Andrea C Radick1, Lisa M Reisch1, Hannah L Shucard1, Michael W Piepkorn2,3, Kathleen F Kerr1, David E Elder4, Raymond L Barnhill5,6,7, Stevan R Knezevich8, Natalia Oster1, Joann G Elmore9. 1. Department of Biostatistics, University of Washington, Seattle, Washington, USA. 2. Division of Dermatology, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA. 3. Dermatopathology Northwest, Bellevue, Washington, USA. 4. Department of Pathology and Laboratory Medicine, Division of Anatomic Pathology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA. 5. Department of Pathology, Institut Curie, Paris Sciences and Letters Research University, Paris, France. 6. Department of Translational Research, Institut Curie, Paris Sciences and Letters Research University, Paris, France. 7. Faculty of Medicine, University of Paris Descartes, Paris, France. 8. Pathology Associates, Clovis, California, USA. 9. Department of Medicine, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, California, USA.
Abstract
BACKGROUND: Diagnostic terms used in histopathology reports of cutaneous melanocytic lesions are not standardized. We describe dermatopathologists' views regarding diverse diagnostic terminology and the utility of the Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis (MPATH-Dx) for categorizing melanocytic lesions. METHODS: July 2018-2019 survey of board-certified and/or fellowship-trained dermatopathologists with experience interpreting melanocytic lesions. RESULTS: Among 160 participants, 99% reported witnessing different terminology being used for the same melanocytic lesion. Most viewed diverse terminology as confusing to primary care physicians (98%), frustrating to pathologists (83%), requiring more of their time as a consultant (64%), and providing necessary clinical information (52%). Most perceived that adoption of the MPATH-Dx would: improve communication with other pathologists and treating physicians (87%), generally be a change for the better (80%), improve patient care (79%), be acceptable to clinical colleagues (68%), save time in pathology report documentation (53%), and protect from malpractice (51%). CONCLUSIONS: Most dermatopathologists view diverse terminology as contributing to miscommunication with clinicians and patients, adversely impacting patient care. They view the MPATH-Dx as a promising tool to standardize terminology and improve communication. The MPATH-Dx may be a useful supplement to conventional pathology reports. Further revision and refinement are necessary for widespread clinical use.
BACKGROUND: Diagnostic terms used in histopathology reports of cutaneous melanocytic lesions are not standardized. We describe dermatopathologists' views regarding diverse diagnostic terminology and the utility of the Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis (MPATH-Dx) for categorizing melanocytic lesions. METHODS: July 2018-2019 survey of board-certified and/or fellowship-trained dermatopathologists with experience interpreting melanocytic lesions. RESULTS: Among 160 participants, 99% reported witnessing different terminology being used for the same melanocytic lesion. Most viewed diverse terminology as confusing to primary care physicians (98%), frustrating to pathologists (83%), requiring more of their time as a consultant (64%), and providing necessary clinical information (52%). Most perceived that adoption of the MPATH-Dx would: improve communication with other pathologists and treating physicians (87%), generally be a change for the better (80%), improve patient care (79%), be acceptable to clinical colleagues (68%), save time in pathology report documentation (53%), and protect from malpractice (51%). CONCLUSIONS: Most dermatopathologists view diverse terminology as contributing to miscommunication with clinicians and patients, adversely impacting patient care. They view the MPATH-Dx as a promising tool to standardize terminology and improve communication. The MPATH-Dx may be a useful supplement to conventional pathology reports. Further revision and refinement are necessary for widespread clinical use.
Authors: Hannah Shucard; Michael W Piepkorn; Lisa M Reisch; Kathleen F Kerr; Andrea C Radick; Pin-Chieh Wang; Stevan R Knezevich; Raymond L Barnhill; David E Elder; Joann G Elmore Journal: JAMA Dermatol Date: 2020-03-01 Impact factor: 10.282
Authors: Suzanne M Dintzis; Galina Y Stetsenko; Colleen M Sitlani; Ann M Gronowski; Michael L Astion; Thomas H Gallagher Journal: Am J Clin Pathol Date: 2011-05 Impact factor: 2.493
Authors: Roberta M Strigel; Elizabeth S Burnside; Mai Elezaby; Amy M Fowler; Frederick Kelcz; Lonie R Salkowski; Wendy B DeMartini Journal: AJR Am J Roentgenol Date: 2017-06 Impact factor: 3.959
Authors: Richard A Scolyer; Robert V Rawson; Jeffrey E Gershenwald; Peter M Ferguson; Victor G Prieto Journal: Mod Pathol Date: 2019-11-22 Impact factor: 7.842
Authors: Joann G Elmore; Raymond L Barnhill; David E Elder; Gary M Longton; Margaret S Pepe; Lisa M Reisch; Patricia A Carney; Linda J Titus; Heidi D Nelson; Tracy Onega; Anna N A Tosteson; Martin A Weinstock; Stevan R Knezevich; Michael W Piepkorn Journal: BMJ Date: 2017-06-28
Authors: Nathalie Bravenboer; Miriam A Bredella; Christophe Chauveau; Alessandro Corsi; Eleni Douni; William F Ferris; Mara Riminucci; Pamela G Robey; Shanti Rojas-Sutterlin; Clifford Rosen; Tim J Schulz; William P Cawthorn Journal: Front Endocrinol (Lausanne) Date: 2020-01-24 Impact factor: 5.555