American Society for Clinical Pathology

National privacy laws diverge between the European Union and United States, hindering transatlantic health data exchange and slowing AI-driven medical innovation. In response, the German Ministry of Health launched the pre-competitive Data for Health initiative, leading to the BRIDGE Pilot Study (2023-2025), a researcher-led effort to address this regulatory and legal gap. Using a mixed-methods approach, including structured surveys (n = 56 expert responses), ranking of steps via relative importance indexing, and 4 Delphi meetings, experts co-developed a practical framework composed of 30 steps in 3 consecutive phases for legally compliant and technically interoperable EU-US health data collaboration. The framework emphasizes early data protection assessments, secure transfer protocols, and iterative governance checks. The final consensus framework provides a stepwise guide to navigate regulatory and legal complexities and operationalize cross-border research. Ongoing input from researchers and stakeholders will help ensure the framework remains adaptable and provides a clear, scalable foundation for cross-border health data exchange.

Abstract Background Laboratory professional credentials attained through the ASCP Board of Certification (ASCP BOC) play a pivotal role in addressing this challenge. By standardizing and enhancing the professional skills of laboratory professionals, ASCP BOC credentials open new avenues for recruitment, retention, and professional development. Stacking credentials, such as pairing Medical Laboratory Scientist, MLS(ASCP) with Specialist in Blood Banking, SBB(ASCP)or other specialized credentials, has emerged as a significant pathway for career growth, skill enhancement, and clear career progression. This study explores how credential stacking enhances individual expertise, supports career advancement, and contributes to creating a skilled and satisfied workforce, ultimately addressing operational challenges and workforce shortages in laboratory settings. Methods This study utilized a comprehensive analysis of ASCP BOC’s credentialing data, focusing on individuals with multiple credentials. Data were segmented by degree (e.g., Bachelor’s, Master’s, PhD), credential count (ranging from 2 to 10), and professional demographics. The analysis also included geographical distribution across the U.S. and internationally to identify patterns and growth trends. Metrics analyzed included the number of professionals holding multiple credentials, time elapsed between the attainment of the first and subsequent credentials and associated professional outcomes. In addition to credentialing data, insights from health and business literature were reviewed to contextualize the findings and explore intentional workforce strategies. Results The data revealed that approximately 9.7% of ASCP BOC credential holders now possess two or more credentials. Credential stacking demonstrates measurable benefits for professionals and employers alike, supporting continuous professional development and specialization. Key findings:Earning Potential: Research has shown stacked credential holders may see as much as a 9% return on average in their salaries.Workforce Strategies: Credential stacking supports clear career progression pathways and continuous professional development, which help attract new talent and retain skilled staff. These strategies foster a positive workplace culture, promote work-life balance, and contribute to greater employee satisfaction.Professional Skills Enhancement: Credential holders with stacked credentials demonstrated consistent scaled score performance (mean = 475), reflecting sustained professional excellence.Operational Impact: Employers noted increased versatility, leadership readiness, and adaptability among multi-credentialed professionals, particularly in specialized laboratory roles.Geographical analyses highlighted hotspots for laboratory professionals seeking multiple credentials in both domestic U.S. regions and internationally. These findings suggest that the ASCP BOC, and by extension the broader laboratory medicine and pathology community, can greatly benefit from promoting and facilitating the acquisition of multiple credentials. By doing so, the field ensures a workforce that is not only highly qualified but also adaptable to the changing dynamics of healthcare, thereby reinforcing the indispensable role of laboratory professionals in the broader healthcare ecosystem. Conclusion Stacking ASCP BOC credentials is a vital strategy for addressing workforce shortages in laboratory medicine and pathology laboratories worldwide. By enhancing professional skills, providing clear career progression pathways, and fostering workplace satisfaction, multi-credentialing supports recruitment and retention efforts while promoting continuous professional development. These strategies align with patient-centric expectations and contribute to a more sustainable and effective laboratory professional workforce.

