Difference between revisions of "L4E rule 7-8 (2014)"

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This article covers '''L4E rule 7''' for the 2014 [[L4E]] [[workload]] system. An overview of the L4E rules is found in the [[L4E rules of 2014]].  
This article covers '''L4E rule 7''' and '''L4E rule 8''' for the 2014 [[L4E]] [[workload]] system. An overview of the L4E rules is found in the [[L4E rules of 2014]].  


The definitive reference for the rule is found on the CAP-ACP website.<ref name=capacp2014>Workload and Workforce Committee of the CAP-ACP. Workload Measurement Guidelines. Canadian Association of Pathologists (CAP-ACP). 2014. URL: [https://www.cap-acp.org/cmsUploads/CAP/File/CAP-ACP%202014%20Workload%20FINAL.pdf https://www.cap-acp.org/cmsUploads/CAP/File/CAP-ACP%202014%20Workload%20FINAL.pdf]. Accessed on: 17 October 2017.</ref>  
The definitive reference for the rule is found on the CAP-ACP website.<ref name=capacp2014>Workload and Workforce Committee of the CAP-ACP. Workload Measurement Guidelines. Canadian Association of Pathologists (CAP-ACP). 2014. URL: [https://www.cap-acp.org/cmsUploads/CAP/File/CAP-ACP%202014%20Workload%20FINAL.pdf https://www.cap-acp.org/cmsUploads/CAP/File/CAP-ACP%202014%20Workload%20FINAL.pdf]. Accessed on: 17 October 2017.</ref>  


==Overview==
==Overview==
*This rule applies to specimens with additional stains and/or diagnostic ([[Quality#Classification_of_IHC_tests|class 1]]) immunostains.
*Rule 7 applies to specimens with additional stains and/or diagnostic ([[Quality#Classification_of_IHC_tests|class 1]]) immunostains requested by the pathologist.
 
*Rule 8 applies to specimens with [[Quality#Classification_of_IHC_tests|class 2 immunostains]] (e.g. ER/PR/HER2 for breast cancer).
Note:
*Class 2 immunostains (e.g. ER/PR/HER2 for breast cancer) are covered by [[L4E rule 8 (2014)|rule 8]].


==Details==
==Details==
==Details==
{| class="wikitable sortable"
{| class="wikitable sortable"
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! Details
! Details
! Examples
! Examples
! Rule
|-
|-
| All specimen types
| All specimen types
| 0.15 L4E/immunostain slide, 0.15 L4E/non-onerous special stains
| 0.15 L4E/[[Quality#Classification_of_IHC_tests|class 1 immunostain]] slide, 0.15 L4E/non-onerous special stain
| does '''not''' include [[Quality#Classification_of_IHC_tests|class 2]] IHC tests (e.g. ER/PR/HER2 for breast ca), does '''not''' include so called ''onerous special stains'' (see below), 1 IHC = 0.33 L4E, 2 IHC = 0.66 L4E, 3 IHC = 1 L4E ...  
| does '''not''' include [[Quality#Classification_of_IHC_tests|class 2 IHC test]]s † (e.g. ER/PR/HER2 for breast ca), does '''not''' include so called ''onerous special stains'' (see below), 1 IHC = 0.33 L4E, 2 IHC = 0.66 L4E, 3 IHC = 1 L4E ...  
| 2 lung cores with CRC demonstrated with 5 IHC = 1 L4E ([[L4E rule 1|rule 1]]) + 5 x 0.15 L4E  
| 2 lung cores with CRC demonstrated with 5 IHC = 1 L4E ([[L4E rule 1|rule 1]]) + 5 x 0.15 L4E  
| Rule 7
|-
|-
| All specimen types
| All specimen types
| 0.5 L4E/onerous special stain
| 0.5 L4E/onerous special stain
| includes only time consuming special stains: [[Warthin-Starry stain]], [[ZN stain]], [[Fite stain]]
| includes only time consuming special stains: [[Warthin-Starry stain]], [[ZN stain]], [[Fite stain]]; stain must be ordered by pathologist - if the stain is done upfront/routinely by the lab it is not counted ‡
| one lung core biopsy with granulomas - ZN, GMS, PASD done = 1 ([[L4E rule 1|rule 1]]) + 0.5 + 2 x 0.15 L4E
| one lung core biopsy with granulomas - ZN, GMS, PASD done = 1 ([[L4E rule 1|rule 1]]) + 0.5 + 2 x 0.15 L4E
| Rule 7
|-
| All specimen types
| 0.33 L4E/immunofluorescent stain
| applies only to immunofluorescent stains (IFs)
| skin biopsy with 4 IFs = 1 L4E ([[L4E rule 1|rule 1]]) + 4 x 0.33 L4E
| Rule 7
|-
| All specimen types
| 0.5 L4E/class 2 immunostain slide
| does '''not''' apply to IHCs done in a diagnostic context, e.g. using ER to demonstrate metastatic breast ca in a vertebra body
| 2 breast cores with ER/PR/HER2 IHC = 1 L4E ([[L4E rule 1|rule 1]]) + 3 x 0.5 L4E
| Rule 8
|}
|}


