Background: Second-opinion review is linked to error reduction and treatment changes in anatomic pathology.
Objective: We sought to establish the rate of diagnostic discrepancy identified by second-opinion dermatopathologic review and the effect on surgical treatment.
Methods: Cases referred for treatment of a malignant neoplasm diagnosed by an outside pathologist were reviewed. The external and internal second-opinion dermatopathologic reports were compared. Discordance in diagnosis, subtype, and treatment change owing to second-opinion review was recorded. The referring pathologist's level of dermatopathologic training was also documented.
Results: A total of 358 cases were included. Dermatopathologic second-opinion diagnosis was discordant with the outside diagnosis in 37 of 358 cases (10.3%). In 32 of 358 cases (8.9%), second-opinion review resulted in a change in treatment, with 28 of 32 (87.5%) of these changes resulting in cancelled surgery. Dermatologists without dermatopathologic fellowship training had the highest rate of discordant diagnoses compared with pathologists and dermatopathologists.
Limitations: This was a retrospective study at a tertiary care facility.
Conclusion: Second-opinion dermatopathologic review is associated with identification of discordant diagnoses and a substantial influence on treatment, with both cancellation of surgery and augmented management. Secondary pathologic review should be considered in high-volume surgical practices.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jaad.2020.12.022 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
An overview of proactive monitoring and management of respiratory issues in ataxia-telangiectasia in a specialist and shared care pediatric clinic.
Front Pediatr
December 2024
Paediatrics and Paediatric Respirology, National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, United Kingdom.
Ataxia-telangiectasia (A-T) is an ultrarare autosomal recessive disorder and occurs in all racial and ethnic backgrounds. Clinically, children and young people with A-T are affected by sinopulmonary infections, neurological deterioration with concomitant bulbar dysfunction, increased sensitivity to ionizing radiation, immunodeficiency, a decline in lung function, chronic liver disease, endocrine abnormalities, cutaneous and deep-organ granulomatosis, and early death. Pulmonary complications become more frequent in the second decade of life and are a leading cause of death in individuals with A-T.
View Article and Find Full Text PDFRetrospective data analysis of referral letters for orofacial vascular anomalies to a tertiary center.
Arch Craniofac Surg
December 2024
Department of Pediatric Dentistry, Hospital Tunku Azizah, Kuala Lumpur, Malaysia.
Background: Vascular anomalies are disorders of the vascular system. These anomalies are classified as either vascular tumors or vascular malformations, with each possessing distinct characteristics. This study was performed to analyze vascular anomaly referrals to a tertiary center, identify patterns of misdiagnosis, and create a proforma to ensure the comprehensiveness of clinical information.
View Article and Find Full Text PDFDevelopment and Feasibility Study of a Triage Tool for Early Referral to Spinal Cord Stimulation for Patients With Chronic Low Back and Leg Pain.
Eur J Pain
February 2025
Department of Anesthesiology, Pain and Palliative Medicine, Radboudumc, Nijmegen, The Netherlands.
Background: In recent years, delayed elective care and growing waiting lists increasingly resulted in postponed surgeries for patients with chronic back and leg pain.
Objective: To develop, implement, and evaluate the feasibility of a triage tool for patients with chronic back and/or leg pain to identify those eligible for referral to spinal cord stimulation (SCS) consultation.
Methods: A triage tool was developed, based on Dutch SCS guidelines, literature review and expert panel consultation.
Measuring the uptake of clinic-based HIV treatment and prevention services following HIV testing and referral at private pharmacies in Kenya.
BMC Health Serv Res
January 2025
Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, USA.
Background: Despite their ubiquity across sub-Saharan Africa, private pharmacies are underutilized for HIV service delivery beyond the sale of HIV self-test kits. To understand what uptake of HIV prevention and treatment services might look like if private pharmacies offered clients free HIV self-testing and referral to clinic-based HIV services, we conducted a pilot study in Kenya.
Methods: At 20 private pharmacies in Kisumu County, Kenya, pharmacy clients (≥ 18 years) purchasing sexual health-related products (e.
Challenges in Breast Pathology: A Review of the Most Common Problems Encountered in a Subspecialty Consult Service Over 1 Year-Retrospective Review of 553 Specimens.
Int J Surg Pathol
January 2025
Department of Pathology and Laboratory Medicine, Mayo Clinic, Jacksonville, FL, USA.
. To identify the most common reasons for consultation to a large specialty breast pathology service at a major institution. To provide insight into the overall challenges in practicing breast pathology.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!