L4E rule 1-3 (2018) - Revision history

Michael: /* See also */

2019-05-20T01:39:54Z

Michael: /* History */

2019-05-19T23:36:38Z

History

← Older revision		Revision as of 23:36, 19 May 2019
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	==History==		==History==
	*''Rule 1'' and ''Rule 3'' are unchanged from ''[[Level 4 equivalent of 2014]]''.		*''Rule 1'' and ''Rule 3'' are unchanged from ''[[Level 4 equivalent of 2014]]''.
	*''Rule 2'' was changed to lower the value of ~~breast core biopsies and~~ prostate core biopsies.		*''Rule 2'' was changed to lower the value of prostate core biopsies sets with a large number of cores; compare with ''[[L4E rule 1-3 (2014)]]''.

	==Details==		==Details==

Michael: /* Details */

2019-05-19T23:33:51Z

Details

← Older revision		Revision as of 23:33, 19 May 2019
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	\|-		\|-
	\| Breast core biopsies & prostate core biopsies		\| Breast core biopsies & prostate core biopsies
	\| 1 L4E for 1st core + 0.25 L4E ~~(1 L2)~~ for each additional core + 3 L4E for synoptic (if mandated - see [[L4E rule 5 (2018)\|L4E rule 5]])		\| 1 L4E for 1st core + 0.25 L4E for each additional core + 3 L4E for synoptic (if mandated - see [[L4E rule 5 (2018)\|L4E rule 5]])
	\| should use clinicians core count (if available), if clinicians' count not available use gross count		\| should use clinicians core count (if available), if clinicians' count not available use gross count
	\| 4 breast cores = 1.75 L4E<br>12 prostate cores (without synoptic report) = 3.75 L4E<br>12 prostate cores (with synoptic report) = 6.75 L4E		\| 4 breast cores = 1.75 L4E<br>12 prostate cores (without synoptic report) = 3.75 L4E<br>12 prostate cores (with synoptic report) = 6.75 L4E

Michael: /* Details */ tweak

2019-05-19T23:32:49Z

Details: tweak

← Older revision		Revision as of 23:32, 19 May 2019
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	\| Simple skin (non-complex skin)		\| Simple skin (non-complex skin)
	\| 0.5 L4E/biopsy (1 L3/biopsy)		\| 0.5 L4E/biopsy (1 L3/biopsy)
	\| biopsies > 2 cm - use [[L4E rule 4 (~~2014~~)\|L4E rule 4]]; includes [[basal cell carcinoma\|BCC]], SCC, actinic keratosis, intradermal nevus		\| biopsies > 2 cm - use [[L4E rule 4 (2018)\|L4E rule 4]]; includes [[basal cell carcinoma\|BCC]], SCC, actinic keratosis, intradermal nevus
	\| punch biopsy of BCC = 0.5 L4E, shave biopsy of [[seborrheic keratosis]] = 0.5 L4E		\| punch biopsy of BCC = 0.5 L4E, shave biopsy of [[seborrheic keratosis]] = 0.5 L4E
	\| Rule 1 <ref name=capacp2018/>		\| Rule 1 <ref name=capacp2018/>
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	\| Surgical GI biopsies (neoplastic/pre-neoplastic)		\| Surgical GI biopsies (neoplastic/pre-neoplastic)
	\| 1 L3/lesion (if submitted in one block) and low grade; lesion with high-grade dysplasia = 1 L4E		\| 1 L3/lesion (if submitted in one block) and low grade; lesion with high-grade dysplasia = 1 L4E
	\| lesions submitted in >1 block: use [[L4E rule 4 (~~2014~~)\|L4E rule 4]]		\| lesions submitted in >1 block: use [[L4E rule 4 (2018)\|L4E rule 4]]
	\| 2 HP polyps in one block = 1 L4E, 1 tubular adenoma negative for HG dysplasia = 0.5 L4E		\| 2 HP polyps in one block = 1 L4E, 1 tubular adenoma negative for HG dysplasia = 0.5 L4E
	\| Rule 1 <ref name=capacp2018/>		\| Rule 1 <ref name=capacp2018/>

