Chantal C H J Kuijpers1, Gerard Burger2, Shaimaa Al-Janabi2, Stefan M Willems3, Paul J van Diest3, Mehdi Jiwa4. 1. Symbiant Pathology Expert Centre, Alkmaar, The Netherlands Department of Pathology, University Medical Centre Utrecht, Utrecht, The Netherlands PALGA, Houten, The Netherlands. 2. Symbiant Pathology Expert Centre, Alkmaar, The Netherlands. 3. Department of Pathology, University Medical Centre Utrecht, Utrecht, The Netherlands. 4. Symbiant Pathology Expert Centre, Alkmaar, The Netherlands Department of Pathology, University Medical Centre Utrecht, Utrecht, The Netherlands.
Abstract
AIM: Double reading may be a valuable tool for improving quality of patient care by identifying diagnostic errors before final sign-out, but standard double reading would significantly increase costs of pathology. We assessed the added value of intradepartmental routine double reading of histopathology specimens prior to multidisciplinary meetings. METHODS: Diagnoses, treatment plans and prognoses of patients are often discussed at multidisciplinary meetings. As part of the daily routine, all pathology specimens to be discussed at upcoming multidisciplinary meetings undergo prior intradepartmental double reading. We identified all histopathology specimens from 2013 that underwent such double reading and determined major and minor discordance rates based on clinical relevance between the initial and consensus sign-out diagnoses. RESULTS: We included 6796 histopathology specimens that underwent double reading, representing approximately 8% of all histopathology cases at our institution in 2013. Double reading diagnoses were concordant in 6566 specimens (96.6%). Major and minor discordances were observed in 60 (0.9%) and 170 (2.5%) specimens, respectively. Urology specimens had significantly more discordances than other tissues of origin, Gleason grading of prostate cancer biopsies being the most frequent diagnostic problem. Furthermore, premalignant and malignant cases showed significantly higher discordance rates than the rest. The vast majority (90%) of discordances represented changes within the same diagnostic category (eg, malignant to malignant). CONCLUSIONS: Routine double reading of histopathology specimens prior to multidisciplinary meetings prevents diagnostic errors. It resulted in about 1% discordant diagnoses of potential clinical significance, indicating that second review is worthwhile in terms of patient safety and quality of patient care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
AIM: Double reading may be a valuable tool for improving quality of patient care by identifying diagnostic errors before final sign-out, but standard double reading would significantly increase costs of pathology. We assessed the added value of intradepartmental routine double reading of histopathology specimens prior to multidisciplinary meetings. METHODS: Diagnoses, treatment plans and prognoses of patients are often discussed at multidisciplinary meetings. As part of the daily routine, all pathology specimens to be discussed at upcoming multidisciplinary meetings undergo prior intradepartmental double reading. We identified all histopathology specimens from 2013 that underwent such double reading and determined major and minor discordance rates based on clinical relevance between the initial and consensus sign-out diagnoses. RESULTS: We included 6796 histopathology specimens that underwent double reading, representing approximately 8% of all histopathology cases at our institution in 2013. Double reading diagnoses were concordant in 6566 specimens (96.6%). Major and minor discordances were observed in 60 (0.9%) and 170 (2.5%) specimens, respectively. Urology specimens had significantly more discordances than other tissues of origin, Gleason grading of prostate cancer biopsies being the most frequent diagnostic problem. Furthermore, premalignant and malignant cases showed significantly higher discordance rates than the rest. The vast majority (90%) of discordances represented changes within the same diagnostic category (eg, malignant to malignant). CONCLUSIONS: Routine double reading of histopathology specimens prior to multidisciplinary meetings prevents diagnostic errors. It resulted in about 1% discordant diagnoses of potential clinical significance, indicating that second review is worthwhile in terms of patient safety and quality of patient care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Authors: Jacob E Tallman; Vignesh T Packiam; Kristen E Wroblewski; Gladell P Paner; Scott E Eggener Journal: Urol Oncol Date: 2017-03-13 Impact factor: 3.498
Authors: Bilge Dundar; Stephanie J Chen; John L Blau; K D Anand Rajan; Megan I Samuelson; Michelle L Greek-Lippe; Kim S Lake; Robert A Robinson Journal: J Pathol Inform Date: 2022-06-24
Authors: Paul J van Diest; André Huisman; Jaap van Ekris; Jos Meijer; Stefan Willems; Hannelore Hofhuis; Xander Verbeek; Myrtle van der Wel; Shoko Vos; Roos Leguit; Michiel van den Brand; Konnie Hebeda; Katrien Grünberg Journal: JCO Clin Cancer Inform Date: 2019-06