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 published in 2010.[2] The system was revised in 2014 and is comprehensive with regard to academic practice and community practice.[3]

This article covers the 2014 revision of L4E. The original system is covered in the article Level 4 equivalent of 2010.

Revised L4E of 2014

Most surgical pathology

As per L4E definition (2014) 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/simple 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 surgical pathology cases

As per L4E definition (2014) adapted from CAP-ACP:[4]

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

As per L4E definition (2014) adapted from CAP-ACP:[4]

Code L4E units Description Details
C1 1 simple (exfoliative) cytology pap test, urine, sputum, fluids (peritoneal, pleural)
C2 2 complex cytology FNAs, brushes, washes

Total workload

Recommended workload per pathologist:[4]

Mean annual L4E units Lower bound ‡ Upper bound ‡
7560 7115 8089

‡ Defined by mean +/- 2 standard deviations.

See also

References

  1. ↑ Maung, R. (2010). "Canadian Association of Pathologists guidelines for measurement of workload". Canadian Journal of Pathology 2 (1): 8-19.
  2. ↑ 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.
  3. ↑ URL: https://www.cap-acp.org/wkload.php. Accessed on: 14 July 2017.
  4. ↑ 4.0 4.1 4.2 4.3 URL: https://www.cap-acp.org/cmsUploads/CAP/File/CAP-ACP%202014%20Workload%20FINAL.pdf. Accessed on: 17 October 2017.
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