New! FREE White Paper on Vaginitis Diagnosis: An Opportunity to Improve Patient Care

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FREE Special Edition White Paper  

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Cover-vagintis-ds
Published statistics indicate that, each year, there are more than 10 million visits to ob-gyn and primary care physicians because of vaginitis. Since this health condition could be caused by a number of different infectious agents, physicians—and their clinical laboratories—must often perform multiple diagnostic tests.

 

That takes time, often doesn’t deliver a definitive diagnosis if the right infectious agent assays were not requested, and can frustrate both physician and patient. Clinical laboratory testing plays a crucial diagnostic role in healthcare in the United States. That’s good news for pathologists, laboratory directors, and laboratory scientists. With the advancements in technology, laboratory test results are helping physicians make earlier and more accurate diagnoses. Numerous new diagnostic tests are available in the clinical marketplace.

 

However, few of these assays possess the right combination of increased sensitivity, reasonable test cost, and the ability to significantly contribute to clinical care. The Dark Report is happy to offer our readers a chance to download our recently published FREE White Paper “Vaginitis Diagnosis: An Opportunity to Improve Patient Care” at absolutely no charge. This free download will provide readers with a detailed overview of current legal challenges that your lab may encounter in the near future.

 

Pathologists and clinical laboratory scientists recognize how important it is that new diagnostic assays fit the following criteria:
  • Improved sensitivity and specificity over existing lab testing technologies.
  • Faster turnaround time to a complete result.
  • Specimen collection methods that are easier to use, safer to transport, and/or have a longer shelf life.
  • Easier for the laboratory to perform, preferably with automation available.
Whenever all of these criteria are met, it presents clinical laboratories with the opportunity to hit a “diagnostic home run” with referring physicians. An example would the diagnosis of vaginitis. Currently there are several tests available for the detection of the causative agents for vaginitis, but few tests are available for the simultaneous detection of these causative agents from one collected specimen. Such a test would be of significant benefit to the clinician and patient, as multiple specimens would not have to be collected.

Every pathologist and laboratory scientist should evaluate this assay and review the clinical guidelines that call for its use in diagnostic and treatment decisions for vaginitis. This white paper is a good starting point. It has been organized to provide an accurate and broad overview of this subject.

DOWNLOAD NOW!

__________________________________________________________

Here is just some of what you will take away...

  1. The role of microscopy and culture.
  2. The emergence of point-of-care testing.
  3. DNA Probe Technology
  4. For more about Implementing DNA Probe Technology in the Lab, please CLICK HERE

DOWNLOAD NOW!

Table of Contents

Preface - Page 3  

Chapter 1. Abstract — Page 5  

Chapter 2. Background— Page 6  

Chapter 3. The Three Common Underlying Causes of Vaginitis — Page 8  

Chapter 4. Diagnosis of Vaginitis: Current Practice — Page 10  

Chapter 5. DNA Probe Technology Opens the Door to Improved Vaginitis Care — Page 12  

Chapter 6. Implications for Patient Care — Page 14  

Chapter 7. Implications for the Laboratory — Page 15  

Chapter 8. Assessing the Opportunity — Page 17

Chapter 9. Implementing DNA Probe Technology in the Lab — Page 21

Chapter 10. Marketing New Vaginitis Testing Capabilities — Page 22  

Chapter 11. The BD Affirm VPIII Microbial Identification System at Work — Page 23

Chapter 12. Conclusion — Page 26

Appendices A-1 About Andrea J. Linscott, PhD — Page 30

A-2 About BD — Page 31

A-3 About DARK DAILY — Page 32

A-4 About The Dark Intelligence Group, Inc., and The Dark Report— Page 33

A-5 About Executive War College on Laboratory and Pathology Management — Page 34

A-6 About Lena Chow — Page 36 Terms of Use — Page 40


DOWNLOAD NOW!

 

 

 

Simple answer to Send My Slides Back Now!

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Dr. Thomas Wheeler entered the following blog (below) on Medscape about a week ago.  There is a simple solution to all of this that negates time, cost and risk for both referring and consulting pathologist/institution.  The answer of course in two words is digital pathology. Particularly with the ever increasing power of cloud computing.  Simply, the referring institution scans and uploads the slides, regardless of patient, physician or pathologist request for consultation or second opinion.  The referring pathologist uses the cloud to review the slides, render his or her report and complete the case.  This negates the need for referring hospital to package, send, check receipt of delivery and record receipt of slides upon return and account for any loss or damage upon return.  The consulting hospital is also spared the need to take receipt of case, inventory contents, accession and maintain slides in original number and condition.  Both sides are spared the cost and resources to maintain either send outs or consults.  A record of slide(s) reviewed is kept and data with regards to images reviewed can be maintained.  Perhaps most importantly, unlike the courier model, both the referring and consulting pathologist have a mechanism to look at the same slide(s) at the same time.

If the case requires additional immunohistochemical stains, these too may be done by referring hospital and later uploaded for review thus negating need to send tissue blocks and allowing referring hospital to capture the TC with potentially less delay than sending the block which would add another day on top of the time to do the stain(s).  This of course will not work depending on size and skill of referring laboratory but the model works the same when possible and requires courier if necessary. 

Lastly, cases of interest for potential further study or teaching are maintained where several participants can have access while maintaining access and patient privacy. No slides leave the originating department.

For reference labs this is common practice - that is hosting images for review by others.  It negates need to overnight slides when technical services are required and provides a shared image for both the reference lab and the client if discussion or repeat testing is needed.

More labs can and should do this on both ends of the slide consult model.  Why is this not more common?

