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m (Michael moved page Level 4 equivalent to Level 4 equivalent of 2014: there is a newer versioin) |
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The development is described in a paper by Maung published in 2010.<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> The system was revised in 2014 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 published in 2010.<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> The system was revised in 2014 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> | ||
This article covers the | This article covers the 2018 revision of L4E. The original system is covered in the article ''[[Level 4 equivalent of 2010]]''. The 2014 version is covered in ''[[Level 4 equivalent of 2014]]''. | ||
==Revised L4E of | ==Revised L4E of 2018== | ||
One L4E unit is considered to be roughly equivalent to 10 minutes. | One L4E unit is considered to be roughly equivalent to 10 minutes. | ||
===Most surgical pathology=== | ===Most surgical pathology=== | ||
As per L4E definition ( | As per L4E definition (2018) adapted from CAP-ACP:<ref name=capacp2018>Workload and Workforce Committee of the CAP-ACP. Workload Measurement Guidelines. Canadian Association of Pathologists (CAP-ACP). 2018. URL: [https://www.cap-acp.org/cmsUploads/CAP/File/CAP-ACP_Workload_Model_2018_Final_2020180907(1).pdf https://www.cap-acp.org/cmsUploads/CAP/File/CAP-ACP_Workload_Model_2018_Final_2020180907(1).pdf]. Accessed on: 19 May 2019.</ref> | ||
{| class="wikitable sortable" | {| class="wikitable sortable" | ||
! Code | ! Code | ||
Line 17: | Line 17: | ||
|- | |- | ||
| L1 | | L1 | ||
| 0. | | 0.125 | ||
| gross only specimens | | gross only specimens | ||
| itemized in the "specimen list and codes" | | itemized in the "specimen list and codes" | ||
|- | |- | ||
| L2 | | L2 | ||
| 0. | | 0.25 | ||
| confirmation of normal | | confirmation of normal | ||
| must include histology | | must include histology | ||
Line 29: | Line 29: | ||
| 0.5 | | 0.5 | ||
| small/simple biopsies | | small/simple biopsies | ||
| includes most skin, cysts, GI tract specimens, small benign specimens - detailed in [[L4E rule 1-3 ( | | includes most skin, cysts, GI tract specimens, small benign specimens - detailed in [[L4E rule 1-3 (2018)|rules 1, 2 and 3]] | ||
|- | |- | ||
| L4 | | L4 | ||
| 1 | | 1 | ||
| biopsies - most internal organs | | biopsies - most internal organs | ||
| detailed in [[L4E rule 1-3 ( | | detailed in [[L4E rule 1-3 (2018)|rules 1, 2 and 3]] | ||
|- | |- | ||
| L5 | | L5 | ||
Line 44: | Line 44: | ||
| 10 | | 10 | ||
| radical resections for malignancy | | radical resections for malignancy | ||
| detailed in [[L4E rule 9 ( | | detailed in [[L4E rule 9 (2018)|rule 9]] | ||
|} | |} | ||
====All other surgical pathology cases==== | ====All other surgical pathology cases==== | ||
As per L4E definition ( | As per L4E definition (2018) adapted from CAP-ACP:<ref name=capacp2018/> | ||
{| class="wikitable sortable" | {| class="wikitable sortable" | ||
! L4E units | ! L4E units | ||
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| L2/block | | L2/block | ||
| non-radical and benign resections, non-biopsy/non-L6 cases | | non-radical and benign resections, non-biopsy/non-L6 cases | ||
| | | 12 blocks = 12 x L2; 10 x L2 = 3 L4Es; details in [[L4E rule 4 (2018)|rule 4]] | ||
|} | |} | ||
===Cytopathology=== | ===Cytopathology=== | ||
As per L4E definition ( | As per L4E definition (2018) adapted from CAP-ACP:<ref name=capacp2018/> | ||
{| class="wikitable sortable" | {| class="wikitable sortable" | ||
! Code | ! Code | ||
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| C1 | | C1 | ||
| 1 | | 1 | ||
| | | all cytology, ''except'' fine needle aspirations (FNAs) | ||
| pap test, urine, sputum, fluids (peritoneal, pleural) | | pap test, urine, sputum, fluids (peritoneal, pleural) | ||
|- | |- | ||
| C2 | | C2 | ||
| 2 | | 2 | ||
| | | fine needle aspirations (FNAs) | ||
| | | | ||
|- | |- | ||
|} | |} | ||
===Additional block/levels=== | ===Additional block/levels=== | ||
Deeper cuts and the submission of additional tissue are dealt with in [[L4E rule 6 ( | Deeper cuts and the submission of additional tissue are dealt with in [[L4E rule 6 (2018)|rule 6]]. | ||
===Special stains and IHC=== | ===Special stains and IHC=== | ||
Special stains and immunostains are dealt with in [[L4E rule 7-8 ( | Special stains and immunostains are dealt with in [[L4E rule 7-8 (2018)|rule 7 and rule 8]]. | ||
===Adjustments for micro only and teaching=== | ===Adjustments for micro only and teaching=== | ||
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===Total workload=== | ===Total workload=== | ||
Recommended workload per pathologist:<ref name= | Recommended workload per pathologist:<ref name=capacp2018/> | ||
{| class="wikitable sortable" | {| class="wikitable sortable" | ||
! Mean annual L4E units | ! Mean annual L4E units | ||
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*[[Workload measurement]]. | *[[Workload measurement]]. | ||
*[[Level 4 equivalent of 2010]]. | *[[Level 4 equivalent of 2010]]. | ||
*[[L4E rules of | *[[Level 4 equivalent of 2014]]. | ||
*[[L4E rules of 2018]]. | |||
*[[L4E quizzes]]. | *[[L4E quizzes]]. | ||
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