Board Of Registry Research Articles

ACSM Committee on Certification and Registry Boards Update on Recertification and Continuing Education Credit Provider Policy

ACSM Committee on Certification and Registry Boards Update on Recertification and Continuing Education Credit Provider Policy

Protocole à fin de constitution d’un registre français des prothèses de hanche

INTRODUCTION: Use of joint prostheses is growing widely, in particular in developed countries. The « Société Française de Chirurgie Orthopédique et Traumatologique » (SOFCOT) has submitted in 2007 to the «Commission Nationale Informatique et liberté» (CNIL) a project for creating a hip prostheses registry. More recently, the « Conseil National Professionnel de chirurgie Orthopédique et Traumatologique » (CNP-COT) developed a national implants and observatory registry on surgical orthopaedic and traumatologic practices and pathologies (RENACOT) aiming to assure traceability and materio-vigilance of hip implants used in France. The main objective of the study is to report the current state of surgical techniques, used implants and their evolutions in hip arthroplasty in France using retrospective data provided by a multicenter registry since 2006.MATERIAL ET METHODS: On the one hand, the research systematically lists the main characteristics of all implants used in hip arthroplasty; and on the other hand, these informations are correlated with epidemiologic, demographic data, CROMs and PROMs. The study group consists by all patients receiving a hip reconstruction either in traumatology (femoral neck fractures) or above all for degenerative diseases. The data are collected in 2 questionnaires. The link between primary and revision surgery of the same prosthesis is automatic through the patient social security N°, sex and operated side.RESULTS: Patient demographics provides the corresponding population epidemiologic information’s. Registered data are available through 3 modes: 1- In running time, the registry board members only can accede to all collected data by internet 2- A biennal report of the national hip replacement activity 3- Any particular request about a specific matter or implant DISCUSSION One of the major registry interests in case of revision is the possibility to assure an automatic link with the corresponding primary arthroplasty. This is only possible if the primary questionnaire is already implemented and if the correspondence between the primary arthroplasty and the same hip reoperation/revision can automatically be established from the moment where both questionnaires are correctly completed in the registry. The CNP, through the RENACOT spreading use, aims to extend such registry practice to all orthopaedic and traumatologic surgical fields.

The Wide Grip Tubing Row Exercise

Peter Ronai, M.S., FACSM, ACSM-CEP, ACSM-EP, EIM-III, CSCS, is a clinical professor of Exercise Science in the Department of Physical Therapy and Human Movement Sciences at Sacred Heart University in Fairfield, Connecticut. He is a fellow of the American College of Sports Medicine (ACSM) and an associate editor of ACSM's Health & Fitness Journal®and writes the Do It Right column. He is a member of the ACSM Committee on Certification and Registry Boards (CCRB). His articles and presentations address tips, tools, and resources exercise professionals can use to better serve their clients and patients. Disclosure: The author declares no conflict of interest and does not have any financial disclosures.

Fabry Disease practice resource: Focused revision

Fabry Disease practice resource: Focused revision

Does Race Impact Survival in Multiple Myeloma?

