Diagnostic discrepancies and their clinical impact in a neuropathology referral practice.

摘要: BACKGROUND During the course of their neuropathology practice, authors received cases to review in consultation. In some cases, patients came authors' hospital for therapy; others, primary pathologists requested a Because changes diagnosis might significantly alter patient management, protocol entry, care costs, or potential physician liability, determined frequency and degrees disagreements with original diagnoses submitted them. METHODS The reviewed first 500 brain spinal cord biopsy that were consultation service second opinion 1995. Disagreements coded into 10 categories, but grouped this analysis as follows: serious (having immediate significance therapy intervention), less potentially substantial (calling change type grade glioma), minor (adding deleting information), those which made themselves. RESULTS There was degree disagreement between 214 (42.8%) cases. counted 44 (8.8%), 96 (19.2%), 50 (10.0%); 24 (4.8%). CONCLUSIONS Clinically important diagnostic errors can affect decisions occur number Thus, seeking expert is prudent cost-effective who are experienced these types Cost savings case management result from confirmation before definitive administered patients. The rates discrepancy opinions other subspecialties pathology should be examined. [See editorial on pages 665-7, issue.] Cancer 1997; 79:796-803. © 1997 American Society.