CAPcasts

With the dramatic rise in demand for COVID-19 testing, laboratories have implemented a variety of testing methods, among them polymerase chain reaction (PCR) tests. Regularly published research findings seem to question the validity or efficacy of many of the testing methods – and PCR is no different, as Dr. Sophia Yohe explains in this CAPcast interview. Dr. Yohe, director of the University of Minnesota Medical School’s Molecular Diagnostics Laboratory, addressed many questions about diagnostic PCR testing for SARS-CoV-2, the virus that causes COVID-19, in an article recently posted on the Precision Medicine Resource Center on CAP.org (https://capatholo.gy/32U3XwO).

When pathologists train they are often monitored every step of the way, and don’t have the opportunity to sign out cases on their own. It’s nerve-wracking to sign out your first cases, explains Dr. Buu Duong in this CAPcast interview. Some common questions that go through the minds of new in practice pathologists can include when to ask for help, when to get review, how many questions are too many questions, and do you look like you don’t have a clue about what you’re doing? In this interview, Dr. Duong will discuss what pathologists need to know during this important transition, and important tips to gain confidence when you first start out in practice.

More resources on navigating challenges during the early stages of your pathology career are available in the New-in-Practice section on CAP.org: https://capatholo.gy/3btuncz.

By mid-2020 in New York, the state had more than 425,000 confirmed cases of corona virus and 23,500 residents dead from the virus. Most of these cases occurred early on as the disease spread rampantly throughout New York City and other parts of the state. Amidst all this trauma, the autopsies from these early COVID patients revealed significant findings, explained Mt Sinai pathologist Mary Fowkes, MD, FCAP, in this CAPcast before her sudden death in November 2020.

In this interview, Dr. Fowkes discussed what’s been gleaned from these autopsies, as well as how she and her colleagues responded during those early months of the pandemic. Dr. Fowkes, who was a member of CAP's Board of Governors and also the president of the New York State Society of Pathologists at the time of her death, added her perspective on the role of her state pathology society during the pandemic.

For more on the pandemic and pathologists, visit the COVID-19 information pages on CAP.org. And to learn more about state pathology societies, go to https://capatholo.gy/2YVI4fs.

Soft tissue pathology is ubiquitous to any subspecialty. Recognizing some of the most common soft tissue lesions, as well as what immunohistochemical studies to order to decipher which lineage from which it arises can be challenging, explains Dr. Nicole Riddle, who will be teaching a course on this topic with Dr. Jerad Gardner at CAP20, entitled Soft Tissue Pathology Is Fun…Really! A Crash Course for General Pathologists, on Weds., Oct. 14 at 9am-11am CT. CAP20 will be held virtually this year from Oct. 10-14 (https://www.capannualmeeting.org/). Follow #cap20virtual on social for the latest on the event.

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-known, representing an important gap in knowledge, explains Dr. Amanda Blouin in this CAPcast interview.

Dr. Blouin, a pathologist at Memorial Sloan Kettering in New York City, will be teaching a course on this topic with Dr. Ronald Jackups at CAP20, which will be held virtually this year from Oct. 10-14. For more information about CAP20, visit www.capannualmeeting.org and follow #cap20virtual on social media.

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 the impact of innovation in the laboratory market space and lessons to be drawn from Ms. Holmes and the trajectory of Theranos. For more information on this year's CAP20 virtual event, visit www.capannualmeeting.org and follow #cap20virtual on social media.

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. Ron Schifman in this CAPcast interview.

The CAP is introducing a new Quality Management Tools program to help participating laboratories enhance the value of their cumulative antimicrobial susceptibility report. Dr. Schifman is currently emeritus Professor of Pathology at the University of Arizona and a member of the CAP Quality Practices Committee. He is one of the architects of this new quality management program involving antimicrobial susceptibility.

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 transfusion plans for their mutual patients, explains Dr. Alexis Peedin in this CAPcast interview. Dr. Peedin led the development of a Clinical Pathology Improvement Program—also known as CPIP—on this topic (https://capatholo.gy/3hIpY7g).

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 Robboy and Governor Dr. Donald Karcher—provide background on the misevaluation, its impact, and future policy implications of their new research.