Several reasons, among them -- cost of scanners, resources to scan and upload slides and maintain control and access, consultants reluctant to adopt digital pathology and/or referring pathologist reluctant to adopt, receiving pathologist may want to do his/her "own stains" and well-established processes in place that facilitate courier models in nearly every laboratory/hospital.  The first is really the still remaining barrier for some labs, the others are largely psychological and technical which requires a culture of change and degree of trust to allow for this kind of slide exchange.

Courtesy of Dr. Thomas Wheeler via Medscape:

Now more than ever, patients seek definitive treatment for cancer or other serious conditions at a major medical center, one different from the institution where the diagnosis is made.  This necessitates transfer of medical records, radiology reports and yes -- the pathology report and associated microscopic slides.  Typically, the slides are reviewed at the final institution where a pathology report on the referred slides is generated.  In most cases the original laboratory requests that the slides be returned along with a copy of the new pathology report.  Problems arise at this juncture.  The new institution may retain the slides or fail to return them in a timely fashion.

Case law is fairly clear that the original slides and blocks are the work product for the originating laboratory, a fact that can be construed to mean ownership.  Therefore, the original laboratory has the legal right to request/demand return of their slides.  After all, they are required to keep these slides for purposes of accreditation and by statute.

So why would the final institution want to keep the slides?  There are several reasons – teaching, clinical research, saving the expense of the return and medicolegal issues.  The first two are relatively straightforward, especially in institutions that have a pathology residency program and an active clinically-oriented research program.  The expense of returning the slides, even by standard mail, is not trivial when multiplied by hundreds or thousands of times over the course of a year.

The medicolegal issues may not be apparent but go something like this:  the pathologist making the last diagnosis on which the treatment decisions are made is ultimately the one who is legally liable in the case of misdiagnosis, regardless of the diagnosis of the original pathologist.  I remember distinctly a case in point.  An older woman had an enlarged neck node removed that the pathologist in the small town community diagnosed as metastatic papillary carcinoma of the thyroid.  The patient was referred to a large tertiary care medical center for additional surgery.  The pathologist at that academic institution “confirmed” a diagnosis of metastatic papillary carcinoma of the thyroid so the patient underwent a total thryoidectomy.  No cancer was found in the thyroid and it was determined subsequently that the women had an occult papillary serous carcinoma of the ovary.  Both pathologists were sued.  The jury found the academic pathologist to be negligent but did not hold the original pathologist responsible, even though both had made the same diagnosis.  The point is a matter of law – the academic pathologist’s action were the “proximate cause” to the patient’s injury.  It really didn’t matter what the original pathologist called it because the treatment plan was based only upon the last diagnosis rendered.  

Given the foregoing vignette, the pathologist at the final institution may feel that he/she should retain (rather than return) these slides, as he/she has now assumed all of the legal risk associated with the diagnosis.  If there is a problem with the patient’s subsequent diagnosis or clinical outcome the slides can easily be pulled and reviewed if they have been retained.  After all, the patient has left the primary institution and is now getting all the care related to this diagnosis at the new institution.  

Are your slides returned when requested?  Are they returned in a timely fashion?  Do you have a way to check off which cases have been returned v not so you can send reminders?  Do you prefer to send originals or recuts?

Image Analysis Strategies for Challenging Biomedical Images using Definiens Developer XD™

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2010-12-15_065128_200px Join us for a webinar: Image Analysis Strategies for Challenging Biomedical Images using Definiens Developer XD™

Register Here:

Learn image analysis strategies from the pros at Definiens using Definiens Developer XD on the following examples:

• The Rolling Ball Method for Correcting Heterogeneous Backgrounds in Fluorescently Stained Golgi Cells
• Three Dimensional Analysis of Dendritic Spines
• Classifying Tumor vs. Non-Tumor and Tumor Morphology in Non-Small Cell Lung Cancer

Speakers:

Peter Duncan – Director, Marketing and Business Development
Dr. Thomas Mrowiec – Consultant, Professional Services
Dr. Florian Leiss – Trainer and Marketing Specialist

Title: Image Analysis Strategies for Challenging Biomedical Images using Definiens Developer XD™

Date: Wednesday, December 22, 2010

Time: 11:00 AM – 12:00 PM EST / 4:00 PM – 5:00 PM GMT

After registering you will receive a confirmation email containing information about joining the Webinar.

System Requirements:

PC-based attendees

Required: Windows® 7, Vista, XP or 2003 Server

Macintosh®-based attendees

Required: Mac OS® X 10.4.11 (Tiger®) or newer

Space is limited.

Reserve your Webinar seat now at:

https://www2.gotomeeting.com/register/227449746

The Transformation of Pathology

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The College of American Pathologists has been active with several ideas concerning the transformation of our specialty with rapid growth of new technologies, disruptive technologies and changes in the healthcare system that will impact medicine.  One of the initiatives being discussed from CAP is increased direct dialogue by pathologists with patients.  True one-on-one meetings with patient's about their pathology and their particular disease and its biology to better inform and educate patients as an integral part of the care team beyond the pathology report.  

Dr. Jennifer Hunt at the Massachusetts General Hospital is leading the effort.  The below video is from the College's YouTube channel that has a few similar videos with more to come.  

If you are a pathologist, are you going to transform?  How do you feel about speaking directly with patients and their families?  