51 Background: Timely biomarker testing is essential for guiding treatment in non–small cell lung cancer (NSCLC). Reflex biomarker testing, ordered by pathologists, integrates biomarkers into the diagnostic process. However, CMS policies, particularly the 14-Day Rule and lack of clarity on ordering authority, limit the use of reflex testing, disrupting standardized workflows and delaying care. This study explores how these policies affect cancer care delivery. Methods: In early 2025, LUNGevity Foundation, with the Association for Molecular Pathology and the American Society for Clinical Pathology, surveyed 115 healthcare professionals to determine the prevalence of standardized workflows, pathologist-ordered biomarker testing, and application of the 14-Day Rule. Results: Findings indicate strong support for pathologist-ordered biomarker testing for reflex testing and timely diagnosis. Most respondents (94%) agreed CMS should recognize pathologists as ordering physicians, with 49% preferring this recognition be provided through guidelines. The majority (74%) strongly agreed this change would improve patient care. Standardized protocols - especially with in-house testing - were more common when pathologists ordered biomarker testing. Yet at 42% of sites using or considering such protocols, pathologists were not the ordering physician. Among these, 57% wanted implementation guidance, and 46% sought regulatory or compliance clarity for how to implement pathologist-initiated testing. Application of the 14-Day Rule varied: 22% applied it to inpatients, 13% to both inpatients and outpatients, and 23% were unsure. Regardless, 78% of those applying the 14-Day Rule said it caused treatment delays, and 40% reported treatment was selected before results were received. When asked how costs of multi-gene panels for in-patients with advanced-stage cancer are managed, 30% of respondents said the laboratory absorbs the cost, and 39% were unsure. Conclusions: Hospitals face the challenge of navigating regulations that impact care delivery - particularly the 14-Day Rule and unclear policies on pathologists' role in ordering biomarker panels, which influence implementation of reflex biomarker testing in the NSCLC diagnostic process. Respondents strongly supported pathologist-ordered testing as essential for reflex workflows and improved patient care. The 14-Day Rule was cited as a barrier to timely treatment, and a cause of financial strain when hospitals bypass the policy to expedite testing. Many were uncertain how testing costs are managed under current constraints, highlighting the need for clearer institutional policies. Hospital administrators should assess the impact of these regulations on care delivery and consider workflow adjustments in collaboration with pathology and oncology. Further research will gather broader input to guide recommendations to CMS, pathologists, and oncologists.

We sought to determine the extent and distribution of workforce shortages within US medical laboratories. The survey was conducted through collaboration between the American Society for Clinical Pathology's (ASCP's) Institute for Science, Technology and Policy in Washington, DC, and the Evaluation, Measurement and Assessment Department and ASCP Board of Certification in Chicago, Illinois. Data were collected using an internet survey distributed to individuals in a position to report on staffing and certifications for their laboratories. Findings from the ASCP 2024 Vacancy Survey indicate that although vacancy rates have declined compared with 2022, they remain elevated relative to those observed before the COVID-19 pandemic. Retirement rates continue to rise, with 10 of the 17 laboratory departments surveyed reporting increases. Among surveyed laboratory departments, the most frequently cited concern regarding artificial intelligence was the challenge of adapting to emerging technologies. Despite this sentiment, the perceived potential of artificial intelligence to transform laboratory operations remains a major source of enthusiasm. Current vacancy survey data suggest continued challenges in recruitment of laboratory professionals. Qualitative analysis results show that there is an urgent need for advocacy for laboratory professionals, increased credentialing of laboratory professionals, and an increase in the number of laboratory education and training programs.

Medical laboratory science professionals face obstacles related to social media use. We aimed to identify social media trends among the medical laboratory science workforce and barriers to professional use. A 23-item qualitative survey was administered to American Society for Clinical Pathology members, with data collected and managed using Research Electronic Data Capture (REDCap) tools. Statistical analysis was completed using Microsoft Excel and REDCap native functions. Entries that were not complete were excluded; pathologists and students were also excluded due to low response rates. Of the 238 participants who met inclusion criteria, 217 (91.2%) had at least 1 social media account. The most frequently cited uses were entertainment (60.8%) and socializing (50.2%), and the most common barriers to professional social media use were privacy concerns (48.9%) and limited time to dedicate to social media activities (48.5%). Among the 21 participants who did not participate in social media, 17 cited privacy concerns, 11 never considering joining, and 9 cited time concerns as barriers to creating social media accounts. Most medical laboratory scientists use social media for personal reasons, with major barriers to professional use being privacy concerns and limited time. Targeted initiatives may be useful for increasing professional social media use.

Abstract Background Intestinal tuberculosis (ITB), predominantly caused by Mycobacterium tuberculosis, remains a significant global health challenge with increasing morbidity rates. As the second most common site of extrapulmonary tuberculosis after lymph nodes, ITB accounts for approximately 50% of abdominal tuberculosis cases, particularly affecting populations in resource-limited settings. Purpose To comprehensively evaluate recent advances in ITB management, focusing on innovative diagnostic approaches, therapeutic strategies, and preventive measures while addressing the challenges in clinical practice and research gaps. Main body Contemporary diagnostic advances incorporate molecular techniques (PCR, LAMP), breath volatile organic compound analysis, and AI-assisted imaging, demonstrating improved sensitivity compared to conventional methods. However, the standard 6–9-month antituberculosis treatment shows limited success (60–70%) due to poor drug penetration and emerging resistance. Novel therapeutic approaches, including targeted drug delivery systems, host-directed therapies, and precision medicine based on pharmacogenomics, show promising results in preliminary studies. The integration of microbiome research has revealed crucial insights into disease pathogenesis and treatment responses. Prevention strategies focusing on high-risk population screening, prophylactic interventions, and socioeconomic measures demonstrate potential in reducing disease burden. Short conclusion A multifaceted approach combining advanced diagnostics, optimized therapeutics, and strategic prevention is essential for addressing the global ITB burden. Future research should focus on developing point-of-care diagnostics, personalized treatment protocols, and evidence-based preventive strategies to improve patient outcomes. Article highlights • Novel molecular diagnostics and AI-assisted imaging significantly improve early detection rates of intestinal tuberculosis. • Integration of microbiome research reveals new therapeutic targets and treatment response predictors. • Personalized medicine approaches show promise in optimizing treatment outcomes and reducing therapy duration. Graphical Abstract