Purpose:Multiple myeloma (MM), a cancer involving abnormal antibody production from plasma cells, accounts for approximately 1.8% of all new cancer cases in the US. The International Staging System (ISS) for MM classifies patients with serum beta2 microglobulin < 3.5mg/l and serum albumin ≥3.5g/dl as having stage I disease, patients with serum beta2 microglobulin ≥ 5.5 mg/l as having stage III disease, and all others as having stage II disease. The median survival by stage at time of diagnosis is 62 months, 45 months, and 29 months, respectively, for stages I, II, and III.The median age at time of diagnosis of MM is 69 years, with approximately 62% of all patients being at least 65 years old at time of diagnosis. There is a 2-fold increase in MM incidence amongst blacks as compared to whites in both the male and female population. This study was conducted to further characterize our MM patient population and to potentially identify racial and gender impact on mortality.Methods:A retrospective chart review of all patients in our geographic region diagnosed with MM between 2012 and 2017 was conducted using the Louisiana Tumor Registry Board database. Clinical data abstraction included epidemiology, laboratory, and pathologic data at time of diagnosis, and time to autologous stem cell transplant and death, if applicable. We performed chi-square analysis, linear regression, and survival analysis to compare survival outcomes between groups.Results:Chart review data was available for 184 of the 243 patients diagnosed with MM between 2012-2017, including 89 (47.6%) males and 98 females (52.4%), and 90 (48.1%) whites and 88 (47.1%) blacks. Females were significantly older than males (66.1 vs 62.6 years, p=0.037) at time of diagnosis yet whites were not significantly older compared to blacks (65.1 vs. 63.9 years, p=0.498). Among the 108 patients with documented stage of disease, 17 (15.7%) patients were diagnosed with stage I MM compared to 40 patients (37.0%) diagnosed at stage II and 51 (47.2%) diagnosed at stage III. With regards to stage, there was no significant difference between race or sex in our population. When adjusted for gender and age at diagnosis, race was a significant predictor of survival time with survival being 6.45 months shorter for black patients with MM compared to whites with the disease. (95% CI, 1.1 to 11.8; p = 0.019)Conclusion:Our data suggest that race exists as an independent predictor of shorter survival in our black patient population with MM. Additional studies investigating the biologic diversity of this disease are warranted to explain this racial disparity. DisclosuresNo relevant conflicts of interest to declare.

A 30 Years’ Experience in Cancer Prevention From Alexandria, Egypt

Background: Cancer registration is a systematic process of data collection of adequate data about patient with confirmed cancer, followed by processing and dissemination of reports to allow understanding of magnitude and pattern of cancer in certain covered population. Alexandria Cancer Registry (ACR) is a well-established central hospital based cancer registry from university hospitals, hospitals of ministry of public health, medical care organization and health insurance hospitals to cover more than 90% of diagnosed cases with cancer. Data are collected active and passive ways. Data abstracts include: age, gender, residence, occupation, date of first diagnosis and contact address of the patient together with items about mode of diagnosis, site, laterality, topography, histology, lymph node affections, modality of treatment and health status during the last visit. Cancer registrars in ACR attended several continuous training activities in abstracting, case ascertainment and TNM coding to allow competence, reliability and accuracy of data through intimate supervision from pathologists, oncologists, surgeons and radiologists in the registry board. Data manipulation and analysis are routinely by CanReg5.0 software. The last report in 2015, shows a total of 4550 confirmed cases have been registered, with a male to female ratio 1:1.1. The report adopted the guidelines of IACR-WHO. The report shows the frequency of cases by systems, age and gender, followed by affected organs within each system. The most affected system was connective tissues and soft tissue including female breast cancer. The second most affected system was gastrointestinal system. Primary hepatocellular carcinoma replaced urinary bladder as the first most frequent cancer among males with young age presentation. As a data bank, several research activities has been done in ACR in the form of case control studies in collaboration with IARC and Mario Negri Institute, Milan, Italy. Screening for colorectal cancer started with University of Alabama at Birmingham. Several interesting findings will be displayed, discussed and explained during the presentation. Conclusion: The appropriate data quality of cancer patients in cancer registry along with the catalog guided biologic repositories are considered as initial pillar to establish a biobank and allowed us to join International Biobank (IBB) and BCNet in IARC to accelerate global understanding of causes of cancer and joining a framework of other members will allow exchange of knowledge and upscale levels of cancer prevention.

Philip Hillkowitz The "Granddaddy of Medical Technologists" and Cofounder of the American Society for Clinical Pathologists and the Jewish Consumptives' Relief Society.

