| Mandatory second opinion in surgical pathology referral material: clinical consequences of major disagreements. | |
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MedLine Citation:
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PMID: 18360282 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Second opinion in pathology is intended to expose clinically significant errors that have a direct impact on patient care. Before definitive treatment of referred patients, our institution requires a second opinion of outside surgical pathology slides. We sought to determine if this local standard of practice has a measurable impact on patient care via clinical and pathologic follow-up. 5629 second opinion surgical pathology cases seen at the University of Iowa Hospitals and Clinics were studied. Each case was classified as: no diagnostic disagreement, minor diagnostic disagreement, or major diagnostic disagreement by the second opinion pathologist at the time of referral. A major diagnostic disagreement was defined as a change in pathologic diagnosis with potential for significant change in treatment or prognosis. Major diagnostic disagreements were categorized by organ system and according to the clinical significance of the changed diagnosis based on clinical and pathologic follow-up. Second opinion surgical pathology resulted in 132 (2.3% of total cases) major diagnostic disagreements and 507 (9.0%) cases with minor disagreements. The organ systems involved in the majority of the major disagreements were the female reproductive tract (32), gastrointestinal tract (27), and skin (24). Of the 132 major diagnostic disagreements, 68 (1.2% of total cases reviewed) prompted changes in the clinical management as a result of the second opinion interpretation. These findings support the idea that mandatory second opinion is an important part of patient care in the referral setting. |
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Authors:
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Elizabeth Manion; Michael B Cohen; Jamie Weydert |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The American journal of surgical pathology Volume: 32 ISSN: 1532-0979 ISO Abbreviation: Am. J. Surg. Pathol. Publication Date: 2008 May |
Date Detail:
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Created Date: 2008-04-28 Completed Date: 2008-05-22 Revised Date: 2009-01-23 |
Medline Journal Info:
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Nlm Unique ID: 7707904 Medline TA: Am J Surg Pathol Country: United States |
Other Details:
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Languages: eng Pagination: 732-7 Citation Subset: IM |
Affiliation:
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Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, IA, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Diagnostic Errors
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prevention & control* Hospitals, Teaching / standards Humans Observer Variation Pathology, Surgical / standards* Patient Care Management / standards* Quality Assurance, Health Care* Referral and Consultation* Reproducibility of Results |
| Comments/Corrections | |
Erratum In:
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Am J Surg Pathol. 2008 Dec;32(12):1919-22 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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