To evaluate the diagnostic efficacy of PDAT and its impact on test utilization, we retrospectively reviewed laboratory results from all BM examinations performed at inpatient and outpatient clinics at our institution from July 1, 2014, to June 30, 2015, which included the first year after implementation of PDAT with IR.
To evaluate the effect of PDAT on test utilization, we compared test orders during the first year of PDAT with test orders from BM studies collected at our institution from the pre-PDAT period of July 1, 2012 to June 30, 2013.
To assess clinician satisfaction with both PDAT and IR, we surveyed hematology/oncology physicians, physician assistants, and nursing personnel 6 months after implementation.
A total of 85 PSRs were issued in the PDAT period (Table 1).
The PDAT group (n = 268) was compared with 274 samples collected during the pre-PDAT period from July 1, 2012, to June 30, 2013.
Analysis of test utilization revealed a decrease in unnecessary testing orders from 124 of 274 cases (45%) pre-PDAT to 2 of 268 cases (0.7%) with PDAT (Table 3).
A satisfaction survey was sent to clinicians 6 months after implementation of PDAT with IR.
Prior to PDAT, we had difficulty completing IRs because of the lack of appropriate ancillary tests being performed.
Our clinicians were strongly in favor of PDAT and IR, so the perceived benefit made agreement on PDAT relatively easy.
One patient in the PDAT group with acute myeloid leukemia died shortly after the procedure, and the ancillary testing was cancelled.
Although both PDAT and IR are popular with our clinicians, the process is time consuming for the pathologist.