PMID- 20957305
OWN - NLM
STAT- MEDLINE
DCOM- 20110622
LR  - 20200825
IS  - 2972-4066 (Electronic)
IS  - 0304-4602 (Linking)
VI  - 39
IP  - 9
DP  - 2010 Sep
TI  - Bone marrow cytogenetics workup: Application of lean management system to 
      determine if additional cell workup is helpful and necessary to analysis.
PG  - 696-9
AB  - INTRODUCTION: High workload volumes in a Cytogenetics laboratory can lead to long 
      result turn-around times (TAT). This study aimed to improve laboratory efficiency 
      by adopting Lean Management System initiatives to increase productivity through 
      the elimination of wastes. This study examined if the prerequisite 20-cell 
      analysis was sufficient for a conclusive result or if additional cell workup was 
      necessary to ascertain the presence of a previous chromosome abnormality among 
      cases on follow-up, or when a single abnormal cell was encountered during the 
      analysis to determine the presence of a clone. MATERIALS AND METHODS: The 
      karyotype results of cases that had additional workup were retrieved from among 
      8040 bone marrow cases of various haematological disorders performed between June 
      2003 and June 2008. RESULTS: Of 8040 cases analysed, 2915 cases (36.3%) had 
      additional cell workup. Only 49 cases (1.7%) led to the establishment of a clone. 
      The majority of these cases could have been resolved without the additional 
      workup, especially if fluorescence in situ hybridization (FISH) or polymerase 
      chain reaction (PCR)-based assays had been utilised. CONCLUSION: This study shows 
      that the additional workup procedure is redundant. The time saved by 
      discontinuing the workup procedure can be used to analyse other cases, leading to 
      increased laboratory efficiency and a faster TAT without compromise to patient 
      care. The practice of additional workup over and above the 20- cell analysis 
      should be dispensed with as little benefit was derived for the amount of 
      additional manpower expended. FISH or PCR-based assays should be utilised to 
      elucidate a case further.
FAU - Lim, Alvin S T
AU  - Lim AS
AD  - Department of Pathology, Singapore General Hospital, Singapore. 
      alvin.lim.s.t@sgh.com.sg
FAU - Chen, Ting Jie
AU  - Chen TJ
FAU - Lim, Tse Hui
AU  - Lim TH
FAU - Tan, Mary
AU  - Tan M
FAU - Lau, Lai Ching
AU  - Lau LC
FAU - Lim, Ping
AU  - Lim P
FAU - Lee, Geok Yee
AU  - Lee GY
FAU - Loo, Li Eng
AU  - Loo LE
FAU - Liaw, Fiona P S
AU  - Liaw FP
FAU - Chuah, Charles T H
AU  - Chuah CT
FAU - Goh, Yeow Tee
AU  - Goh YT
FAU - Tien, Sim Leng
AU  - Tien SL
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PL  - Singapore
TA  - Ann Acad Med Singap
JT  - Annals of the Academy of Medicine, Singapore
JID - 7503289
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - *Bone Marrow
MH  - *Bone Marrow Cells
MH  - *Cytogenetics
MH  - Efficiency
MH  - Efficiency, Organizational
MH  - Female
MH  - Hematologic Diseases/*diagnosis/pathology
MH  - Humans
MH  - In Situ Hybridization, Fluorescence/instrumentation/methods
MH  - Karyotyping/instrumentation/methods
MH  - Male
MH  - Polymerase Chain Reaction
EDAT- 2010/10/20 06:00
MHDA- 2011/06/23 06:00
CRDT- 2010/10/20 06:00
PHST- 2010/10/20 06:00 [entrez]
PHST- 2010/10/20 06:00 [pubmed]
PHST- 2011/06/23 06:00 [medline]
PST - ppublish
SO  - Ann Acad Med Singap. 2010 Sep;39(9):696-9.