Clarient Launches Insight® Dx Mammostrat® Breast Cancer Recurrence

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Test Novel Test Designed to Help Classify Risk of Recurrence of Breast Cancer, and Aid in Management of Therapy

ALISO VIEJO, Calif., Dec. 9, 2010 /PRNewswire/ -- Clarient, Inc. (Nasdaq: CLRT), a premier technology and services resource for pathologists, oncologists and the pharmaceutical industry, today announced the commercial launch of Mammostrat, a patented, novel test designed to help quantify the likelihood of recurrence of breast cancer following surgery and initial treatment. The Mammostrat test employs an optimal set of five biomarkers that are able to be identified visually on a patient's tumor specimen by using a well-established technology called immunohistochemistry. Those biomarkers are then analyzed using a mathematical algorithm to generate an assessment of risk for cancer recurrence. Mammostrat is well-validated, having been clinically studied on more than 3,000 women, as reported in multiple peer-reviewed journals, including Breast Cancer Research (Volume 12, 2010), Clinical Cancer Research (Volume 14, October 2006), and the Journal of Clinical Oncology (Volume 24, July 2008).

Data fromMammostrat trials have also been presented at national conferences, including the American Society of Clinical Oncology (ASCO) and the San Antonio Breast Cancer Symposium. By using the Mammostrat test pathologists, oncologists and patients can gain greater understanding of the aggressiveness of a patient's disease and guide clinical management. Mammostrat provides additional clinical information that cannot be obtained from routinely used prognostic factors. The Mammostrat test can be performed on small biopsy samples, and results are typically delivered in as little as 48-72 hours, thereby allowing more rapid treatment decisions. "Mammostrat can be an important tool for clinicians assessing the aggressiveness of their patient's breast cancer," said Clarient Vice Chairman and Chief Executive Officer Ron Andrews. "Mammostrat results can provide clinicians important information to help select the appropriate therapeutic management for each individual patient. For patients, Mammostrat offers the confidence that the decisions being made to manage their breast cancer are based on the clinical characteristics of their specific disease using the most current validated technology available." More than 210,000 women in the U.S. develop breast cancer each year.

Mammostrat test development was targeted to breast tumors which express estrogen receptor, the most commonly identified subtype of breast cancer representing about 75 percent of the women diagnosed each year. The standard of care for most of these patients includes surgery to remove the tumor, followed by anti-hormonal therapy (e.g. tamoxifen or aromatase inhibitors). Andrews continued, "Mammostrat fits well within the combined Clarient goals of bringing value to both the patient and to the healthcare system. The test provides validated information more rapidly than other tests currently available, which may allow for treatment to begin earlier in the course of the disease."

Clarient is currently in coverage determination discussions with both government and private insurance carriers. Patents covering the use of the Mammostrat test were granted in the U.S. and Europe in the summer of 2010. For more information on the Mammostrat test, please visit http://www.clarientinc.com/mammostrat.aspx.

 

About Clarient

Clarient combines innovative diagnostic technologies with world class pathology expertise to assess and characterize cancer. Clarient's mission is to become the leader in cancer diagnostics by dedicating itself to collaborative relationships with the healthcare community to translate cancer discovery and research into better patient care. Clarient's principal customers include pathologists, oncologists, hospitals, and biopharmaceutical companies. The rise of individualized medicine as the new direction in oncology has created the need for a centralized resource providing leading diagnostic technologies, such as flow cytometry and molecular testing. Clarient is that resource, having created a state-of-the-art commercial cancer laboratory providing the most advanced oncology testing and diagnostic services.

Caliper Life Sciences to Acquire Cambridge Research & Intrumentation

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The acquistions continue with companies involved with digital pathology.

Adds Proprietary Multiplexed In Vivo and Tissue Imaging Technology to Caliper’s Leading Portfolio of Drug Discovery, Imaging and Diagnostics Solutions

HOPKINTON, Mass. & WOBURN, Mass, December 9, 2010 -- Caliper Life Sciences, Inc. (Nasdaq: CALP), a leading provider of products and services for drug discovery research, today announced that it has entered into a definitive agreement to acquire privately-held Cambridge Research & Instrumentation, Inc. (CRi) for approximately $20.0 million, including net debt.  CRi’s patented preclinical and tissue-based multiplexed analysis systems will expand Caliper’s life sciences tools portfolio, particularly as it bridges into clinical research, pathology and clinical market applications.  Under the agreement, in exchange for all of CRi’s outstanding equity securities, Caliper will issue common stock valued at approximately $10.5 million, pay cash of approximately $7.5 million, and assume CRi indebtedness of approximately $2.0 million.  CRi’s revenues are expected to be approximately $12.0 million in 2010 and the technology should deliver a 20%+ growth rate upon reconfiguration and integration into Caliper’s portfolio and operations.  Ultimately, Caliper’s entry into the emerging digital and multiplexed pathology market segment has the potential to deliver a substantially greater growth profile.

"CRi’s advanced platforms add an important new dimension of capability to our suite of next-generation life science tools, and positions Caliper to further address biomarker discovery and companion diagnostics solutions for personalized medicine development programs," said Kevin Hrusovsky, President and CEO of Caliper Life Sciences.  "This acquisition extends the reach of Caliper's proprietary offerings along the in vitro to in vivo bridge by filling the gap in tissue analysis platforms.  Similar to the approach we used in our successful commercialization of other disruptive technologies such as microfluidic LabChips and whole animal optical imaging systems, we see an opportunity to leverage CRi’s advanced multiplex technology towards unmet needs in a rapidly changing market, in this case the billion-dollar tissue imaging and digital pathology clinical research market.  With CRi’s technologies in our toolkit, we will be able to offer a more comprehensive suite of tools and services to address the important emerging trend toward personalized medicine."

“We are delighted for CRi to join Caliper," said George Abe, President and CEO of CRi.  "Caliper’s market leadership and extensive corporate relationships within the biotech and pharmaceutical industries, coupled with its rich culture of nurturing and commercializing innovative technologies, make Caliper the right partner to fully realize the market potential of CRi's portfolio of multiplexed imaging technologies."

