Data-Driven Iterative Refinement of Bone Marrow Testing Protocols Leads to Progressive Improvement in Cytogenetic and...

Area of Science:

• Hematology
• Clinical Pathology
• Laboratory Medicine

Background:

• Standard ordering protocols for bone marrow biopsy tests are essential for accurate diagnosis.
• Optimizing test utilization is crucial for managing healthcare costs and improving efficiency.

Purpose of the Study:

• To evaluate the impact of iteratively refining standard ordering protocols on test utilization and results for bone marrow biopsy specimens.
• To assess the cost-effectiveness and performance improvements associated with protocol revisions.

Main Methods:

• Utilized 18 months of test utilization and result data to revise protocols for cytogenetic and molecular test selection.
• Compared test utilization and results before and after protocol revision.

Main Results:

• Protocol revisions led to a reduction in total tests and associated charges.
• Decreases in both concordant and discordant tests were observed, specifically in revised disease categories and reflex testing cases.
• An increased fraction of positive tests was noted, also limited to reflex testing.

Conclusions:

• Data-driven, iterative protocol revision enhances test utilization and performance in bone marrow biopsy testing.
• Continuous analysis of testing data enables ongoing improvement in test ordering decisions and cost reduction.