Publications by authors named "M Piepkorn"
The new revised MPATH-Dx (version 2.0) reporting schema for melanocytic lesions is presented. Principal changes include the simplification of the previous five-class version 1.
View Article and Find Full Text PDFImportance: Pathologic assessment to diagnose skin biopsies, especially for cutaneous melanoma, can be challenging, and immunohistochemistry (IHC) staining has the potential to aid decision-making. Currently, the temporal trends regarding the use of IHC for the examination of skin biopsies on a national level have not been described.
Objective: To illustrate trends in the use of IHC for the examination of skin biopsies in melanoma diagnoses.
Article Synopsis
- The incidence of melanoma cases has been rising, and studies show significant disagreement among pathologists when diagnosing intermediate melanocytic lesions.
- Researchers aimed to explore which pathologist characteristics influence their likelihood of diagnosing these lesions as higher or lower grade and identifying invasive melanoma.
- Data was analyzed from two national studies involving 338 pathologists, looking at various factors like demographics, experience, and specialty training, to understand how these characteristics affect diagnostic tendencies.
Background: A standardized pathology management tool for melanocytic skin lesions may improve patient care by simplifying interpretation and categorization of the diverse terminology currently extant.
Objective: To assess an online educational intervention that teaches dermatopathologists to use the Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis (MPATH-Dx), a schema collapsing multiple diagnostic terms into 5 classes ranging from benign to invasive melanoma.
Methods: Practicing dermatopathologists ( 149) from 40 US states participated in a 2-year educational intervention study (71% response rate).
Diagnostic error can be defined as deviation from a gold standard diagnosis, typically defined in terms of expert opinion, although sometimes in terms of unexpected events that might occur in follow-up (such as progression and death from disease). Although diagnostic error does exist for melanoma, deviations from gold standard diagnosis, certainly among appropriately trained and experienced practitioners, are likely to be the result of uncertainty and lack of specific criteria, and differences of opinion, rather than lack of diagnostic skills. In this review, the concept of diagnostic error will be considered in relation to diagnostic uncertainty, and the concept of overdiagnosis in melanoma will be presented and discussed.
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