Abe will join Caliper as Senior Vice President, Cellular & Tissue Analysis, reporting directly to Kevin Hrusovsky, Caliper’s President and CEO.  In this role, Abe will be responsible for directing the growth and strategic direction of the tissue analysis business.

CRi’s headquarters and manufacturing operations will be consolidated with Caliper’s existing operations in Hopkinton, Mass.  The manufacturing relocation is expected to occur in mid-2011, at which time the CRi Woburn facility will be closed.  Approximately 75% of CRi’s 49 employees will be offered continuing employment with Caliper.  Overall, Caliper expects to incur restructuring, integration, and initial capital investment costs of approximately $2.5 million, occurring mainly in 2011, in order to achieve anticipated business combination synergy cost benefits of between $2.5 - $3.0 million per year, which will be fully phased in by the end of 2011.  The transaction is expected to be EBITDA accretive in 2011.

CRi’s multispectral imaging technology is revolutionizing the analysis of tissue samples. Over the last decade, CRi has successfully formed relationships with leading universities, medical institutions, and pharmaceutical and biotechnology companies around the globe. Researchers at Pfizer, Merck, Novartis, Dana Farber Cancer Center, Stanford, and Baylor College of Medicine have employed CRi’s inForm, Nuance, Vectra and Maestro products to perform high throughput, quantitative imaging of intact tissue, simultaneous analysis of multiple biomarkers, and multispectral imaging of small animals.

About Caliper Life Sciences
Caliper Life Sciences is a premier provider of cutting-edge technologies enabling researchers in the life sciences industry to create life-saving and enhancing medicines and diagnostic tests more quickly and efficiently. Caliper is aggressively innovating new technology to bridge the gap between in vitro assays and in vivo results, enabling the translation of those results into cures for human disease. Caliper’s portfolio of offerings includes state-of-the-art microfluidics, lab automation and liquid handling, optical imaging technologies, and discovery and development outsourcing solutions. For more information please visit http://www.caliperLS.com.

About CRi, Inc.
Cambridge Research & Instrumentation (CRi) develops and markets optical imaging systems to advance biomedical research and molecular-based drug and diagnostic development. CRi’s patented systems enable researchers and clinicians to quantify multiple disease and drug response markers in intact tissue samples, at a cellular level or in living small animals. CRi’s products integrate a unique multispectral imaging technology with proprietary image analysis algorithms to achieve unparalleled accuracy and sensitivity, rapidly and cost-effectively. CRi’s award-winning systems include Nuance™ and TRIO™ for multispectral imaging on brightfield and fluorescence microscopes; inForm™ automated image analysis software; Vectra™ for high-throughput slide imaging and analysis; and Maestro™ for in-vivo optical imaging. Learn more at http://www.cri-inc.com.

Digital Image Hub Webinar from SlidePath

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Webinar Series From SlidePath

Online software demonstrations are on:

Tuesday 14th December 2010 9:00 AM (PDT)

Thursday 16th December 2010 12:00 PM (EDT)

Click here to register for your preferred time with your contact details. If the above times are not suitable, please suggest an alternative time for a demonstration.

Visit our website http://www.slidepath.com

 
SlidePath logo 
 
Digital Image Hub 
Manage Scientific Images and Data
SlidePath's Digital Image Hub provides:
  • A secure, web-based repository for management and annotation of high resolution images
  • An automated Tissue Microarray (TMA) based management system
  • Image analysis for biomarker quantification in tissue sections and tissue microarrays
  • The ability to integrate project information, digital slides and multimedia into a fully searchable,                            hierarchical database


Plant split screen

 
Grace Kelly B.Sc.,
Business Development Assistant,
grace.kelly@slidepath.com
+353 18667825
Building 1,
Swift Square,
Northwood,
Dublin 9, Ireland.
 

 

Via Lab Soft News — Major Increases in Pathology RVUs for 2011

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Major Increases in Pathology RVUs for 2011

Editor's note: Joe Plandowski sent me the following good news about increased reimbursement for pathology for 2011.

We are hearing news on a daily basis about a 25% SGR (Sustainable Growth Rate) cut for 2011 and continual cuts in third party payer reimbursements. However, when pathologists and anatomic lab managers wake up in 2011, they will be dancing in the streets. The Medicare fee increases from 2010 to 2011, in the face of a flat SGR, are mind-boggling. Pathology received major changes to its RVUs thanks to a lot of lobbying by organized pathology. Pathologists ought to be quietly celebrating their good fortune because it came out of the hides of other specialists. The following are some examples (w/o geographic adjustments):

  • 88112 (non-Gyn cytology) is going to $111.72, a 9.8% increase
  • 88305 (tissue diagnosis) is going to $115.04, a 10.6% increase
  • 88312 (special stain) is going to $116.15, a 15.8% increase
  • 88313 (special stain) is going to $84.81, a 15.6% increase
  • 88342 (IHC) is going to $113.20, a 12.9% increase

I can't remember ever seeing such large percentage increases. And, these increases are coming at a time of fiscal restraint in medicine. Wait for the howling to begin as this news spreads. If pathologists thought they had a tough time with clinicians, it just got tougher. Particularly so, when clinicians discover those increases came directly out of their pockets.

via labsoftnews.typepad.com

Senate Approves 1-Year Medicare Doc Fix

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December 8, 2010 — In a rare show of bipartisanship, the Senate today passed legislation that freezes Medicare reimbursement to physicians through the end of 2011 and averts a 25% pay cut scheduled for January 1.

The bill, approved in a voice vote, now goes to the House, where it is expected to pass. Organized medicine has warned that if the massive pay cut takes effect on New Year's Day, droves of physicians will close their doors not only to Medicare patients but also military families, whose TRICARE coverage is based on the Medicare fee schedule.