- In the early 20th century, the future of hospital-based clinical pathology practice was uncertain and this situation led to the formation of the American Society for Clinical Pathologists in 1922. Philip Hillkowitz, MD, and Ward Burdick, MD, were its cofounders. No biography of Hillkowitz exists. - To explore the life, beliefs, and accomplishments of Philip Hillkowitz. - Available primary and secondary historical sources were reviewed. - Hillkowitz, the son of a Russian rabbi, immigrated to America as an 11-year-old child in 1885. He later attended medical school in Cincinnati, Ohio, and then moved to Colorado, where he began his clinical practice, which transitioned into a clinical pathology practice. In Denver, he met Charles Spivak, MD, another Jewish immigrant and together they established the Jewish Consumptives' Relief Society, an ethnically sensitive tuberculosis sanatorium that flourished in the first half of the 20th century because of its national fundraising network. In 1921, Hillkowitz and Burdick, also a Denver-based pathologist, successively organized the pathologists in Denver, followed by the state of Colorado. Early the next year, they formed the American Society for Clinical Pathologists (ASCP). Working with the American College of Surgeons, the ASCP put hospital-based practice of clinical pathology on solid footing in the 1920s. Hillkowitz then established and oversaw the ASCP Board of Registry of Medical Technologists. - Philip Hillkowitz changed the directions of clinical pathology and tuberculosis treatment in 20th century America, while simultaneously serving as a successful ethnic power broker within both the American Jewish and Eastern European immigrant communities.

Correlation of University Comprehensive and National Certification Exam Scores for Medical Laboratory Science Students

This retrospective study evaluated the ability to predict certification by the American Society for Clinical Pathology (ASCP) Board of Certification (BOC), using an overall score cutoff of 60% on a university comprehensive exam. The study also evaluated overall and content area scores (Blood Bank, Chemistry, Hematology, Immunology, Laboratory Operations, Microbiology, and Urinalysis and Other Body Fluids) for correlation between the university and BOC exams. Overall university exam scores ranged from 35-86% (percentage of correct answers) for students completing both exams from 2006-2015 (n = 152). BOC exam scores ranged from 287-755 (scaled from 0-999, with 400 required to pass). The overall correlation between scores was 0.65. Content area correlations ranged from 0.00 (Immunology) to 0.55 (Microbiology) for students completing both exams from 2012-2015 (n = 51). A receiver operating characteristic curve resulted in an overall university exam score cutoff of 55% showing the highest sensitivity and specificity for predicting success. Using the hypothesized 60% cutoff, one student showed a false positive result. All students scoring above 67% on the comprehensive exam passed the certification exam. In general, this study indicates that there are large variations when comparing results between comprehensive and certification exams. ABBREVIATIONS:ASCP - American Society for Clinical Pathology; BOC - Board of Certification; BOR - Board of Registry; GPA - grade point average; MLS - medical laboratory science/scientist; NAACLS - National Accrediting Agency for Clinical Laboratory Sciences; ROC - receiver operating characteristic; SD - standard deviation

A Look Ahead to 2016 for ACSM’s Committee on Certification and Registry Boards

A Look Ahead to 2016 for ACSM’s Committee on Certification and Registry Boards

Important Updates from ACSM’s Committee for Certification and Registry Boards

Important Updates from ACSM’s Committee for Certification and Registry Boards

Unification of the NCA and the ASCP Board of Registry

1. Susan Morris, MPH, MLS(ASCP)CM[⇑][1] 1. Former NCA President, New Board of Certification Governor, St. Luke's Magic Valley Medical Center, Twin Falls, Idaho 1. Address for Correspondence: Susan Morris, Patient Safety Officer, St. Luke's Magic Valley Medical Center, 650 Addison Ave. West, Twin Falls, Idaho 83301, susanm{at}mvrmc.org Introduction Professional credentials are the cornerstone for defining and achieving recognition of an independent scope of practice. When multiple competing credentials exist, that identity is less clear to those outside the profession. The combination of the two largest laboratory certification organizations in 2009 was a landmark event for increasing recognition of laboratory professionals. During the 1970's, irreconcilable differences erupted between pathologists and technologists regarding the composition and operation of the ASCP Board of Registry, which led to the formation of the National Credentialing Agency. NCA was founded as a free-standing certification organization, based on the principles of peer certification, exam development based on practice analyses and psychometrics, and mandatory re-certification to demonstrate continued competency. Over time, there were outcries from educators, students, employers, and professionals in the field. The complexities that resulted from having two competing certifications for NAACLS-accredited programs were making their lives and careers more difficult. They wanted the two organizations to find a way to come together. After thirty years of fierce competition, both organizations began to recognize that the differences that created the separation, and loomed so large at that time, had all but disappeared. Although there were still pathologists participating on the Board of Registry (BOR), they were clearly minority stakeholders on the board. Both NCA and the BOR had chosen to participate in an accreditation program that ensured best practices, including the requirement of re-certification. Both organizations began to realize that the way to have the greatest impact on our profession was to focus… ABBREVIATIONS: AGT – Association of Genetic Technologists, ASCP – American Society for Clinical Pathology, BOC – Board of Certification, BOR – Board of Registry, NCA – National Credentialing Agency. [1]: #corresp-1