Michael: /* Details */

2019-05-19T23:32:18Z

Details

← Older revision		Revision as of 23:32, 19 May 2019
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	\|-		\|-
	\| Breast core biopsies & prostate core biopsies		\| Breast core biopsies & prostate core biopsies
	\| 1 L4E for 1st core + 0.25 L4E (1 L2) for each additional core + 3 L4E for synoptic (if mandated - see [[L4E rule 5]])		\| 1 L4E for 1st core + 0.25 L4E (1 L2) for each additional core + 3 L4E for synoptic (if mandated - see [[L4E rule 5 (2018)\|L4E rule 5]])
	\| should use clinicians core count (if available), if clinicians' count not available use gross count		\| should use clinicians core count (if available), if clinicians' count not available use gross count
	\| 4 breast cores = 1.75 L4E<br>12 prostate cores (without synoptic report) = 3.75 L4E<br>12 prostate cores (with synoptic report) = 6.75 L4E		\| 4 breast cores = 1.75 L4E<br>12 prostate cores (without synoptic report) = 3.75 L4E<br>12 prostate cores (with synoptic report) = 6.75 L4E

Michael: /* Tutorial */

2019-05-19T23:27:52Z

Tutorial

← Older revision		Revision as of 23:27, 19 May 2019
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	{{hide3\|9. Random colonic biopsies 20 frags. L4E?\|Answer: 3 L4E<br>Why? Rule 1: 20 frags x L3/3 frags ~ 6.66 L3 -> truncated to 6 L3, 6 L3 ~ 3 L4E}}		{{hide3\|9. Random colonic biopsies 20 frags. L4E?\|Answer: 3 L4E<br>Why? Rule 1: 20 frags x L3/3 frags ~ 6.66 L3 -> truncated to 6 L3, 6 L3 ~ 3 L4E}}

	{{hide3\|10. Prostate biopsy with 12 cores. L4E?\|Answer: 6 L4E<br>Why? Rule 2: 12 cores x ~~1 L3~~/core ~ ~~12 L3; 12 L3 ~ 6~~ L4E}}		{{hide3\|10. Prostate biopsy with 12 cores without synoptic report. L4E?\|Answer: 3.75 L4E<br>Why? Rule 2: 1 L4E (first core) + 11 cores x 0.25 L4E/core ~ 3.75 L4E}}

	{{hide3\|11. Breast biopsy with 2 cores. L4E?\|Answer: 1 L4E<br>Why? Rule 2: ~~2 cores x~~ 1 ~~L3/core ~ 2 L3; 2 L3~~ ~ 1 L4E}}		{{hide3\|11. Breast biopsy with 2 cores. L4E?\|Answer: 1.25 L4E<br>Why? Rule 2: 1 L4E + 0.25 L4E ~ 1.25 L4E}}

	{{hide3\|12. Endometrial biopsy in 2 blocks. L4E?\|Answer: 1 L4E<br>Why? Rule 3: 1-3 blocks ~ 1 L4E}}		{{hide3\|12. Endometrial biopsy in 2 blocks. L4E?\|Answer: 1 L4E<br>Why? Rule 3: 1-3 blocks ~ 1 L4E}}

Michael: /* Details */

2019-05-19T23:17:46Z

Details

← Older revision		Revision as of 23:17, 19 May 2019
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	\| Breast core biopsies & prostate core biopsies		\| Breast core biopsies & prostate core biopsies
	\| 1 L4E for 1st core + 0.25 L4E (1 L2) for each additional core + 3 L4E for synoptic (if mandated - see [[L4E rule 5]])		\| 1 L4E for 1st core + 0.25 L4E (1 L2) for each additional core + 3 L4E for synoptic (if mandated - see [[L4E rule 5]])
	\| ~~maximum of 20 cores;~~ should use clinicians core count (if available), if clinicians' count not available use gross count		\| should use clinicians core count (if available), if clinicians' count not available use gross count
	\| 4 breast cores = 1.75 L4E<br>12 prostate cores (without synoptic report) = 3.75 L4E<br>12 prostate cores (with synoptic report) = 6.75 L4E		\| 4 breast cores = 1.75 L4E<br>12 prostate cores (without synoptic report) = 3.75 L4E<br>12 prostate cores (with synoptic report) = 6.75 L4E
	\| Rule 2 <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>		\| Rule 2 <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>

