Background: Second opinion review of pathology cases can identify diagnostic errors that impact patient care.
Objective: We sought out to determine discrepancy rates and clinical impact of review of pathology cases to reassess our policy of review on all second opinion cases.
Methods: All second opinion pathology cases over 1 year (2018) were retrospectively reviewed for discrepancy, multiple pathologist review and clinicopathologic features via chart and slide review. Cases were categorized as no significant discordance, major discordance without management change and major discordance with management change.
Results: Among 4239 second opinion cases, 3.7% (156/4239) had major discordance with no change in management and 1% (42/4239) had major discordance with change in management. Discordance was significantly associated with multiple pathologist review at our institution (P < 0.001). Highest rates of discordance were observed for thyroid fine needle aspiration (15.3%, 26/170), tissue biopsy of bone/soft tissue (9.6%), endocrine (8.8%), genitourinary (6.7%), gynecologic (6.2%), hematopathology (4%), gastrointestinal/liver (3.7%) and thoracic (3%) sites.
Conclusions: Our study showed a 1% major discordance rate with resulting significant change in clinical management, spread across nearly all subspecialties. Thus, we support recommendations for review of relevant outside pathology material for all patients for which review has the potential to illicit management change such as instituting a major medical or surgical therapy.
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http://dx.doi.org/10.1093/intqhc/mzab032 | DOI Listing |
Sci Rep
January 2025
Department of Statistics, College of Natural and Computational Science, Debre Tabor University, Debre Tabor, Ethiopia.
The human immunodeficiency virus systematically undermines the immune system, which serves as our body's inherent safeguard against diseases. Currently, it is the most serious threat to public health. Ethiopia is among the countries with the highest prevalence of HIV/AIDS.
View Article and Find Full Text PDFInt J Drug Policy
January 2025
Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.
Sexualised drug use (SDU) is a highly prevalent phenomenon of increasing public health significance in communities of men who have sex with men (MSM). This prospectively registered PRISMA-ScR-adherent systematic scoping review examines the current state of knowledge surrounding violence amongst MSM in the context of SDU. A broad search was conducted across four databases, with no restrictions.
View Article and Find Full Text PDFThe studyPayne R, Clarke A, Swann N, et al. Patient safety in remote primary care encounters: multimethod qualitative study combining Safety I and Safety II analysis. 2023;0:1-14.
View Article and Find Full Text PDFClin Genitourin Cancer
December 2024
University of North Carolina School of Medicine, Chapel Hill, NC; University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC; Department of Urology, University of North Carolina, Chapel Hill, NC.
Purpose: Prehabilitation in patients with bladder cancer recommended for cystectomy has the potential to improve functional status and outcomes after cystectomy. Prior research has shown that increasing exercise preoperatively can improve strength and quality of life, but research has not yet investigated the impact on length of stay, readmissions, complications and mortality.
Methods: We compared historical controls (2021-2022) for patients with bladder cancer who underwent radical cystectomy at a major academic center to those referred for prehabilitation consultation (2023) on postoperative outcomes, namely hospital length of stay, 30 and 90 day readmission rates, postoperative complications and 90-day mortality.
N Z Med J
January 2025
Professor, School of Social and Cultural Studies, Victoria University of Wellington, Wellington, New Zealand.
Aim: Patient barriers to accessing hospice and palliative care (PC) have been well studied. Important, yet less investigated, is how cancer patients whose hospice referrals were not accepted are being cared for. This article aims to understand the referral process from PC providers' perspectives and the implications of the current palliative system for patients, families and health professionals.
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