A Retrospective Review of Healthcare Disparities among Economic Subgroups with Hematologic Malignancies

Background: In 2007, one in five Americans reported delayed or inadequate health care. Of those, 15.5 million had no insurance coverage. The number of underinsured patients increased to 25.2 million in 2007. Furthermore, a recent study showed that Non-Hodgkin's lymphoma patients with Medicaid or no insurance presented at a later stage. The mission of our institution, MetroHealth Medical Center, a county hospital, is to provide excellent health care to all individuals, regardless of their ability to pay. A significant number of patients who are uninsured or underinsured are treated at this institution, as well as patients with adequate insurance coverage. Along with financial and social staff to assist these patients in obtaining access to Medicare and Medicaid benefits, MetroHealth employs a unique rating system to assess patients' financial needs in a timely manner and provide assistance with these needs. Our primary objective was to evaluate whether a lack of adequate health insurance significantly delayed the time to diagnosis and/or treatment of patients with hematologic malignancies.Methods: Patients with hematologic malignancies, diagnosed between 1999 and 2007, were identified using the computerized Tumor Registry Board at our institution. We retrospectively compared the diagnostic interval (time from presentation to a medical provider, with a symptom or finding clearly related to malignancy, until diagnosis) and the treatment interval (time from diagnosis to treatment) in patients with or without insurance. Patients with hematologic malignancies who had an indication for treatment at the time of diagnosis were included in the study, however, patients requiring emergent treatment at the time of presentation were excluded (as financial evaluation would not be required for such treatment). We also considered covariates of age, sex, race and patient compliance (as measured by the number of “no show” appointments in the diagnostic and treatment intervals).Results: A total of 206 patients were identified who met the inclusion criteria and for whom the relevant time intervals and covariates could be determined. Kaplan-Meier curves were constructed to compare subgroups based on insurance status. We found no difference in thediagnostic ortreatment intervals for insured vs uninsured patient (a: 18 vs 20 days, p = 0.7071; b: 20 vs 28 days, p = 0.2433), or when the patients were grouped by type of insurance (a: p = 0.6000, b: p = 0.2196).Cox proportional hazards models were used to evaluate the effect of the covariates on the diagnostic and treatment intervals. A significant correlation was found between patient non-compliance and both diagnostic (p = 0.0007, HR = 0.8184) and treatment intervals (p = 0.0499, HR = 0.8841). Hazard ratios should be interpreted as the relative decrease in the probability of diagnosis (or treatment) within any time interval, given one additional “no show” appointment. The treatment interval was also found to be significantly correlated with race (p = 0.0050, HR = 0.6884). Otherwise the time intervals were independent of the tested covariates.Conclusion: The financial evaluation and assistance system employed at MetroHealth Medical Center allows patients to receive rapid access to needed health care. No delays in time to diagnosis or treatment, related to insurance status, were observed in patients with hematologic malignancies seen at this institution over a 9 year period. In a time when national health care reform is being contemplated, this system may serve as a useful model for health care access to individuals with varying financial means. Of note, a small disparity in treatment interval was seen related to race. This may be due to correlation between race and type of malignancy, but is being investigated further.

