care. If the wrong test is ordered, there is an obvious impact on overall quality as is also the converse — if the right test is not ordered. Certainly as laboratorians we understand the impact of not correlating our sophisticated test results which clearly puts the clinician at risk of not responding correctly to our laboratory studies. The second driver is the impact of inappropriate test utilization on the cost of care, whether the impact is on the patient, on the laboratories or the institution in which those laboratories reside, and in how we best utilize the limited laboratory resources that we have.
Finally, healthcare reform, whether done today or in the future, will impact the laboratory. Clearly, rising healthcare costs will force us to focus on how to best utilize limited laboratory resources. As bundled payments become increasingly the primary mechanism of payment for patient care, clearly there will be incentives to do the right test at the right time as opposed to performing volumes of tests. All of these big picture issues really point to the realities of healthcare — both for today and into the future.
The Big Picture
Jump to section:
- Optimizing Laboratory Testing for Hematologic Disorders Series
- The Big Picture: We Need to Focus On...
- LAP: A Test That Time Has Passed By
- LAP: Assay History
- LAP: Original Clinical Utility
- LAP Procedure—an Inexact Science!
- Typical Staining Type Reaction
- Subjective Nature of the Scoring Process
- LAP Scoring Example
- LAP Discontinued at Mayo Clinic
- Low LAP Scores* Not Specific for CML: A Mayo 1-Year Experience
- Low LAP Scores* Do Not Indicate Myeloid Malignancy: A Mayo 1-Year Experience
- High LAP Scores* Not Specific for PV: A Mayo 1-Year Experience
- High LAP Scores* Do Not Indicate Myeloid Malignancy: A Mayo 1-Year Experience
- LAP: A Test Whose Time Has Passed
- Consequences of an Abnormal LAP
- Alternatives to LAP
- Alternatives to LAP: BCR/ABL
- Alternatives to LAP: JAK2