The Classic Myeloproliferative Neoplasms

Why Do We Have Test Utilization Issues?

October 2011

Test utilization issues also come about because of the realities within today’s clinical practices. There are certainly varying levels of understanding how to use hematologic associated assays amongst clinicians, even hematologists, as today’s practice has gotten significantly more complex. Also realize that patients with particular hematologic diseases may see a hematologist or internist who may not have experience with that particular disease. Probably most important is that clinical knowledge at the time of test ordering is incomplete, and a clinician is compelled to order everything because it may be the only chance to get that information. Finally, we must realize that initial laboratory studies can help narrow the diagnostic choices and the specific testing needs. If laboratories don’t have a review and ordering process in place, clinicians have no choice but to order excess testing.

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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