Crawling toward obsolescence: The extended lifespan of amylase for pancreatitis.

The correlation between hyperamylasemia and acute pancreatitis was discovered in 1929, yet another test, lipase, was shown to provide better diagnostic performance in the late 1980s and early 1990s. Subsequent studies demonstrated co-ordering amylase with lipase did not provide additional benefit, only added cost. We sought to investigate the impact of studies advocating for the obsolescence of amylase on its clinical demand.

Associations between ABO non-identical platelet transfusions and patient outcomes-A multicenter retrospective analysis.

Background: Due to platelet availability limitations, platelet units ABO mismatched to recipients are often transfused. However, since platelets express ABO antigens and are collected in plasma which may contain ABO isohemagglutinins, it remains controversial as to whether ABO non-identical platelet transfusions could potentially pose harm and/or have reduced efficacy.

Study Design And Methods: The large 4-year publicly available Recipient Epidemiology and Donor Evaluation Study-III (REDS-III) database was used to investigate patient outcomes associated with ABO non-identical platelet transfusions.

Graphical analysis of guideline adherence to detect systemwide anomalies in HIV diagnostic testing.

Background: Analyses of electronic medical databases often compare clinical practice to guideline recommendations. These analyses have a limited ability to simultaneously evaluate many interconnected medical decisions. We aimed to overcome this limitation with an alternative method and apply it to the diagnostic workup of HIV, where misuse can contribute to HIV transmission, delay care, and incur unnecessary costs.

Development and Implementation of a Standard Format for Clinical Laboratory Test Results.

Objectives: Surprisingly, laboratory results, the principal output of clinical laboratories, are not standardized. Thus, laboratories frequently report results with identical meaning in different formats. For example, laboratories report a positive pregnancy test as "+," "P," or "Positive.

Transfusion practices in a large cohort of hospitalized children.

Background: While previous studies have described the use of blood components in subsets of children, such as the critically ill, little is known about transfusion practices in hospitalized children across all departments and diagnostic categories. We sought to describe the utilization of red blood cell, platelet, plasma, and cryoprecipitate transfusions across hospital settings and diagnostic categories in a large cohort of hospitalized children.

Study Design And Methods: The public datasets from 11 US academic and community hospitals that participated in the National Heart Lung and Blood Institute Recipient Epidemiology and Donor Evaluation Study-III (REDS-III) were accessed.

Variation in Neonatal Transfusion Practice.

Objective: To estimate the incidence of blood product transfusion, including red blood cells, platelets, and plasma, and characterize pretransfusion hematologic values for infants during their initial hospitalization after birth.

Study Design: Retrospective cohort study using data from 7 geographically diverse US academic and community hospitals that participated in the National Heart Lung and Blood Institute Recipient Epidemiology and Donor Evaluation Study-III (REDS-III) from 2013 to 2016. Pretransfusion hematologic values were evaluated closest to each transfusion and no more than 24 hours beforehand.

Red blood cell transfusion does not increase risk of venous or arterial thrombosis during hospitalization.

Previous observational studies suggest associations between red blood cell (RBC) transfusion and risk for arterial or venous thrombosis. We determined the association between thrombosis and RBC transfusion in hospitalized patients using the Recipient Database from the National Heart Lung and Blood Institute (NHLBI) Recipient Epidemiology and Donor Evaluation Study-III. A thrombotic event was a hospitalization with an arterial or venous thrombosis ICD-9 code and administration of a therapeutic anticoagulant or antiplatelet agent.

Transfusion Medicine Equations Made Internet Accessible.

Multiple mathematical equations inform the practice of transfusion medicine. These equations apply to a wide range of topics: dosage of blood products, calculation of fluid volumes, and even specific treatment decisions (e.g.

A 20-Year Evaluation of LOINC in the United States' Largest Integrated Health System.

Context.—: Clinical laboratories are obligated to implement Logical Observation Identifier Names and Codes (LOINC), an informatics standard used to uniquely identify laboratory tests. The historical progress of laboratories in achieving this goal is unknown.

Incidence of Clostridioides difficile infections among young and middle-aged adults: Veterans Health Administration.

Objective: Clostridioides difficile infection (CDI) remains a significant public health concern, resulting in excess morbidity, mortality, and costs. Additional insight into the burden of CDI in adults aged <65 years is needed.

Design/setting: A 6-year retrospective cohort study was conducted using data extracted from United States Veterans Health Administration electronic medical records.

LabRS: A Rosetta stone for retrospective standardization of clinical laboratory test results.

Objective: Clinical laboratories in the United States do not have an explicit result standard to report the 7 billion laboratory tests results they produce each year. The absence of standardized test results creates inefficiencies and ambiguities for secondary data users. We developed and tested a tool to standardize the results of laboratory tests in a large, multicenter clinical data warehouse.

Criteria to Screen Molecular Tests for the Diagnosis of Herpes Simplex Virus in the Central Nervous System have no Propensity to Harm.

Objectives: Investigators have ruled out herpes simplex virus (HSV) infection without the detection of herpes simplex deoxyribonucleic acid in cerebrospinal fluid (CSF) (i.e., HSV polymerase chain reaction [PCR]) by laboratory (normal CSF white blood cell count and protein) and clinical criteria (age ≥2 years, no history of human immunodeficiency virus or solid-organ transplant).

Clinical laboratory analytics: Challenges and promise for an emerging discipline.

The clinical laboratory is a major source of health care data. Increasingly these data are being integrated with other data to inform health system-wide actions meant to improve diagnostic test utilization, service efficiency, and "meaningful use." The Academy of Clinical Laboratory Physicians and Scientists hosted a satellite meeting on clinical laboratory analytics in conjunction with their annual meeting on May 29, 2014 in San Francisco.