The clinical laboratory workforce plays a crucial role in health care delivery, yet little is known about the unique pressures and challenges this workforce faces. The objective of this study was to identify factors that contribute to burnout, discrimination, exclusion, and inequity in pathology and laboratory medicine. A nationwide survey was conducted in 2 phases. In phase 1, 2391 laboratory professionals were surveyed over a 1-week period about their experiences with burnout, discrimination, and work-related stress. In phase 2, the survey was extended to 1 month and questions were added to elicit more detailed information about diversity, equity, and inclusion (DEI) as well as wellness. Results showed a high prevalence of burnout, discrimination, and stress among laboratory professionals, with significant differences among certain demographic groups. Women, Black, indigenous, or people of color individuals and those with disabilities reported higher rates of discrimination. The study also showed a need for mentorship and resources to address educational barriers. Findings from this study highlight the urgent need for interventions to address burnout, discrimination, exclusion, and inequity in the laboratory workforce. Initiatives to increase workforce diversity, promote mentorship and diversity training programs, and improve recognition of the laboratory workforce are recommended. The results underscore the pressing need to addressing the challenges and apprehensions laboratory professionals face, including enhancing recognition of their role in patient care, tackling systemic problems related to discrimination and equity, and enhancing the provision of support and resources for managing burnout and fostering well-being.

Breast implant surgery is a popular plastic surgery procedure performed worldwide. Despite its global popularity, patients undergoing breast implant surgery are at risk for systemic illness and more than one form of cancer. We conducted a nursing workflow analysis at our facility and determined that it is not standard practice to screen patients for the presence or absence of breast implant devices at every health care encounter. This lack of screening for breast implant devices may adversely affect patient safety by hindering the rapid identification of systemic illness or cancer related to breast implant devices and delaying effective medical intervention. Based on the results of the workflow analysis, we initiated a formal call for nursing action. We identified a nursing workflow process to increase patient safety and developed a universal screening tool for implantable devices. We defined universal screening for implantable devices as assessing all patients for the presence or absence of an implantable device, specifically breast implant devices, at every health care encounter. Implementing a universal process for screening patients for implantable devices at every health care encounter can be easily formulated into a policy and procedure and/or an electronic health record (EHR) update or enhancement. This article discusses how we utilized a workflow process map to translate universal screening for implantable devices into an EHR enhancement.

PURPOSETo evaluate the scope and types of cancer research projects in sub-Saharan Africa (SSA) to identify research gaps and inform future efforts.METHODSThis retrospective observational study summarized information on cancer research projects in SSA from the International Cancer Research Partnership (ICRP) between 2015 and 2020, alongside 2020 cancer incidence and mortality data from the Global Cancer Observatory. SSA cancer research projects were identified as led by investigators in SSA countries, or by investigators in non-SSA countries with collaborators in SSA, or in database keyword searches. Projects from the Coalition for Implementation Research in Global Oncology (CIRGO) were also summarized.RESULTSA total of 1,846 projects were identified from the ICRP database, funded by 34 organizations in seven countries (only one, Cancer Association of South Africa, based in SSA); only 156 (8%) were led by SSA-based investigators. Most projects focused on virally induced cancers (57%). Across all cancer types, projects were most frequently related to cervical cancer (24%), Kaposi sarcoma (15%), breast cancer (10%), or non-Hodgkin lymphoma (10%). Gaps were observed for several cancers with higher incidence/mortality burden in SSA; for example, prostate cancer accounted for only 4% of projects but 8% of cancer-related deaths and 10% of new cases. Approximately 26% were dedicated to etiology. Treatment-related research declined over the study period (14%-7% of all projects), while projects related to prevention (15%-20%) and diagnosis/prognosis (15%-29%) increased. Fifteen CIRGO projects were identified; seven were relevant across multiple cancer types, and 12 focused either wholly or partially on cancer control (representing 50% of the total research effort).CONCLUSIONThis analysis shows notable discrepancies between cancer burden and research projects and identifies opportunities for future strategic investments in cancer care in SSA.