title: Molecular Testing in Anatomic Pathology and Adherence to Guidelines: A College of American Pathologists Q-Probes Study of 2230 Testing Events Reported by 26 Institutions.
abstract: BACKGROUND
  The appropriate and timely performance of molecular testing in anatomic pathology is an indicator of quality. The National Comprehensive Cancer Network (NCCN) publishes a comprehensive treatment guideline that includes recommendations for ancillary testing.
  
  
  OBJECTIVE
  To establish benchmarks for rates of adherence to NCCN testing recommendations through a multi-institutional study.
  
  
  METHODS
  Participants in a 2013 Q-Probes study of the College of American Pathologists reported data from molecular testing on anatomic pathology cases, excluding hematolymphoid neoplasms, breast primary carcinomas, and gynecologic cytology.
  
  
  RESULTS
  Twenty-six institutions reported data from 2230 molecular testing events. In a retrospective study limited to colon, lung, and melanoma, there was strict adherence to guidelines in a median 71% (10th to 90th percentile range, 33%-90%) and there was at least loose adherence in a median 95% (10th to 90th percentile range, 57%-100%). There was adequate tissue to complete testing in a median 98% (10th to 90th percentile range, 86%-100%); in aggregate the adequacy rate for cell blocks was lower (84%, P < .001). Median test turnaround time was 8 days (10th to 90th percentile range, 4-13 days). In a prospective collection of all organ sites, there was strict adherence to guidelines in a median 53% (10th to 90th percentile range, 20%-71%), and there was at least loose adherence in a median 94% (10th to 90th percentile range, 75%-100%). Adherence to guidelines was higher for lung specimens and in institutions with more multidisciplinary conferences.
  
  
  CONCLUSIONS
  This multi-institutional study provides benchmarking data on appropriateness and timeliness of molecular testing in anatomic pathology.
authors: Keith E
authors: KE
authors: Volmar
authors: Michael O
authors: MO
authors: Idowu
authors: Rhona J
authors: RJ
authors: Souers
authors: From the Department of Pathology, Rex Pathology Associates, Raleigh, North Carolina (Dr Volmar); the Department of Pathology, Virginia Commonwealth University, Richmond (Dr Idowu); the Department of Biostatistics, College of American Pathologists, Northfield, Illinois (Ms Souers); and the Department of Pathology, Mayo Clinic Jacksonville, Jacksonville, Florida (Dr Nakhleh).
authors: Raouf E
authors: RE
authors: Nakhleh
mesh_terms: D019985:Benchmarking; D003110:Colonic Neoplasms / Q000175:diagnosis / Q000235:genetics; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000235:genetics; D008545:Melanoma / Q000175:diagnosis / Q000235:genetics; D009369:Neoplasms / Q000175:diagnosis* / Q000235:genetics*; D057089:Pathology, Molecular / Q000592:standards*; D017410:Practice Guidelines as Topic / Q000592:standards; D011446:Prospective Studies; D011786:Quality Control; D012189:Retrospective Studies; D012955:Societies, Medical; D011795:Surveys and Questionnaires; D014481:United States