The sponsors of the latest Medicare "doc fix," as such legislation is called, are Senate Majority Leader Harry Reid (D-NV); his Republican counterpart, Minority Leader Mitch McConnell (R-KY); Sen. Max Baucus (D-MT), chairman of the Senate Finance Committee; and Sen. Chuck Grassley (R-IA), the committee's ranking Republican.

In addition to temporarily defusing the Medicare reimbursement crisis, the Senate legislation extends a variety of Medicare payment policies that would otherwise expire, and it funds several relatively minor changes to Medicare, Medicaid, and the Children's Health Insurance Program. The total cost of the bill tops $19 billion, with $14.9 billion of that representing the Medicare doc fix.

A year ago, the legislation might have been funded through deficit spending, but now that they command the 41 votes needed to sustain a filibuster, Senate Republicans are in a position to insist that a bill like this one pay for itself. Accordingly, bill sponsors propose to offset its cost by amending a provision in the Affordable Care Act (ACA) pertaining to tax credits that help individuals and families purchase health coverage. When they earn more money than expected in a given year, these individuals and families are required under the law to pay back some or all of the tax credit amounts received for buying insurance. However, if they are at or below 400% of the federal poverty level, their maximum repayments are limited to $250 for individuals and $400 for families.

The latest doc fix legislation would increase these pay-back limits for some individuals and families and lower them for others, based on their income. Senate sponsors estimate that this amendment to the ACA would save $19 billion. Several hundred million dollars more in Medicare savings round out the bill's funding.

The 25% reduction in Medicare rates scheduled for January 1 is triggered by the program's sustainable growth rate formula for setting physician compensation. The legislation passed in the Senate does not eliminate this cut but, rather, postpones it to January 1, 2012. Lawmakers hope that in the interim they can enact a permanent doc fix that would replace the sustainable growth rate formula with one physicians consider more equitable.

 

“Doctor, Are You Telling Me the Truth?”

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Courtesy of Medscape (registration required)

"Honesty is the best policy" and "the patient always comes first."

As absolute and correct as those aphorisms may be, they can be hard for doctors to apply in the complex world of modern medicine.

A recent Medscape medical ethics survey of over 10,000 physicians found that when it comes to patient treatment, a significant number of physicians struggle when it comes to topics relating to honest, straight-forward communication, and even pain management. Physicians from a broad range of specialties answered 3 questions pertaining to patient treatment:

-     Would you ever hide information from a patient about a terminal or preterminal diagnosis, because you believe that it will bolster their spirit or attitude?
-      Would you ever prescribe a treatment that's a placebo, simply because the patient wanted treatment?
-      Would you ever undertreat a patient's pain, because of a fear of repercussions or because you are concerned that a patient -- even a terminal patient -- might become addicted?

Open Communication Is Often Difficult

When it comes to delivering bad news, 59.8% of physicians indicate they "tell it exactly as I see it," while 14.6% indicate that they soften the news and "give hope even if there is little chance." Two percent indicate that unless a patient is going to die imminently, they don't tell him or her how bad the situation is and nearly one quarter (23.8%) say "it depends."

"The kind of compassion that brings people into medicine is the type of compassion that is needed for delivering bad news," says Kenneth Goodman, PhD, Director of the Bioethics Program at the University of Miami and author of Ethics and Evidence-Based Medicine: Fallibility and Responsibility in Clinical Medicine. But that compassion should never compromise the truth, he cautions.

Many of the physicians surveyed augmented their responses noting that, while they are honest, they try hard to deliver bad news in the most gentle, humane, and supportive way possible. That's exactly what patients should expect from their doctors, Goodman advises. But in "softening" the truth, he believes that doctors don't need to deviate from it.

"If there is something positive you can say, by all means say it. But only tell the truth: 'I will be there with you. I will help you manage your pain. I will see to it that you can arrange your affairs.' Those are truthful things," Goodman says.

When doctors withhold information, they make it more difficult for patients to chart their course and undermine their own credibility.

From the patient's point of view, "If I don't know my time is limited I can't put my affairs in order. I can't say, 'I'm sorry,'" he says. What's more, "it's not like patients are asking Dr. Kildare, 'What are my chances, Doc?' Patients are increasingly educated. If you don't tell them, they're going to be looking it up on the internet the next day, so you should probably be the source of the data, because you're a human and you care about them."

CBLPath Opens New Molecular Diagnostics Lab

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Recent approvals from New York State Department of Health launch new capabilities

RYE BROOK, N.Y., December 8, 2010 — CBLPath has received approval from the New York State Department of Health to offer T and B cell gene rearrangement by PCR.  PCR (polymerase chain reaction) is a molecular diagnostic technique used to amplify a single or few strands of DNA to create millions of copies of that sequence.  This rapid, accurate technique is becoming increasingly important for the early diagnosis of malignant diseases such as leukemia and lymphomas.  

“Our new PCR tests provide enhanced accuracy, specificity, sensitivity and throughput - benefits that can be applied to a broad range of samples,” said Dr. Carlos D. Urmacher, Chief Medical Officer, CBLPath.  “PCR will provide valuable diagnostic, prognostic and theranostic information to enable physicians to develop efficacious therapies for their patients.”

Molecular testing is just one component of CBLPath’s offering to address the industry convergence of anatomic, molecular and digital pathology combined with radiology.  The convergence is focused on integrating these different disciplines to deliver better diagnoses, faster. 

“CBLPath has a unique leadership position in the convergence,” said David W. Bryant, Chief Executive Officer, CBLPath.  “At the core of our organization are pathologists.  Their expertise enables us to offer pragmatic, evidence-based, clinical solutions developed by medical professionals for medical professionals.  With our added molecular capabilities, CBLPath is able to harness the full power of the convergence to provide better care to patients.”

