| Cerner Primary Mnemonic: | 4K PSA Total with Reflex 4K Score |
| PDM | 1859233 |
| Informatics - Workgroup | Molecular-send outs |
| Synonyms * | |
| Display Name * | 4K PSA Total with Reflex 4K Score |
| Specimen Sources (combined Order Entry and Specimen Navigator) * |
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| Specimen Types (combined Order Entry and Specimen Navigator) * |
Blood
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| Body Fluids (types sent through AOEs) |
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| Specimen Navigator Specimen Types |
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| Specimen Navigator Specimen Sources |
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| Specimen Navigator Short Name | |
| Ordering info (EPIC SmartText) | High Grade (Gleason 7+) Prostate Cancer Risk Evaluation
The 4K score should only be ordered when medically reasonable for consideration of biopsy after excluding benign cause of PSA elevation.
Limitation an Exclusions for the 4Kscore
Do not use this test for a patient:
1) With a previous diagnosis of prostate cancer
2) That has received a DRE in a previous 96 hours (4Days) before phlebotomy. A DRE performed after phlebotomy is acceptable.
3) That has received within the previous six (6) months 5-alpha reductase inhibitor such as (5-ARI) therapy such an Avedaart(R) (dutasteride) or Proscar (R) (finasteride).
4) That has undergone within the previous six (6) months any procedure or therapy to treat symptomatic BPH or any invasive, urologic procedure that many be associated with a secondary PSA elevation prior to phlebotomy.
5) Test is limited to patients age 45 and over.
The 4Kscore Test will not be performed with a positive biopsy result
|
| IP Orderable (inpatient) | Yes |
| OP Orderable (outpatient) | Yes |
AOEs *
| AOE PDM |
AOE Display |
AOE Description |
Prompt |
| 1759833G |
What was the patient's DRE Results |
What was the patient's DRE Results |
X |
| 1759833K |
Patient Authorization |
Patient Authorization |
X |
| 1759833L |
Clinical Indication for ordering |
Clinical Indication for ordering |
X |
| 17598333 |
Patient History (select all that apply) |
Patient History (select all that apply) |
X |
| 1759833M |
What is the patient's prior Biopsy Histo |
What is the patient's prior Biopsy History |
X |
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| AP AOEs | |
| Special History | No |
| Build Comments | |
| Filter * | genetics |
| Cerner Site Restrict | BioReference Health LLC |
Cerner Results
| Result Desc |
Result display |
Result PDM |
| 4K % Free PSA |
4K % Free PSA |
1859233C |
| 4K PSA rflx >3.0 |
4K PSA rflx >3.0 |
1859233A |
| 4K Score Calculation |
4K Score |
1759833A |
| 4K Free PSA |
4K Free PSA |
1859233B |
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| PROCEDURE ID |
114900 |
| PDM |
1859233 |
| ORDER DISPLAY NAME |
4K PSA Total with Reflex 4K Score |
| PROCEDURE NAME |
4K PSA TOTAL WITH REFLEX 4K SCORE |
| PROCEDURE MASTER NUMBER |
LAB11268 |
| SHORT PROCEDURE NAME |
4K PSA TOTAL WITH REFLEX 4K SCORE |
| CATEGORY CODE |
1.0 |
| CATEGORY CODE RECORD NAME |
LAB BLOOD ORDERABLES |
| SYNONYMS |
|
| CLINICALLY ACTIVE |
Yes |
| ORDERABLE |
Yes |
| PERFORMABLE |
Yes |
| FILTER GENOMICS |
Generic Genomics Procedure |
| REFERENCE LINK URL |
https://labs.northwell.edu/epic/test/114900 |
| ORDERING INSTRUCTIONS |
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| DEFAULT SPECIMEN TYPE |
Blood |
| SPECIMEN TYPE PICK LIST |
Blood |
| SPECIMEN TYPE LIST |
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| OP SPECIMEN TYPE LIST |
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| SPECIMEN SOURCE PICK LIST |
Blood, Arterial Blood, Capillary Blood, Central Line Blood, Venous |
| SPECIMEN SOURCE DEFAULT - MALE |
Blood, Venous |
| SPECIMEN SOURCE DEFAULT - FEMALE |
Blood, Venous |
| SPECIMEN SOURCE LIST |
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| OP SPECIMEN SOURCE LIST |
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| IP LAB TEST COMPONENTS FOR REPORT |
4KFREEPSA 4KFREEPSAPCT 4KPSARFLX3 4KSCORECALC SPECAPPEAR |
| OP LAB TEST COMPONENTS FOR REPORT |
4KFREEPSA 4KFREEPSAPCT 4KPSARFLX3 4KSCORECALC SPECAPPEAR |
| ORDER QUESTIONS |
["3046000032", "3046000031", "3046200000", "3046200001", "3046000030"] |
| ORDER QUESTIONS RECORD NAME |
NH IP PRIOR BX HX NH IP DRE RESULTS NH IP ORDERS PT AUTHORIZATION NH IP ORDERS CLINICAL INDICATION FOR ORDERING NH IP PATIENT HX |
| INPATIENT ORDER QUESTIONS |
["3046000032", "3046000031", "3046200000", "3046200001", "3046000030"] |