Impact of Expected Changes in National Papanicolaou Test Volume on the Cytotechnology Labor Market

With the new screening and treatment guidelines and the prospect of human papillomavirus vaccination for adolescents, the current total volume of Papanicolaou (Pap) tests will be significantly reduced. We used available data to assess the current supply and demand in the cytotechnology labor market and how an expected change in Pap test volume impacts this market. Cytotechnologists' data were obtained from the American Society for Clinical Pathology (ASCP) Board of Registry and the Center for Medicare and Medicaid Services. Data for wages and vacancies were obtained from American Society for Cytotechnologists and ASCP Surveys. Cytotechnology training program data were obtained from annual reports of the Cytotechnology Programs Review Committee of American Society for Cytopathology. In the current market, the demand for cytotechnologists increases by 3.6% and the supply by 4.0% each year. At any given time, there is a vacancy rate of 3%. In the coming years, the demand will decrease remarkably with a projected total demand for cytotechnologists of 5,623 instead of 8,033 by the year 2010 and of 8,538 instead of 14,146 by the year 2026. The cytotechnology market faces an impending crisis. There is a high need for prospectively collected accurate data on demand for and supply of cytotechnologists.

ASCP Board of Registry’s 2006 Annual Survey of Medical Laboratory Science Programs

ASCP Board of Registry’s 2006 Annual Survey of Medical Laboratory Science Programs

Colloquium – ACSM Committee on Certification and Registry Boards (CCRB) Annual Updates on Certification and Accreditation

Colloquium – ACSM Committee on Certification and Registry Boards (CCRB) Annual Updates on Certification and Accreditation

Colloquium – ACSM Committee on Certification and Registry Boards (CCRB) Annual Updates on Certification and Accreditation

Colloquium – ACSM Committee on Certification and Registry Boards (CCRB) Annual Updates on Certification and Accreditation

Colloquium – ACSM Committee on Certification and Registry Boards (CCRB) Annual Updates on Certification and Accreditation

Colloquium – ACSM Committee on Certification and Registry Boards (CCRB) Annual Updates on Certification and Accreditation

Colloquium – ACSM Committee on Certification and Registry Boards (CCRB) Annual Updates on Certification and Accreditation

Colloquium – ACSM Committee on Certification and Registry Boards (CCRB) Annual Updates on Certification and Accreditation

Colloquium – ACSM Committee on Certification and Registry Boards (CCRB) Annual Updates on Certification and Accreditation

Colloquium – ACSM Committee on Certification and Registry Boards (CCRB) Annual Updates on Certification and Accreditation

Colloquium – ACSM Committee on Certification and Registry Boards (CCRB) Annual Updates on Certification and Accreditation

It is important to employ training practices that ensure that fire-fighter instructors work in an environment which does not provoke unacceptable rises in core temperature (>38°C). PURPOSE: To assess the effects of a two-day fire-behaviour training (FBT) course on the core temperature (Tc) of fire-fighter instructors in order to establish whether current training practices ensure a safe working environment. METHODS: Eleven males (mean±sd age 38.3±4.3 yr, body mass 88.5±12.7 kg and stature 177.8±5.3 cm) from two regional training centres completed three days of standard FBT, wearing full protective clothing and breathing apparatus. Two consecutive days (HOT1 and HOT2, mean ambient temperature of 12.7°C) each consisted of a morning and an afternoon heat exposure (approximately 30 minutes in duration). The third day was a control (NORM), without heat exposure (mean Tc of 19.3 °C). Tc was measured at baseline (BASE) and at the start and end of the two exposures (PRE-AM, POST-AM and PRE-PM, POST-PM respectively) for each subject using a telemetry pill (HQ Inc, USA). RESULTS: There was a different pattern of Tc response over the two HOT days compared with the NORM day due to the significant increase in Tc associated with each of the heat exposures (p<0.01, PRE to POST, Table 1). Mean Tc did not reach 38°C, but in 10 out of 44 individual exposures subjects had a T above 38°C post heat exposure. In contrast, baseline T for the three days was not significantly different and showed a consistent significant increase to PRE-AM values (p<0.01, BASE to PRE-AM, Table 1) associated with the wearing of protective clothing and morning activities. The mean (±sd) unit temperatures of the HOT and NORM days were 160.2 (±89.3) and 27.6 (±8.4) °C respectively. CONCLUSION: The physiological strain experienced due to heat exposure in firefighter instructors resulted in a significant increase in Tc above that experienced during similar physical exertion with no heat exposure. While mean Tc did not reach 38°C, defined as an acceptable limit for work, Tc did rise above 38°C after approximately 1 in 4 individual heat exposures.