Insights on the “Why, When, and How” of Integrating Molecular Testing in Anatomic Pathology Practice: Dedicated to the Memory of Gregory J. Naus, MD (1951–2015)
Bibliographic record
Abstract
The Canadian Anatomic and Molecular Pathology (CAMP) conference was created with the future in mind. As conference chairs, Greg Naus, MD, and I envisioned that CAMP would serve as a forum for practicing anatomic pathologists to get together in a collegial and intellectually rigorous atmosphere to learn about the practical aspects of integrating anatomic and molecular pathology in a rapidly changing world. Online education, including blogs, podcasts, and social media, can be an invaluable resource for keeping up to date with the latest advances, but they present us with a huge amount of unfocused information. By offering an in-depth understanding of the “why, when, and how” of molecular testing in anatomic pathology with limited details regarding the technical details of molecular testing, CAMP intends to help pathologists improve their skills and innovation in case reporting. CAMP's speakers are not only teachers but also navigators for the vast amount of information available on each subject.In keeping with our vision, each year one clinical topic will be selected for a multidisciplinary discussion. For 2016 the topic was breast cancer. One entire morning was organized in conjunction with the participants of the Canadian Breast Cancer Symposium. This brought together more than 200 medical experts in breast cancer from surgery, medical oncology, radiology, radiation oncology, and pathology to review important aspects of our practice. Another highlight of CAMP 2016 was the presentation of the “2015 WHO Classification of Lung Tumors” by our distinguished guest speaker, William Travis, MD, followed by a panel discussion on biomarkers in lung cancer, with active participation from medical oncology.The articles selected for this special section are based on presentations at CAMP. They will appear in 2 parts: part 1 in the August issue of the Archives, and part 2 in the September issue. The special section comprises 7 articles written by distinguished, nationally and internationally recognized experts in pathology and medical genetics from the United States and Canada, selected for leadership in their field and teaching expertise. The topics reflect challenges in daily practice encountered by surgical pathologists. They are intended to make pathologists comfortable with the vast repertoire of molecular tests that have recently changed our specialty.Part 1 of the special section in this issue includes 4 articles: Esmeralda Celia Marginean, MD, has prepared an article titled “The Ever-Changing Landscape of Drug-Induced Injury of the Lower Gastrointestinal Tract”; Martin Trotter, MD, PhD, FRCPC, and colleagues have written an article titled “Practical Strategies to Improve the Clinical Utility of the Dermatopathology Report”; Brandon Sheffield, MD, has written “Immunohistochemistry as a Practical Tool in Molecular Pathology”; and Malcolm Hayes, MMed(Path), and colleagues have contributed an article titled “Practical Considerations in Breast Papillary Lesions: A Review of the Literature.”Part 2 in the September issue will include 3 articles: Graham Slack, MD, has prepared an article titled “The Pathology of Reactive Lymphadenopathies: A Discussion of Common Reactive Patterns and their Malignant Mimics”; Allen Gown, MD, has written “Diagnostic Immunohistochemistry: What Can Go Wrong and How to Prevent It”; and Kasmintan Schrader, MBBS, PhD, and colleagues have written “How to Screen for Hereditary Cancers in General Pathology Practice.”The Canadian Association of Pathologists accredits CAMP for a maximum of 13.5 hours. The first edition of CAMP was attended by 78 participants from the United States (13 different states), Canada (7 provinces), and Australia. Participants were mainly pathologists from academic, community, and private practices, as well as medical oncologists and industry representatives.I would like to thank Archives Editor-in-Chief Philip Cagle, MD, for his generous offer to host these articles and for his sensitive offer to dedicate this Special Section to the memory of Dr Greg Naus, and I offer special thanks to all CAMP speakers and to the authors and reviewers who made this edition possible. Last but not least, I would like to thank Ms Katie Giesen, managing editor, and the entire editorial office of the Archives of Pathology & Laboratory Medicine for their support and help.Organizing CAMP was an amazing learning experience for me, and I enjoyed every aspect of it: fundraising, Web design, contract negotiation, speaker and topic selection, accreditation, budgeting, and conference management. CAMP's first conference, held January 28–31, 2016, at Fairmont Chateau Whistler, was dedicated to Dr Greg Naus, my cochair for CAMP, my dear colleague, friend, beloved husband, and exceptional life partner. I will continue the vision we shared about CAMP, which signifies our last project together, and will try to build its success as a legacy to the teacher and educator that Greg was. See you at CAMP 2017 (http://www.pathologycamp.ca).I hope you enjoy reading this section and find the information presented useful in your daily practice.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.019 | 0.055 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.005 | 0.011 |
| Scholarly communication | 0.009 | 0.010 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.006 | 0.022 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".