Michael: /* Details */

2019-05-19T23:17:10Z

Details

← Older revision		Revision as of 23:17, 19 May 2019
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	\|-		\|-
	\| Breast core biopsies & prostate core biopsies		\| Breast core biopsies & prostate core biopsies
	\| 1 L4E for 1st core, 0.25 L4E (1 L2) for each additional core		\| 1 L4E for 1st core + 0.25 L4E (1 L2) for each additional core + 3 L4E for synoptic (if mandated - see [[L4E rule 5]])
	\| maximum of 20 cores; should use clinicians core count (if available), if clinicians' count not available use gross count		\| maximum of 20 cores; should use clinicians core count (if available), if clinicians' count not available use gross count
	\| 4 breast cores = 1.75 L4E<br>12 prostate cores (without synoptic report) = 3.75 L4E		\| 4 breast cores = 1.75 L4E<br>12 prostate cores (without synoptic report) = 3.75 L4E<br>12 prostate cores (with synoptic report) = 6.75 L4E
	\| Rule 2 <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>		\| Rule 2 <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>
	\|-		\|-

Michael: /* Details */

2019-05-19T23:05:41Z

Details

← Older revision		Revision as of 23:05, 19 May 2019
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	\|-		\|-
	\| Breast core biopsies & prostate core biopsies		\| Breast core biopsies & prostate core biopsies
	\| 0.5 L4E~~/core~~ (1 ~~L3 per~~ core)		\| 1 L4E for 1st core, 0.25 L4E (1 L2) for each additional core
	\| maximum of 20 cores; should use clinicians core count (if available), if clinicians' count not available use gross count		\| maximum of 20 cores; should use clinicians core count (if available), if clinicians' count not available use gross count
	\| 4 breast cores = 2 L4E<br>12 prostate cores = 6 L4E		\| 4 breast cores = 1.75 L4E<br>12 prostate cores (without synoptic report) = 3.75 L4E
	\| Rule 2 <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>		\| Rule 2 <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>
	\|-		\|-

