The Classic Myeloproliferative Neoplasms

Why Do We Have Test Utilization Issues?

October 2011

So why do we have test utilization issues? First of all, laboratories typically do not provide sufficient guidance on how to use assays in hematologic diseases. Instead, it is frequently just a listing of available tests. I think we all realize that also, as new technology emerge, there can be a lack of understanding or certainly a lack of effort put forth to understand how these tests should be utilized in the context of other existing assays. Laboratories frequently do not have processes to either review test requests or to sequentially add or delete tests after initial results are determined. Laboratory information systems don’t make it easy for clinicians to efficiently order assays and get information. And finally, laboratory reports do not always transmit the intended information and often come across as just lists of results instead of a correlation and diagnosis based on all the results for that episode of care.

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Why Do We Have Test Utilization Issues?

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Jump to section:

• Introduction
• Optimizing Laboratory Testing for Hematologic Disorders Series
• Goals for Today's Presentation
• Example of a Recent MPN Referral
• Why Do We Have Test Utilization Issues?
• Why Do We Have Test Utilization Issues?
• So What Should We Do?
• WHO Classification
• Important Laboratory Assays in the MPNs
• JAK2 V617F Background
• JAK2 V617F Background
• Question #1 — JAK2 V617F
• JAK2 V617F
• JAK2 V617F at Mayo Clinic
• Conclusion #1 — JAK2 V617F
• JAK2 Exon 12 Sequencing Background
• Question #2 — JAK2 Exon 12 Sequencing
• JAK2 Exon 12 Sequencing: When Not to Use
• JAK2 Exon 12 Sequencing
• Conclusion #2 — JAK2 Exon 12 Sequencing
• MPL Exon 10 Sequencing Studies: Background
• Question #3 — MPL Exon 10 Sequencing
• MPL Exon 10 Sequencing: When to Use
• MPL Exon 10 Sequencing: When Not to Use
• MPL Exon 10 Sequencing
• Conclusion #3 — MPL Exon 10 Sequencing
• Roles of Other Assays in Classic MPN
• Summary
• Myeloproliferative Neoplasm: A Diagnostic Approach to Peripheral Blood Evaluation
• Myeloproliferative Neoplasm: A Diagnostic Approach to Bone Marrow Evaluation
• Implementing a Utilization Approach
• Questions