| INPATIENT ORDER QUESTIONS RECORD NAME |
NH IP PRIOR BX HX NH IP DRE RESULTS NH IP ORDERS PT AUTHORIZATION NH IP ORDERS CLINICAL INDICATION FOR ORDERING NH IP PATIENT HX |
| ORDER SPECIFIC QUESTION OVERRIDE |
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| INPATIENT QUESTION OVERRIDE |
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| LOCATION RESTRICT LIST IP |
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| LOCATION RESTRICT LIST IP RECORD NAME |
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| LOCATION RESTRICT LIST INCLUDE IP |
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| LOCATION RESTRICT LIST OP |
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| LOCATION RESTRICT LIST OP RECORD NAME |
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| LOCATION RESTRICT LIST INCLUDES OP |
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| EDP AMB ORDER SPECIFIC QUESTIONS RECORD NAME |
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| EDP IP ORDER SPECIFIC QUESTIONS RECORD NAME |
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| EDP IP SPECIMEN SOURCE |
Blood, Venous Blood, Central Line Blood, Arterial Blood, Capillary Blood, Peripheral |
| EDP OP SPECIMEN SOURCE |
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| EDP IP SPECIMEN TYPE |
Blood |
| EDP OP SPECIMEN TYPE |
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| DERIVED EDP IP BUTTONS S |
Blood, Venous Blood, Arterial Blood, Central Line Blood, Capillary |
| DERIVED EDP IP BUTTONS T |
Blood |
| DERIVED EDP OP BUTTONS S |
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| DERIVED EDP OP BUTTONS T |
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| IP ORDERABLE |
1 |
| OP ORDERABLE |
1 |
| STANDARD LAB COMPONENTS |
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| STANDARD LAB COMPONENTS RECORD NAME |
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| COMPONENT DATA REQUIREMENT |
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EPIC OP AOEs
| Question ID | Question Name | Question | Response Type | Response List | Require Response |
| 3046000030 |
NH IP PATIENT HX |
Patient History Other |
Custom List |
Confirmed Abnormal DRE
Confirmed PSA > 3.0 ng ml
Not Provided
Presistant & Significant Rise in PSA |
Yes |
| 3046000031 |
NH IP DRE RESULTS |
What was the patient's DRE Results |
Custom List |
Abnormal/Suspicious
Normal/Not Suspicious
Unavailable |
Yes |
| 3046000032 |
NH IP PRIOR BX HX |
What is the patient's prior Biopsy History |
Custom List |
Not Provided
Yes, Negative
Yes, Positive |
Yes |
| 3046200000 |
NH IP ORDERS PT AUTHORIZATION |
Patient Authorization: |
Custom List |
No
Not Given
Yes |
No |
| 3046200001 |
NH IP ORDERS CLINICAL INDICATION FOR ORDERING |
Clinical Indication for ordering: |
Custom List |
45-54 years old and total PSA>=2 ng/mL
55-75 years old and total PSA >=3 ng/mL
>=76 years old and total PSA >4 ng/mL |
No |
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EPIC IP AOEs
| Question ID | Question Name | Question | Response Type | Response List | Require Response |
| 3046000030 |
NH IP PATIENT HX |
Patient History Other |
Custom List |
Confirmed Abnormal DRE
Confirmed PSA > 3.0 ng ml
Not Provided
Presistant & Significant Rise in PSA |
Yes |
| 3046000031 |
NH IP DRE RESULTS |
What was the patient's DRE Results |
Custom List |
Abnormal/Suspicious
Normal/Not Suspicious
Unavailable |
Yes |
| 3046000032 |
NH IP PRIOR BX HX |
What is the patient's prior Biopsy History |
Custom List |
Not Provided
Yes, Negative
Yes, Positive |
Yes |
| 3046200000 |
NH IP ORDERS PT AUTHORIZATION |
Patient Authorization: |
Custom List |
No
Not Given
Yes |
No |
| 3046200001 |
NH IP ORDERS CLINICAL INDICATION FOR ORDERING |
Clinical Indication for ordering: |
Custom List |
45-54 years old and total PSA>=2 ng/mL
55-75 years old and total PSA >=3 ng/mL
>=76 years old and total PSA >4 ng/mL |
No |
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EPIC Components (results - crosswalked through Cerner)
| Component ID | Component Name | Base Name | Common Name | External Name | Cerner Result PDM |
| 3047800788.0 |
4K % FREE PSA |
4KFREEPSAPCT |
4K PCT FREE PSA |
4K % Free PSA |
1859233C |
| 3047800790.0 |
4K PSA RFLX >3.0 |
4KPSARFLX3 |
4K PSA RFLX GREATER THAN 3 |
4K PSA rflx >3.0 |
1859233A |
| 3047800791.0 |
4K SCORE CALCULATION |
4KSCORECALC |
4K SCORE CALCULATION |
4K Score |
1759833A |
| 3047800789.0 |
4K FREE PSA |
4KFREEPSA |
4K FREE PSA |
4K Free PSA |
1859233B |
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