Michael: update

2019-05-19T22:59:51Z

update

← Older revision		Revision as of 22:59, 19 May 2019
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	\| 1-5 frags = 1 L4E, 6-10 frags = 2 L4E, 11-15 frags = 3 L4E, 16-20 frags = 4 L4E<br>"complex skin" includes inflammatory skin, malignancies except [[basal cell carcinoma\|BCC]] and [[skin squamous cell carcinoma\|SCC]], atypical melanocytic lesions, adnexal tumours, lymphoid infiltrates		\| 1-5 frags = 1 L4E, 6-10 frags = 2 L4E, 11-15 frags = 3 L4E, 16-20 frags = 4 L4E<br>"complex skin" includes inflammatory skin, malignancies except [[basal cell carcinoma\|BCC]] and [[skin squamous cell carcinoma\|SCC]], atypical melanocytic lesions, adnexal tumours, lymphoid infiltrates
	\| inflammatory skin biopsy 3 frags = 1 L4E, adnexal skin tumour 6 frags = 2 L4E		\| inflammatory skin biopsy 3 frags = 1 L4E, adnexal skin tumour 6 frags = 2 L4E
	\| Rule 1 <ref name=~~capacp2014~~/>		\| Rule 1 <ref name=capacp2018/>
	\|-		\|-
	\| Simple skin (non-complex skin)		\| Simple skin (non-complex skin)
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	\| biopsies > 2 cm - use [[L4E rule 4 (2014)\|L4E rule 4]]; includes [[basal cell carcinoma\|BCC]], SCC, actinic keratosis, intradermal nevus		\| biopsies > 2 cm - use [[L4E rule 4 (2014)\|L4E rule 4]]; includes [[basal cell carcinoma\|BCC]], SCC, actinic keratosis, intradermal nevus
	\| punch biopsy of BCC = 0.5 L4E, shave biopsy of [[seborrheic keratosis]] = 0.5 L4E		\| punch biopsy of BCC = 0.5 L4E, shave biopsy of [[seborrheic keratosis]] = 0.5 L4E
	\| Rule 1 <ref name=~~capacp2014~~/>		\| Rule 1 <ref name=capacp2018/>
	\|-		\|-
	\| Medical GI biopsies		\| Medical GI biopsies
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	\| 1-3 frags = 0.5 L4E, 4-6 frags = 1 L4E, 7-9 frags = 1.5 L4E, 10-12 frags = 2 L4E, 13-15 frags = 2.5 L4E, 16-18 frags = 3 L4E, 19-21 frags = 3.5 L4E, 22-24 frags = 4 L4E		\| 1-3 frags = 0.5 L4E, 4-6 frags = 1 L4E, 7-9 frags = 1.5 L4E, 10-12 frags = 2 L4E, 13-15 frags = 2.5 L4E, 16-18 frags = 3 L4E, 19-21 frags = 3.5 L4E, 22-24 frags = 4 L4E
	\| 6 frags colorectal biopsies = 1 L4E		\| 6 frags colorectal biopsies = 1 L4E
	\| Rule 1 <ref name=~~capacp2014~~/>		\| Rule 1 <ref name=capacp2018/>
	\|-		\|-
	\| Surgical GI biopsies (neoplastic/pre-neoplastic)		\| Surgical GI biopsies (neoplastic/pre-neoplastic)
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	\| lesions submitted in >1 block: use [[L4E rule 4 (2014)\|L4E rule 4]]		\| lesions submitted in >1 block: use [[L4E rule 4 (2014)\|L4E rule 4]]
	\| 2 HP polyps in one block = 1 L4E, 1 tubular adenoma negative for HG dysplasia = 0.5 L4E		\| 2 HP polyps in one block = 1 L4E, 1 tubular adenoma negative for HG dysplasia = 0.5 L4E
	\| Rule 1 <ref name=~~capacp2014~~/>		\| Rule 1 <ref name=capacp2018/>
	\|-		\|-
	\| Breast core biopsies & prostate core biopsies		\| Breast core biopsies & prostate core biopsies
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	\| maximum of 20 cores; should use clinicians core count (if available), if clinicians' count not available use gross count		\| maximum of 20 cores; should use clinicians core count (if available), if clinicians' count not available use gross count
	\| 4 breast cores = 2 L4E<br>12 prostate cores = 6 L4E		\| 4 breast cores = 2 L4E<br>12 prostate cores = 6 L4E
	\| Rule 2 <ref name=~~capacp2014~~>Workload and Workforce Committee of the CAP-ACP. Workload Measurement Guidelines. Canadian Association of Pathologists (CAP-ACP). ~~2014~~. URL: [https://www.cap-acp.org/cmsUploads/CAP/File/CAP-~~ACP%202014%20Workload%20FINAL~~.pdf https://www.cap-acp.org/cmsUploads/CAP/File/CAP-~~ACP%202014%20Workload%20FINAL~~.pdf]. Accessed on: ~~17 October 2017~~.</ref>		\| Rule 2 <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>
	\|-		\|-
	\| Core biopsies (not including prostate, breast)		\| Core biopsies (not including prostate, breast)
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	\| 1-5 cores = 1 L4E, 6-10 cores = 2 L4E, 11-15 cores = 3 L4E, 16-20 cores = 4 L4E		\| 1-5 cores = 1 L4E, 6-10 cores = 2 L4E, 11-15 cores = 3 L4E, 16-20 cores = 4 L4E
	\| 3 cores of lymph node = 1 L4E, 6 cores of mediastinal mass = 2 L4E		\| 3 cores of lymph node = 1 L4E, 6 cores of mediastinal mass = 2 L4E
	\| Rule 2 <ref name=~~capacp2014~~/>		\| Rule 2 <ref name=capacp2018/>
	\|-		\|-
	\| Fragmented tissue/ curettage		\| Fragmented tissue/ curettage
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	\| 1-3 blocks = 1 L4E, 4-6 blocks = 2 L4E, 7-9 blocks = 3 L4E, 10-12 blocks = 4 L4E, 13-15 blocks = 5 L4E, 16-18 blocks = 6 L4E, 19-21 blocks = 7 L4E		\| 1-3 blocks = 1 L4E, 4-6 blocks = 2 L4E, 7-9 blocks = 3 L4E, 10-12 blocks = 4 L4E, 13-15 blocks = 5 L4E, 16-18 blocks = 6 L4E, 19-21 blocks = 7 L4E
	\| endometrial biopsy in 2 blocks = 1 L4E, TURP in 7 blocks = 3 L4E, bladder biopsy in 12 blocks = 4 L4E		\| endometrial biopsy in 2 blocks = 1 L4E, TURP in 7 blocks = 3 L4E, bladder biopsy in 12 blocks = 4 L4E
	\| Rule 3 <ref name=~~capacp2014~~/>		\| Rule 3 <ref name=capacp2018/>
	\|}		\|}

