Errors in histopathology reporting: detection and avoidance

被引:50
作者
Ramsay, AD [1 ]
机构
[1] Great Ormond St Hosp Sick Children, Dept Histopathol, Camelia Botnar Labs, London WC1N 3JH, England
关键词
diagnosis; medical audit; professional competence; quality assurance; quality of health care; surgical pathology;
D O I
10.1046/j.1365-2559.1999.00719.x
中图分类号
Q2 [细胞生物学];
学科分类号
071009 ; 090102 ;
摘要
specimens more commonly affected. Generic audit strategies that can be used to minimize the risk of errors in reports are discussed, together with the use of audit to evaluate diagnostic criteria and pathological scoring or grading systems. The role of audit in determining the informational content of reports is included, and there is consideration of the relationship between sample size and error rates. The limited extent to which audit can be used to assess the performance of individual pathologists is also covered. The histopathological diagnosis is the bedrock of modern oncology, and plays a major role in the treatment of many other types of disease. Errors in these reports can critically affect patient care and may become the subject of media concern. This article considers how audit in histopathology can provide information about errors and inconsistencies in the diagnosis of surgical specimens, The use of audit to generate information about the background level of errors in pathology reports is reviewed, along with findings about the nature of these errors and the types of specimens more commonly affected. Generic audit strategies that can be used to minimize the risk of errors in reports are discussed, together with the use of audit to evaluate diagnostic criteria and pathological scoring or grading systems. The role of audit in determining the informational content of reports is included, and there is consideration of the relationship between sample size and error rates. The limited extent to which audit can be used to assess the performance of individual pathologists is also covered.
引用
收藏
页码:481 / 490
页数:10
相关论文
共 90 条
[1]   Evidence of effectiveness of clinical audit in improving histopathology reporting standards of mastectomy specimens [J].
Appleton, MAC ;
Douglas-Jones, AG ;
Morgan, JM .
JOURNAL OF CLINICAL PATHOLOGY, 1998, 51 (01) :30-33
[2]   Where should paediatric surgery be performed? [J].
Arul, GS ;
Spicer, RD .
ARCHIVES OF DISEASE IN CHILDHOOD, 1998, 79 (01) :65-70
[3]   AUTOPSY ANALYSIS IN SURGICAL PATIENTS - A BASIS FOR CLINICAL AUDIT [J].
BARENDREGT, WB ;
DEBOER, HHM ;
KUBAT, K .
BRITISH JOURNAL OF SURGERY, 1992, 79 (12) :1297-1299
[4]   VALUE OF EXTERNAL QUALITY ASSESSMENT OF THE TECHNICAL ASPECTS OF HISTOPATHOLOGY [J].
BARR, WT ;
WILLIAMS, ED .
JOURNAL OF CLINICAL PATHOLOGY, 1982, 35 (10) :1050-1056
[5]   Practising by the evidence: The role of pathology [J].
Batstone, G .
JOURNAL OF CLINICAL PATHOLOGY, 1997, 50 (06) :447-448
[6]   OBSERVER VARIABILITY IN REPORTING OF BREAST-LESIONS [J].
BECK, JS .
JOURNAL OF CLINICAL PATHOLOGY, 1985, 38 (12) :1358-1365
[7]   Colorectal cancer pathology reporting: A regional audit [J].
Bull, AD ;
Biffin, AHB ;
Mella, J ;
Radcliffe, AG ;
Stamatakis, JD ;
Steele, RJC ;
Williams, GT .
JOURNAL OF CLINICAL PATHOLOGY, 1997, 50 (02) :138-142
[8]  
BURTON EC, 1998, JAMA-J AM MED ASSOC, V280, P1273
[9]   EXTERNAL QUALITY ASSESSMENT OF IMMUNOASSAYS FOR SPECIFIC PROTEINS IN SERUM - 18 MONTHS EXPERIENCE IN THE UNITED-KINGDOM [J].
CHAMBERS, RE ;
WHICHER, JT ;
BULLOCK, DG .
ANNALS OF CLINICAL BIOCHEMISTRY, 1984, 21 (JUL) :246-253
[10]  
CHAUDHARY V, 1995, GUARDIAN 0714, P6