 CBLPath will continue to expand its test menu in the area of Molecular Diagnostics over the next several months.  For more information as well as the complete test menu, please go to http://www.CBLPath.com.

 About CBLPath

CBLPath is a national specialty lab offering a full convergence of anatomic, molecular and digital pathology services. The company provides a one-stop solution for comprehensive sub-specialized diagnostics, and timely, accurate, patient-centered disease management guidance. Through its Best Practice ™ Partnership Program, CBLPath partners with pathologists to help them grow their practices, while giving them the ability to stay independent and “keep medicine local.” The company also provides sub-specialty physicians access to comprehensive, high-quality testing in their local market. Founded in 1988, CBLPath established a reputation for providing timely, highly accurate diagnoses along with extraordinary customer service and a true patient-centered commitment. For more about the company, please visit http://www.CBLPath.com.

CRi’s Maestro Dynamic Imaging system for in-vivo kinetic imaging named one of the Scientist’s Top 10 Innovations of 2010.

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TOP10_logo_web
All-optical kinetic imaging system generates real-time images of biodistribution and biological activity in small, live animals

Woburn, Massachusetts - December 1, 2010

Cambridge Research & Instrumentation, Inc. (CRi), a leader in multicolor imaging solutions for preclinical and clinical research, today announced the latest addition to an already impressive number of awards. The Scientist, Faculty of 1000’s magazine of the life sciences, announced the winners of the “Top 10 Innovations of 2010”, among them CRi’s Maestro Dynamic™ in-vivo imaging system.

Watching drugs or biologics pulse through a patient in real time usually takes expensive equipment such as a PET and/or CT scanner. For in vivo mouse studies on tight budgets researchers commonly bind a fluorescent marker to the compound of interest, and take a fluorescence snapshot. The natural background fluorescence of the entire mouse—which makes it hard to distinguish the target from normal tissue—is then subtracted away to sharpen the image. But subtracting background fluorescence in a live movie proved challenging. So the scientists and engineers at Cambridge Research & Instrumentation Inc. (CRI) took a page from PET scan technology: using the compound’s pharmacokinetics—the rate at which the drug is absorbed, circulated, and excreted—they improved the resolution by compensating for the background at every time point.

The technology, called Maestro Dynamic, could be especially useful for tracking how long cancer drugs remain at their target before being metabolized and/or excreted. Normally, to obtain data about drug accumulation in organs or tumors, one would sacrifice a cohort of mice every hour or two over the course of a day. By continually collecting data in real time, says James Mansfield, director of the company’s multispectral imaging systems, the number of mice needed could be reduced from around 100–200 to about 10.

About CRi, Inc.

Cambridge Research & Instrumentation (CRi) develops and markets optical imaging systems to advance biomedical research and molecular-based drug and diagnostic development. CRi’s patented systems enable researchers and clinicians to quantitate multiple disease and drug response markers in intact tissue samples, at a cellular level or in living small animals. CRi’s products integrate a unique multispectral imaging technology with proprietary image analysis algorithms to achieve unparalleled accuracy and sensitivity, rapidly and cost-effectively. CRi’s award-winning systems include Nuance™ and TRIO™ for multispectral imaging on brightfield and fluorescence microscopes; inForm™ automated image analysis software; Vectra™ for high-throughput slide imaging and analysis; and Maestro™ for in-vivo optical imaging. Learn more at http://www.cri-inc.com.

 

Deconstructing the Language of CPT: How to Master Pathology Coding and Documentation

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UPCOMING LIVE WEBINAR
DECEMBER 9, 2010


Deconstructing the Language of CPT:
How to Master Pathology Coding and Documentation

Understanding the basic concepts of pathology CPT coding
and the strategies for avoiding errors

chappy manning

Your Presenter:

Chappy Manning, RN, CPC, Billing Support Service Coding Coordinator, PSA, LLC

LIVE EVENT! December 9, 2010 at 3pm EST

Coding is the language that all new physicians must learn to speak if they want to get paid for their services. It’s the most common form of communication between doctors and third-party payers. And what you don’t know can cost you-in lost revenue, overcharges and even potential fines.  If you’re new to pathology coding, this is your opportunity to become more comfortable with the language and concepts of CPT. Ms. Manning will detail the most common coding and documentation errors and teach you the strategies that can help you avoid them.

Learn More an register NOW at:  http://www.darkdaily.com/pathology-residents-education-program/deconstructing-the-language-of-cpt-how-to-master-pathology-coding-and-documentation

RSNA: iPad helps untether radiologists from reading room

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Mobility is coming to radiology, and the iPad has a lot to do with that. At this week's Radiological Society of North America annual conference in Chicago, several teams of researchers are presenting papers on how well the Apple tablet-style device performs in various clinical settings.

The iPad's resolution isn't quite good enough for primary reading, but it's getting there. "The iPad holds great potential in mobile imaging, for secondary diagnosis and as an adjunct to an imaging report, and potentially screening for gross pathology," Dr. Frederick Weiss of the University of Maryland said in introducing a study on evaluating images for the presence of tuberculosis,AuntMinnie.com reports. In fact, Weiss' Baltimore-based research team found no significant difference in the number of misdiagnoses of TB on an iPad vs. a commercial-grade LCD monitor.

Among radiologists participating in the study, 30 percent preferred the image quality on an LCD PACS monitor, while 20 percent said the iPad delivered a better image. The remaining 50 percent found no major differences. "Subjectively, the majority of participants felt that the iPad was equal or superior to the LCD monitors used at a typical workstation with regard to the image quality and visualization," Weiss said.