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	==Quiz==		==Quiz==
	You can test your knowledge in the ''[[Quiz:L4E rules 1-3 (~~2014~~)\|L4E rules 1-3 quiz]]''.		You can test your knowledge in the ''[[Quiz:L4E rules 1-3 (2018)\|L4E rules 1-3 quiz]]''.

	==See also==		==See also==

← Older revision		Revision as of 01:39, 20 May 2019
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	==See also==		==See also==
	*[[L4E rules of 2018]].		*[[L4E rules of 2018]].
			*[[L4E rule 1-3 (2014)]].

	==References==		==References==

← Older revision		Revision as of 23:27, 19 May 2019
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	{{hide3\|9. Random colonic biopsies 20 frags. L4E?\|Answer: 3 L4E<br>Why? Rule 1: 20 frags x L3/3 frags ~ 6.66 L3 -> truncated to 6 L3, 6 L3 ~ 3 L4E}}		{{hide3\|9. Random colonic biopsies 20 frags. L4E?\|Answer: 3 L4E<br>Why? Rule 1: 20 frags x L3/3 frags ~ 6.66 L3 -> truncated to 6 L3, 6 L3 ~ 3 L4E}}

	{{hide3\|10. Prostate biopsy with 12 cores. L4E?\|Answer: 6 L4E<br>Why? Rule 2: 12 cores x ~~1 L3~~/core ~ ~~12 L3; 12 L3 ~ 6~~ L4E}}		{{hide3\|10. Prostate biopsy with 12 cores without synoptic report. L4E?\|Answer: 3.75 L4E<br>Why? Rule 2: 1 L4E (first core) + 11 cores x 0.25 L4E/core ~ 3.75 L4E}}

	{{hide3\|11. Breast biopsy with 2 cores. L4E?\|Answer: 1 L4E<br>Why? Rule 2: ~~2 cores x~~ 1 ~~L3/core ~ 2 L3; 2 L3~~ ~ 1 L4E}}		{{hide3\|11. Breast biopsy with 2 cores. L4E?\|Answer: 1.25 L4E<br>Why? Rule 2: 1 L4E + 0.25 L4E ~ 1.25 L4E}}

	{{hide3\|12. Endometrial biopsy in 2 blocks. L4E?\|Answer: 1 L4E<br>Why? Rule 3: 1-3 blocks ~ 1 L4E}}		{{hide3\|12. Endometrial biopsy in 2 blocks. L4E?\|Answer: 1 L4E<br>Why? Rule 3: 1-3 blocks ~ 1 L4E}}