The purpose of this study was to examine a system of quality assurance in which microscopic slides from all surgical cases were subject to peer review before completion of the final pathology report. Three thousand surgical pathology cases were evaluated and the diagnoses entered on preliminary diagnosis sheets. Microscopic slides were reviewed and coded reviewer opinions entered on photostatic copies of preliminary diagnosis sheets. Reviewer comments were incorporated into the final pathology reports at the discretion of the responsible pathologist. Two hundred thirty-three (7.8%) cases were identified in which at least one reviewer disagreed with the preliminary diagnosis; in 67 of the 233 cases (2.2%) the final diagnosis was modified as a result of the review process. Changes in final diagnoses were judged to be significant in 29 (0.96%) cases. These results suggest that systematic review of surgical pathology diagnoses prior to preparation of final pathology reports may be a useful tool in assuring quality and consistency in diagnoses.
The purpose of this study was to assess the clinical and pathological value of reports resulting from review of all completed surgical pathology cases submitted to the Army Histopathology Registry (AHR). All histopathological cases completed in the British Army are sent to the AHR for archiving; prior to placing cases in the archive both microscopic material and submitted reports are reviewed by staff of the AHR. A "nonagreed" report is produced for those cases in which the reviewing pathologist has a dissenting opinion or for which he thinks other comments may be helpful. All nonagreed reports produced over a 19 month period were subjected to a further pathological and clinical review. The original surgical pathology reports were compared with AHR reports and the significance of the differences in diagnosis assessed. During the study interval, 4.0% of total cases reviewed were identified as nonagreed record cases. The clinical and pathological reviews placed the nonagreed cases into significant categories in 2.1% and 1.9% of instances respectively. These findings suggest that nonselected review of completed surgical pathology cases identifies a significant proportion of cases for which dissenting opinions may have important clinical and pathological consequences.
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