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Updated: May 7, 2026
Integration of Wet and Dry Bench Processes Optimizes Targeted Next-generation Sequencing of Low-quality and Low-quantity Tumor Biopsies
Published on: April 11, 2016
Optimizing personalized bone marrow testing using an evidence-based, interdisciplinary team approach
Adam C Seegmiller1, Annette S Kim, Claudio A Mosse
1Depts of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Room C-3321A, 1161 21st Ave S, Nashville, TN 37232-2561; mary.zutter@vanderbilt.edu.
Objectives:
To address the overuse of testing that complicates patient care, diminishes quality, and increases costs by implementing the diagnostic management team, a multidisciplinary system for the development and deployment of diagnostic testing guidelines for hematologic malignancies.
Methods:
The team created evidence-based standard ordering protocols (SOPs) for cytogenetic and molecular testing that were applied by pathologists to bone marrow biopsy specimens on adult patients. Testing on 780 biopsy specimens performed during the six months before SOP implementation was compared with 1,806 biopsy specimens performed during the subsequent 12 months.
Results:
After implementation, there were significant decreases in tests discordant with SOPs, omitted tests, and the estimated cost of testing to payers. The fraction of positive tests increased. Clinicians reported acceptance of the new procedures and perceived time savings.
Conclusions:
This process is a model for optimizing complex and personalized diagnostic testing.
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