Meanwhile, improved apps for reading CT and MRI images and suitable encryption measures for the iPad could help untether radiologists from the traditional reading room and, in the words of Nassau University Medical Center (East Meadow, N.Y.) radiology resident Dr. Toshi Clark, "help combat the trend of decreasing radiologist-patient and -clinician interaction," according to Health Imaging News.

Clark believes that outpatient imaging centers and emergency departments specifically could benefit from reading images on iPads. In the former case, radiologists could quickly show results to patients, helping to improve office efficiency. In the ED, Clark believes clinicians could rely on iPads for image guidance, for checklists when inserting central lines and for taking ultrasounds of patients in intensive care who are too unstable to be moved to rooms with PACS terminals.

Clark says the iPad's resolution of 1024-by-768 pixels already meets the requirements for MRI, CT and ultrasound images. Wi-Fi access addresses any speed problems related to downloading large image files, too, Clark tells Health Imaging News. "Finally, data security/HIPAA compliance would be ensured by 128-bit SSL connections and passcode encryption of all data, features of iPhone OS 4.0," Clark and his colleagues wrote in the paper, due to be presented Wednesday.

Source: http://www.fiercemobilehealthcare.com/story/rsna-ipad-helps-untether-radiologists-reading-room/2010-11-30?utm_medium=nl&utm_source=internal

Cytopathologist Needed

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QDx Pathology Services is a national, private, full-service Pathology Laboratory located in Central New Jersey. We are seeking full-time dynamic candidates to work in our state-of-the-art Pathology laboratory.

Seeking Board Certified Cytopathologist. Two to three years experience is desirable but not required. Additional GYN, GI or GU pathology interest preferred.

 

QDx offers an excellent benefit package.

Kindly fax your CV to

Megan Bradford, 908-272-1478

or e-mail to ATTN: admin@qdxpath.com.

 

46 Jackson Drive

Cranford, NJ  07016

Office: 866-909-7284

Fax:  908-272-1478

 

Check Out MikroScan @ California Society of Pathologists Meeting

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EVENT: New Whole Slide Imaging System will be on exhibit at the California Society of Pathologists 63rd Annual Convention this week in San Francisco.

Are you attending this show?
If so, you can get an up close look at the new WSI solution. Visit MikroScan's booth #210.

If you will not make it to the convention, then you can get more info and see online demos here:
http://www.mikroscan.com/whole-slide-scanners/demo-videos/

 

Philips introduces new CT platform that eliminates tradeoffs between low dose and image quality

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Ingenuity CT and Ingenuity TF PET/CT systems showcase how meaningful innovation can impact patient care

Chicago, Ill., USA – At the 96th annual meeting of the Radiological Society of North America (RSNA) in Chicago, Royal Philips Electronics (NYSE: PHG, AEX: PHI) announced today the new Philips Ingenuity CT (computed tomography) platform, an innovative technology that will help redefine low dose imaging. The Ingenuity CT features iDose4, Philips’ next-generation iterative reconstruction technique, designed to provide equivalent diagnostic image quality at up to 80 percent less dose; improve spatial resolution by up to 35 percent with up to 50 percent less dose; or simply improve spatial resolution by up to 68 percent. This new platform is available as a standalone or hybrid imaging system via the Ingenuity CT scanner and the Ingenuity TF PET/CT system.

“The Ingenuity CT system maintains outstanding image quality at the absolute lowest possible dose without wasting a moment of valuable clinician time. In the past, because the combination of great image quality, low dose and fast reconstruction times has been a challenge for the industry, CT scanning has often been about trade-offs. The launch of the Philips Ingenuity CT, the next step towards fully optimizing low-dose imaging, is proof of Philips’ commitment to eliminating the need to make trade-offs in patient care,” said Gene Saragnese, general manager, Imaging Systems, for Philips Healthcare.

At the heart of the Ingenuity CT is a new level of clinical integration and a wide variety of applications that put the focus on the patient while enhancing economic value. iDose4, Philips’ newest generation iterative reconstruction technique adds improvement in image quality and fast reconstruction times, while reducing dose.

“Healthcare is about doing the right thing for the patient both in the short and long term. CT provides incredibly valuable information but also uses radiation and requires injected contrast for certain exams,” said Dianna M. E. Bardo, M.D., associate professor of Radiology and director of Cardiac Radiology, Oregon Health and Science University. “With the Ingenuity CT, we can obtain critical images while knowing we’ve done everything possible to protect our patients in the long term by reducing dose.”

Another exclusive to the Ingenuity platform is SyncRight, a new tool designed to enhance communications between the scanner and the injector creating consistent image quality from patient to patient, up to 15 percent reduction in injected contrast per patient, providing better visualization of vascular structures, resulting in fewer repeat exams.

Clinical integration, innovation and patient focus are forces driving healthcare, however, most radiology departments are simultaneously being asked to do more with less. The Ingenuity CT platform provides the efficiency tools needed to help clinicians in the radiology, emergency and / or pediatric department to remain competitive. Tools include RapidView IR and a new, easy to use operator console that was designed to increase throughput by up to 25 percent and reducing decision points by up to 50 percent.

The Ingenuity CT also integrates the IntelliSpace Portal and extended Brilliance Workspace, across hospital information systems (HIS), radiology information systems (RIS) and picture archiving and communication systems (PACS).

New Ingenuity TF PET/CT: a revolution in hybrid imaging

Philips is a leader in delivering nuclear medicine technologies and services to clinicians around the world. Philips Ingenuity TF PET/CT is a premium hybrid imaging system to conduct studies in oncology imaging, cardiac perfusion and diagnostic CT. The system includes Time-of-Flight technology for exceptional speed and full-fidelity PET (positron emission tomography) imaging to enhance patient care.

