<<Disclaimer: Verify this information before applying it to your situation.>>

After many questions from local group members and a Mother who recognized her children did not receive complete lab work from Quest Diagnostics I decided to write to them and inquire about their testing procedures. I had also stopped at a local lab and asked which tests were being submitted to Quest for Celiac Disease screening. I was informed that Quest no longer performs antiendomysial testing. I have confirmed this with Harvey W. Kaufman, M.D. of Quest [log in to unmask] Quest may be doing business in other states as Associated Pathologists Laboratories (APL) and American Medical Laboratories, Inc.

There are a couple of issues with this. First of all if a physician is only writing endomysial and gliadin testing on the script and is unaware of this change in policy(which is happening in buffalo,ny and probably all across the country) then the patient will only receive gliadin results and possibly a misdiagnosis. By Law if a test is not written on the script another test can not be substituted. I would recommend you pass this information onto your local support group leaders and anyone who has had testing recently and recommend they request a copy of test results to be sure the correct tests were performed. Most physician are not even sure which tests to run so they will probably miss this error. Also certain people will test false negative in the new Quest Panel. Which is listed below in Dr. Kaufman's response.

   Second,Quest is setting what they feel is their standard in screening for CD. This is not the standard of Celiac experts. Quest is also recommending to physicians these sub par screening standards. The endomysial is the most specific of CD and also the most expensive and labor
intensive to perform. How many lives are affected by Quest from this change of policy?

This should be a wake up call to leaders of our national organizations. There have been many posts regarding consolidating efforts and unity of groups. This is a perfect example as to why this must happen.

Below is Dr. Kaufmans response. I did ask him how Quest would help us find the misdiagnosed because of their policy change, He did not reply.

Mike

Dear Mr. Mike Lodico,
Your initial communication has stimulated much activity and interest at
Quest Diagnostics.  We have consulted with some experts including one at
Harvard Medical School as to the best panel for diagnosis of Celiac Disease. This will include Tissue Transglutaminase (IgA), Gliadin Antibodies, IgA,IgG, and Total IgA.The order code for this Celiac Disease Panel will be 10167N, to be performed at Quest Diagnostics' Nichols
Institute. We will shortly communicate this new offering to our physician clients.

You also raised an issue as to what tests we perform.  As I mentioned in my first communication to you, Quest Diagnostics performs only the tests that are ordered by the physician. If an order is ambiguous, we contact the
physician for clarification. We try to guide physicians to order the best tests. Educating physicians is an enormous opportunity and challenge.By creating panels that best address common medical situations, we hope that patient health care will improve.

Sincerely,
Harvey W. Kaufman, M.D.





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