Effective March 1, 2019, H. pylori IgG serologic testing will be discontinued as an orderable test at Spectrum Health Laboratory. This testing is no longer recommended by clinical guidelines.
Browsing Category
Main lab
For Hemoglobin A1c testing, Mayo Clinic Laboratory has switched to an Ion-Exchange High-Performance Liquid Chromatography (HPLC) method (Bio-RAD D100) which is the same method of A1c testing used at Spectrum Health Regional Laboratory. They no longer offer the alternative method, boronate affinity chromatography, for A1c testing.
When A1c cannot be determined due to interferences that affect the Bio-RAD 100 method, measurement of serum fructosamine is recommended (Mayo test FRUCT).
Effective January 19, 2019, Spectrum Health Regional Laboratory – Toxicology is proud to announce the availability of two new drug screen panels:
Effective December 3rd, 2018, the test code for ANA Screen [LAB147] will be discontinued and replaced with ANA Screen Double Reflex [LAB1230491].
Microbiology, Test Utilization
Helicobacter pylori Diagnosis – Serologic Testing is no Longer Recommended
Overview
Clinical guidelines no longer recommend serologic testing as a method for the diagnosis of H. pylori infection. Rather than IgG serology testing, other non-invasive testing methods such as H. pylori stool antigen and urea breath tests may be used to both diagnose and monitor response to therapy for H. pylori infection. In anticipation of an increase in stool antigen testing, currently a reference lab send-out test, Spectrum Health Regional Laboratory (SHRL) will be implementing this test as of October 29, 2018. By offering this test in-house, results will typically be available one day faster than present state.
Effective August 8th, Spectrum Health Laboratory will ask all patients to indicate how long they have been fasting (regardless of whether they were fasting or not) when they present for Lipid testing. In light of recent discussions in the literature that debate the utility of fasting prior to lipid testing; we recognize that some clinicians may now not require their patients to be fasting and hope that reporting out length of fasting (hours) with each lipid result will allow all clinicians to better interpret their patient’s lipid results. If fasting is desired; Spectrum Health Laboratory recommends no caloric or caffeine intake for at least 8 hours. The patient is not to drink (other than water), eat, smoke, chew gum, candy, cough drops, etc. for at least 8 hours prior to their blood tests. Prescribed medications are allowed.
Effective October 15th, 2017, all specimens collected for Blood Bank must have two signatures on the specimen written in ink that is resistant to smearing after a patient has been identified according to the Patient Identification Policy.
One of the two collectors/witnesses must be a lab staff member, unless specimen is collected in Spectrum Health Surgery, Infusion Center, Special Care Hospital, Cardiac Cath Lab Procedure Room, or a cord blood in Labor and Delivery. For Outpatients, the patient may serve as the witness and initial the tube label.
On June 27th, the name of the current order “Respiratory (non-sputum) Culture without Gram stain” will change to “Throat Culture Comprehensive.” All other specimen collection details and culture workup will remain the same. Given the fact that there are currently several similarly named tests, this change is being made to reduce confusion regarding test selection and to clarify acceptable specimen types.
Immunochemistry, Test Utilization
Utility of specific IgE (sIgE) testing to foods and food allergen components
The diagnostic evaluation of allergic disease occurs in the context of a patient’s complete clinical presentation. Important factors include, age, clinical signs and symptoms, relevant allergen exposures, and the performance characteristics (sensitivity, specificity, and predictive values) of the allergy tests themselves. Allergy tests yield information about sensitization to allergens, which is not always equivalent to allergic hypersensitivity (i.e., sensitivity); thus, interpretation in the context of clinical history is essential for accurate diagnosis.
Safety of our patient and quality of care are of utmost importance. For this reason we require specimens sent to the Spectrum Health Cytology Laboratory be labeled with at least two patient identifiers, (i.e., patient legal name, birth date and MRN.) We will no longer return to the collection site, unlabeled, mislabeled specimens lacking two patient identifiers or specimen containers with multiple different patient labels. These specimens will be discarded and repeat collection will be necessary.
Procedures to verify correct labeling of patient specimens at the time of collection are recommended. Specimen containers should not be pre-labeled. Variation of the “time-out” procedure used in the hospital and surgical center setting is an excellent way of confirming that the specimen is correctly labeled. This can easily be achieved by having the patient verify his or her name and birth date, by reading the label placed on the specimen container at the time the specimen is collected. This “time out” should occur before the specimen leaves the examination or treatment room.
It is our mission to provide the best and safest care we can to our patients. We know that physicians and other practitioners are required to see patients more efficiently and at times with less than adequate time allowed. Following a “time out” procedure and not pre-labeling specimen containers will prevent errors that may lead to diagnoses being assigned to wrong patients, hence, unnecessary procedures and lack of follow-up for the appropriate patient.