Difference between revisions of "Level 4 equivalent of 2014"
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The development is described in a paper by Maung.<ref name=pmid15762279>{{Cite journal | last1 = Maung | first1 = RT. | title = What is the best indicator to determine anatomic pathology workload? Canadian experience. | journal = Am J Clin Pathol | volume = 123 | issue = 1 | pages = 45-55 | month = Jan | year = 2005 | doi = | PMID = 15762279 }}</ref> It has since been revised and is comprehensive with regard to academic practice and community practice.<ref>URL: [https://www.cap-acp.org/wkload.php https://www.cap-acp.org/wkload.php]. Accessed on: 14 July 2017.</ref> | The development is described in a paper by Maung.<ref name=pmid15762279>{{Cite journal | last1 = Maung | first1 = RT. | title = What is the best indicator to determine anatomic pathology workload? Canadian experience. | journal = Am J Clin Pathol | volume = 123 | issue = 1 | pages = 45-55 | month = Jan | year = 2005 | doi = | PMID = 15762279 }}</ref> It has since been revised and is comprehensive with regard to academic practice and community practice.<ref>URL: [https://www.cap-acp.org/wkload.php https://www.cap-acp.org/wkload.php]. Accessed on: 14 July 2017.</ref> | ||
==Revised L4E of 2014== | |||
===Surgical pathology & cytopathology=== | |||
L4E units for surgical pathology adapted from Maung:<ref name=Can_J_Pathol_2010_2_8-19/> | |||
{| class="wikitable sortable" | |||
! Code | |||
! L4E units | |||
! Description | |||
! Details | |||
|- | |||
| L1 | |||
| 0.15 | |||
| gross only specimens | |||
| itemized in the "specimen list and codes" | |||
|- | |||
| L2 | |||
| 0.333 | |||
| confirmation of normal | |||
| must include histology | |||
|- | |||
| L3 | |||
| 0.5 | |||
| small biopsies | |||
| includes most skin, cysts, GI tract specimens, small benign specimens | |||
|- | |||
| L4 | |||
| 1 | |||
| biopsies - most internal organs | |||
| detailed in rules 1, 2 and 3 | |||
|- | |||
| L5 | |||
| 5 | |||
| complex biopsies - includes medical and transplant biopsies, explant organs | |||
| | |||
|- | |||
| L6 | |||
| 10 | |||
| radical resections for malignancy | |||
| detailed in rule 9 | |||
|- | |||
| C1 | |||
| 1 | |||
| simple (exfoliative) cytology | |||
| pap test, urine, sputum, fluids (peritoneal, pleural) | |||
|- | |||
| C2 | |||
| 2 | |||
| complex cytology | |||
| FNAs, brushes, washes | |||
|- | |||
|} | |||
===All other cases=== | |||
{| class="wikitable sortable" | |||
! L4E units | |||
! Description | |||
! Details | |||
|- | |||
| L2/block | |||
| non-radical and benign resections, non-biopsy/non-L6 cases | |||
| detailed by rule 4, e.g. 10 blocks = 10 x L2; 10 x L2 = 3.33 L4Es | |||
|} | |||
==Details of the original L4E system== | ==Details of the original L4E system== | ||
Revision as of 13:37, 17 October 2017
Level 4 equivalent, abbreviated L4E, is a workload measurement system endorsed by the Canadian Association of pathologists.[1]
The development is described in a paper by Maung.[2] It has since been revised and is comprehensive with regard to academic practice and community practice.[3]
Revised L4E of 2014
Surgical pathology & cytopathology
L4E units for surgical pathology adapted from Maung:[1]
| Code | L4E units | Description | Details |
|---|---|---|---|
| L1 | 0.15 | gross only specimens | itemized in the "specimen list and codes" |
| L2 | 0.333 | confirmation of normal | must include histology |
| L3 | 0.5 | small biopsies | includes most skin, cysts, GI tract specimens, small benign specimens |
| L4 | 1 | biopsies - most internal organs | detailed in rules 1, 2 and 3 |
| L5 | 5 | complex biopsies - includes medical and transplant biopsies, explant organs | |
| L6 | 10 | radical resections for malignancy | detailed in rule 9 |
| C1 | 1 | simple (exfoliative) cytology | pap test, urine, sputum, fluids (peritoneal, pleural) |
| C2 | 2 | complex cytology | FNAs, brushes, washes |
All other cases
| L4E units | Description | Details |
|---|---|---|
| L2/block | non-radical and benign resections, non-biopsy/non-L6 cases | detailed by rule 4, e.g. 10 blocks = 10 x L2; 10 x L2 = 3.33 L4Es |
Details of the original L4E system
Surgical pathology
L4E units for surgical pathology adapted from Maung:[1]
| Description | L4E units |
|---|---|
| Surgical - level 1 | 0.15 |
| Surgical - level 2 | 0.33 |
| Surgical - level 3 | 0.5 |
| Surgical - level 4 | 1.0 |
| Surgical - level 5 | 5.0 |
| Surgical - level 6 | 15.0 |
Modifiers to the base scores (above) - based on Maung:[1]
| Description | L4E units |
|---|---|
| Additional stains & IHC >=4 for case |
+1.0 |
| Immunofluorescence | +0.5 |
| Intraoperative consultation | 3 |
| Each additional intraoperative consultation |
2 |
Total workload
Recommended mean workload per pathologist adapted from Maung:[1]
| Practise type | Annual L4E units (mean & standard deviation) |
|---|---|
| Rural | 5,589 (5,393-5,784) |
| Independent | 6,316 (6,095-6,537) |
| Specialized | 7,043 (6,797-7,290) |
See also
References
- ↑ 1.0 1.1 1.2 1.3 1.4 Maung, R. (2010). "Canadian Association of Pathologists guidelines for measurement of workload". Canadian Journal of Pathology 2 (1): 8-19.
- ↑ Maung, RT. (Jan 2005). "What is the best indicator to determine anatomic pathology workload? Canadian experience.". Am J Clin Pathol 123 (1): 45-55. PMID 15762279.
- ↑ URL: https://www.cap-acp.org/wkload.php. Accessed on: 14 July 2017.