Level 4 equivalent of 2014
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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
Most surgical pathology
L4E units for surgical pathology adapted from CAP-ACP:[4]
| 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 |
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 |
Cytopathology
| Code | L4E units | Description | Details |
|---|---|---|---|
| C1 | 1 | simple (exfoliative) cytology | pap test, urine, sputum, fluids (peritoneal, pleural) |
| C2 | 2 | complex cytology | FNAs, brushes, washes |
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 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.
- ↑ URL: https://www.cap-acp.org/cmsUploads/CAP/File/CAP-ACP%202014%20Workload%20FINAL.pdf. Accessed on: 17 October 2017.