In today’s Internet, services are very different in their requirements on the underlying transport network. In the future, this diversity will increase and it will be more difficult to accommodate all services in a single network. A possible approach to cope with this diversity within future networks is the introduction of support for running isolated networks for different services on top of a single shared physical substrate. This would also enable easy network management and ensure an economically sound operation. End-customers will readily adopt this approach as it enables new and innovative services without being expensive. In order to arrive at a concept that enables this kind of network, it needs to be designed around and constantly checked against realistic use cases. In this contribution, we present three use cases for future networks. We describe functional blocks of a virtual network architecture, which are necessary to support these use cases within the network. Furthermore, we discuss the interfaces needed between the functional blocks and consider standardization issues that arise in order to achieve a global consistent control and management structure of virtual networks.

M. Merli, M. Spina, S. Luminari, C. Stelitano, V. Ferretti, C. Gabutti, C. Targhetta, C. Visco, A. Levis, D. Rossi, A. M. D’Arco, L. Rigacci, A. Ambrosetti, A. Chiappella, P. Musto, L. Arcaini Hematology, University of Pavia Medical School, Fondazione Policlinico S. Matteo, Pavia, Italy, Medical Oncology, National Cancer Center, Aviano, Italy, Oncology and Hematology, University of Modena and Reggio Emilia, Modena, Italy, Hematology, Osp Riuniti, Reggio Calabria, Italy, Hematology, Osp Niguarda Ca’ Granda, Milan, Italy, Hematology, Osp A Businco, Cagliari, Italy, Hematology, Osp S Bortolo, Vicenza, Italy, Hematology, Osp SS Antonio e Biagio, Alessandria, Italy, Hematology, Avogadro University, Novara, Italy, Oncohematology, Osp Umberto I, Nocera Inf, Italy, Hematology, Osp Careggi, Firenze, Italy, Hematology, University of Verona, Verona, Italy, Hematology 2, AO S Giovanni Battista, Turin, Italy, Hematology, IRCCS CROB, Rionero in Vulture, Italy

Introduction: DNA-based genetic tests for heritable conditions contribute to patient care decisions regarding diagnosis, treatment, counseling, and referral.A genotype has meaning in the context of the clinical indications, an understanding of the relevant genetic associations, and the analytical characteristics of the test.We undertook a study to assess reporting practices to identify and address shortcomings in the processes by which laboratory and clinical settings communicate.Methods: Using DNA-based cystic fibrosis as a model, we reviewed existing laboratory requisitions and reports.We surveyed laboratory professionals and clinicians about their experience in ordering, reporting, and using tests and results.A workgroup reviewed findings and proposed approaches to improve the quality and usefulness of reports.Results: Report content and format varied and was somewhat dependent on the requisition.Variation was particularly evident when describing residual risk and inconclusive diagnostic results.Non-medical personnel were found to have roles in reviewing reports and communicating results to patients.Our data also indicated physicians' general dissatisfaction with wording used in the report's interpretive component.At a workshop held in November 2005, attendees concluded a model for communicating test results in a clear context is needed.Conclusion: A model for reporting results has been developed for surgical pathology that is potentially applicable to genetic testing.This "synoptic" report uses standard language, arrived at through clinician feedback, in reporting the result in terms of what is clinically relevant and actionable.We propose this useful for effectively communicating such concepts as residual risk, uncertainty associated with negative findings, implications for family members, and test limitations.For example, many OB-GYNs order cystic fibrosis carrier testing during routine care and a synoptic report may aid in understanding the residual risk and its clinical relevance.Another potential advantage in developing a synoptic style report is the recognition and integration of good reporting practices and a practical means to implement professional recommendations.We anticipate these efforts will influence educational and information resource initiatives that address the appropriate use of genetic tests and integration of test results into patient care decisions.