Ingenuity TF PET/CT also improves imaging performance with the introduction of Astonish TF, the next evolution of Time-of-Flight (TOF) technology. Combined with 4-D TOF capabilities, Astonish TF shows a 50 percent improved contrast resolution while maintaining quantitative accuracy with up to four times the reconstruction speed of previous-generation systems. Additionally, the system also features iDose4 for an undivided and holistic approach to low-dose, high-quality CT imaging.

 

Philips ushers in new era of imaging with introduction of Ingenia, the first-ever digital broadband MRI system

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Philips Ingenia provides high image quality to aid diagnostic confidence, increases clinical versatility, and improves productivity by shortening MRI exam times

Best, Netherlands – Today at the 96th annual meeting of the Radiological Society of North America (RSNA) in Chicago, Royal Philips Electronics (NYSE: PHG, AEX: PHI) showcased Philips Ingenia, the first-ever digital broadband magnetic resonance imaging (MRI) solution. Driven by Philips’ commitment to developing innovative patient care solutions, Ingenia MR delivers exceptional image clarity, scanning efficiency and scalability. The Philips Ingenia MR system is pending U.S. FDA 510(k) and is not available for sale in the U.S.

In order to visualize detailed structures within the human body, MRI orchestrates the application of radio frequency (RF), audio frequency and static magnetic fields, the strength of which is measured in Tesla (T) units. Clinicians have long relied on MRI for its exceptional ability to differentiate various soft tissues. Until now, all MRI systems have utilized analog components for the signal acquisition and processing needed to generate patient images. However, the use of analog components during these processes has limited the upper reaches of image clarity and quality.

The Ingenia MR system introduces, for the first time in MRI, digital signal acquisition and processing directly in the RF receive coil nearest to the patient. By digitizing the signal directly in the RF receive coil and maintaining the digital connection throughout the entire MRI scanning process, Ingenia is able to generate up to a 40 percent improvement in signal-to-noise ratio. Improving signal-to-noise ratio enables the delivery of crisp image clarity that clinicians need to help make informed decisions possible for a wider range of clinical procedures, including traditional applications like neuro and musculoskeletal and fast-growing applications like body and cardiac.

The Ingenia MR system incorporates an integrated, hidden posterior coil enabling full body coverage and eliminating the need to place multiple connecting coils around various parts of the body. This approach eliminates unnecessary prep time while offering each patient a more comfortable patient experience regardless of their unique imaging needs. When utilizing an Ingenia system, clinicians will find they spend significantly less time on the logistics related to patient set-up, contributing to as much as a 30 percent increase in throughput. Ingenia is available in 1.5T and 3.0T versions to accommodate varied imaging needs.

“Image quality is a top priority, but it is only part of practicing excellent medicine. There is increasing pressure to be as fully optimized as possible and in a busy hospital environment, there simply isn’t much time to worry about process optimization,’" said Hans-Peter Busch, M.D., director of radiology for Krankenhaus der Barmherzigen Brüder hospital in Trier, Germany. “The Ingenia MR system optimizes workflow by completely eliminating or reducing time consuming steps like coil and patient manipulation. Compounded over time, this makes a real difference in terms of efficiency – in addition to being more comfortable for the patient."

Flexible solution suits a wide variety of clinical applications, today and tomorrow

Ingenia’s increased performance provides a reliable, patient-friendly approach for oncology imaging, staging and treatment assessment. Ingenia brings whole body oncology staging and follow-up to the clinical mainstream by delivering fast and simple solutions allowing anatomical fusion with diffusion datasets for robust clinical results at both 1.5T and 3.0T.

Ingenia’s digital capabilities also overcome the scalability limitations typical of analog based systems. Similar to the transition from limited channel analog television to unlimited channel digital broadband HD television, the digital signal acquisition and transmission capability of Ingenia is independent of the number of channels. Unlike fixed channel analog systems, users can add new and future clinical applications, which may require higher channel coils, in an easy and cost-effective way.  In addition, if a higher channel coil is required for a clinical procedure, Ingenia’s channel independent architecture is capable of performing the exam without requiring expensive hardware and software upgrades to the MRI system. This gives hospitals the flexibility they need to stay on the clinical cutting edge, now and in the future.

“At Philips we believe that meaningful innovations start with the patient,” said Saragnese. “MR is continuing to expand its role with applications for every part of the body and the Ingenia system is taking the lead with smart, reliable tools for better image quality and shorter exam times, which can lead to increased diagnostic confidence and a simpler patient and clinician experience overall.”

Google Explores the Human Body with HTML5

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Google has just soft-launched its latest browser experiment, the Google Body Browser, which is basically Google Earth for the human body. Think of it as a three-dimensional, multi-layered browser version of those Visible Man/Woman model kits. Or a virtualized version of Slim Goodbody, if you will.

Google showed off the app at the WebGL Camp. WebGL is a cross-platform low-level 3D graphics API that is designed to bring plugin-free 3D to the web. It uses the HTML5 Canvas element and does not require Flash, Java or other graphical plugins to run.

If you visit bodybrowser.googlelabs.com in a supported web browser, you’ll get a three-dimensional layered model of the human anatomy that you can zoom in on, rotate and search. WebGL support hasn’t hit mainstream browsers, but the beta versions of Google Chrome, Safari and Firefox all support it. Once you’ve got a compatible browser, visiting the Body Browser home page shows off the human body. You can adjust the various layers of skin, muscles, tissues and the skeletal system. What’s really cool is that if you type in an organ or bone or ventricle system, you are taken directly to that area in the anatomy, zoomed in. You can turn labels on or off and the app supports multitouch so users of trackpads (Magic or otherwise) or multi-touch mice can zoom in with ease.

Original article found here