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The Landscape of Inappropriate Laboratory Testing:
Overuse and Underuse by the Numbers

Laboratory testing is the single highest-volume medical activity and drives clinical decision-making across medicine. However, the overall landscape of inappropriate testing, which is thought to be dominated by repeat testing, has not until recently been surveyed systematically. Systematic differences in initial vs. repeat testing, measurement criteria, and other factors would suggest new priorities for improving laboratory testing. This CAP webinar will review results of a 15-year systematic review and meta-analysis of the appropriateness of laboratory testing. It showed that the landscape of overutilization varies systematically by clinical setting (initial vs. repeat), test volume, and measurement criteria; and that underutilization is also widespread, but understudied. Expanding the current focus on reducing repeat testing to include ordering the right test during initial evaluation may lead to fewer errors and better care. This is a free, non-CME webinar.

Ramy Arnaout, MD, DPhil
Beth Israel Deaconess Medical Center

Sept. 16, 2014
2-3:00 PM CT

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Practical Genomics for the Practicing Pathologist Webinar Series–The Critical First Steps: Specimen Acquisition and Handling for Cancer Genomics

This CME webinar will address specimen acquisition and handling for cancer genomic testing. It will cover important considerations to communicate with the clinical team to ensure adequate specimens are presented for pathology review.


    1. Recognize the historical patterns and future trends of molecular
        testing that impact cancer genomics.
    2. Determine how the pathology workflow can be streamlined to
        improve tissue-based molecular diagnostics.
    3. Identify considerations that must be taken into account
        for handling tissue-based specimens to ensure adequate quantity,
        quality, and purity are present.
    4. Identify considerations that must be taken into account for
        handling blood and fluid specimen samples.

Colin C. Pritchard, MD, PhD
University of Washington Medical Center

Sept. 24, 2014
11 AM-12:00 PM CT

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New Roles and New Rules:
Pathologists in an Electronic Health Record (EHR) World

This CME webinar will describe EHRs and will prepare pathologists for challenges and opportunities that pathologists and laboratories face as EHRs transform the management of laboratory information in patient care. Insights will be provided to help pathologists be proactive in pathology-related EHR concerns in their institutions.

 • Anticipate, and suggest remediation for potential problems and gaps in
    EHR handling of laboratory test results and test orders.
 • Describe data standards important in pathology and how they affect
    pathology data in the EHR.
 • Identify evolving roles and responsibilities for pathologists in
    laboratory-related EHR issues.

October 1, 2014
12 PM-1 PM CT

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Economics 101:
In-house vs. Reference Testing: Criteria to Consider for Molecular Testing

In today's challenging healthcare environment the search for the most value out of our diagnostic tests is becoming more and more prominent. There are clearly more tests available than any single laboratory could run. As a result, pathologists and medical directors frequently must answer the question "Should I offer this test, or send it to a reference laboratory?"

The purpose of this webinar is to address this challenging question and systematically review the numerous components in this decision making process. Specifically, this talk will provide the tools to address the following six areas:

 • Medical Management Value
 • Current Status of Testing
 • Stakeholder Analysis
 • Instrumentation Analysis
 • Financial Analysis
 • SWOT (Strengths, Weaknesses, Opportunities, Threats)

This webinar is designed to of educational value to both the early career pathologist to experienced medical directors. At the end of this presentation, the participants should be able to:

 1. Define the key components in the decision to either perform a test in
     house or send it to a reference lab
 2. Perform and identify the value in performing a stakeholder analysis, and
     how it can be utilized to effectively communicate about the service
 3. Employ key financial concepts to compose a break even analysis of a
     particular service
 4. Perform a SWOT analysis as a defined tool to "scan the horizon" for
     influencing factors

Jordan S. Laser, MD, FCAP

Oct 22, 2014
11-12 pm PM CT

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Ex vivo pathology applications of IVM:
Cooler than Frozen

Ex vivo microscopy (EVM) involves the rapid imaging of biopsy material without requiring traditional fixation, sectioning and staining. A number of emerging technologies exist, including rapid confocal and wide-field optical coherence tomography. Potential applications of EVM include replacement of conventional frozen sections for surgical margin evaluation, including adequacy assessment of excisional biopsies. It can also be used to triage which specimens may be sent for traditional histology, and for assurance that specimens submitted for molecular profiling contain sufficient appropriate material. Down the road, the quality of the imaging may allow for definitive primary diagnosis, speeding up the workflow of patient evaluation. New technologies for rapid staining (immunofluorescence or FISH) may also allow same-day molecular phenotyping.

Since pathologists are expert at interpreting microscopic images, it is important that pathology as a field plays a role in how these technologies will be used. In this talk, I will review the key, commercially available EVM technologies and discuss the implications for pathology involvement and workflow.

Richard M. Levenson, MD, FCAP

Oct 23, 2014
11-12 PM CT

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Breast Predictive Factors:
Resolving Test Interpretation Challenges

This interactive case-based webinar worth 1.5 CME, will answer your common questions and challenges related to HER2 and ER/PgR testing. Two of the ASCO/CAP Guideline authors will facilitate a tumor board-like experience where participants weigh-in on real patient cases. This is a unique opportunity to come together and learn from the experts and other pathologists doing breast predictive factors testing.

As a result of participating in this education activity, you will be able to:

 • Accurately interpret HER2 tests as positive, negative or equivocal
    according to the ASCO/CAP HER2 Guideline criteria.
 • Evaluate and integrate HER2 test results with clinical
    and morphologic findings.
 • Determine appropriate next steps when a HER2 test result
    is discordant with the patient’s profile or other HER2 tests.
 • Apply the ASCO/CAP Guideline criteria for reporting
    HER2 test results.
 • Provide appropriate resolution and clarification in reports
    when HER2 results are equivocal, indeterminate,
    or complex (eg, intratumoral heterogeneity
    or chromosome 17 aneusomy).

Nov. 6, 2014
12-1:30 PM CT

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