Note:  
Notes:  
*[[Quality#Classification_of_IHC_tests|Class 2 IHC tests]] are covered by [[L4E rule 8 (2014)|L4E rule 8]].
*‡ Stomach biopsies which (routinely) come with a Warthin-Starry are not counted.


==See also==
==See also==
*[[L4E rules of 2014]].
*[[L4E rules of 2014]].
*[[L4E rule 7-8 (2018)]].


==References==
==References==

Latest revision as of 01:10, 20 May 2019

This article covers L4E rule 7 and L4E rule 8 for the 2014 L4E workload system. An overview of the L4E rules is found in the L4E rules of 2014.

The definitive reference for the rule is found on the CAP-ACP website.[1]

Overview

  • Rule 7 applies to specimens with additional stains and/or diagnostic (class 1) immunostains requested by the pathologist.
  • Rule 8 applies to specimens with class 2 immunostains (e.g. ER/PR/HER2 for breast cancer).

Details

Specimen type(s) Weight (L4E) Details Examples Rule
All specimen types 0.15 L4E/class 1 immunostain slide, 0.15 L4E/non-onerous special stain does not include class 2 IHC tests † (e.g. ER/PR/HER2 for breast ca), does not include so called onerous special stains (see below), 1 IHC = 0.33 L4E, 2 IHC = 0.66 L4E, 3 IHC = 1 L4E ... 2 lung cores with CRC demonstrated with 5 IHC = 1 L4E (rule 1) + 5 x 0.15 L4E Rule 7
All specimen types 0.5 L4E/onerous special stain includes only time consuming special stains: Warthin-Starry stain, ZN stain, Fite stain; stain must be ordered by pathologist - if the stain is done upfront/routinely by the lab it is not counted ‡ one lung core biopsy with granulomas - ZN, GMS, PASD done = 1 (rule 1) + 0.5 + 2 x 0.15 L4E Rule 7
All specimen types 0.33 L4E/immunofluorescent stain applies only to immunofluorescent stains (IFs) skin biopsy with 4 IFs = 1 L4E (rule 1) + 4 x 0.33 L4E Rule 7
All specimen types 0.5 L4E/class 2 immunostain slide does not apply to IHCs done in a diagnostic context, e.g. using ER to demonstrate metastatic breast ca in a vertebra body 2 breast cores with ER/PR/HER2 IHC = 1 L4E (rule 1) + 3 x 0.5 L4E Rule 8

Notes:

  • ‡ Stomach biopsies which (routinely) come with a Warthin-Starry are not counted.

See also

References

  1. Workload and Workforce Committee of the CAP-ACP. Workload Measurement Guidelines. Canadian Association of Pathologists (CAP-ACP). 2014. URL: https://www.cap-acp.org/cmsUploads/CAP/File/CAP-ACP%202014%20Workload%20FINAL.pdf. Accessed on: 17 October 2017.