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[PMID]:28967955
[Au] Autor:Desouki MM; Li Z; Hameed O; Fadare O
[Ad] Endereço:Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN.
[Ti] Título:Intraoperative Pathologic Consultation on Hysterectomy Specimens for Endometrial Cancer: An Assessment of the Accuracy of Frozen Sections, "Gross-Only" Evaluations, and Obtaining Random Sections of a Grossly "Normal" Endometrium.
[So] Source:Am J Clin Pathol;148(4):345-353, 2017 Oct 01.
[Is] ISSN:1943-7722
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objectives: Pathologic intraoperative consultation (IOC) is a common approach for segregating the subset of patients with endometrial cancer who likely require a lymphadenectomy. Methods: We evaluate factors related to the performance and value of IOC, including the accuracy of frozen sections, "gross-only examinations," and obtaining random sections when a gross lesion is not apparent. Results: IOC was performed by gross examination only in 17 (8%) of 250 cases, the specificity and negative predictive value of which in diagnosing cancer were 100% and 85%, respectively. Among the 64 cases wherein a gross lesion was not apparent and random sections were examined, a final diagnosis of carcinoma was rendered in 20, of which only three (15%) had a diagnosable malignancy on the random section. The frozen-section/final diagnosis concordance was 80% for tumor grade. Determining the depth of myometrial invasion was problematic, with 36% underestimation and 2.6% overestimation. Conclusions: Obtaining random sections in the absence of a gross lesion has no significant benefit, and a negative result is likely to provide inaccurate data to the surgeon. Frozen-section analyses are a generally reliable tool to determine "low-risk" pathologic parameters that were evaluated herein when a gross lesion is present.
[Mh] Termos MeSH primário: Neoplasias do Endométrio/diagnóstico
Secções Congeladas
Período Intraoperatório
Patologia Cirúrgica/métodos
Encaminhamento e Consulta
[Mh] Termos MeSH secundário: Neoplasias do Endométrio/patologia
Neoplasias do Endométrio/cirurgia
Feminino
Seres Humanos
Histerectomia
Valor Preditivo dos Testes
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171020
[Lr] Data última revisão:
171020
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171003
[St] Status:MEDLINE
[do] DOI:10.1093/ajcp/aqx076


  2 / 1587 MEDLINE  
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[PMID]:28967954
[Au] Autor:Zarbo RJ; Copeland JR; Varney RC
[Ad] Endereço:Pathology and Laboratory Medicine, Henry Ford Health System, Detroit, MI.
[Ti] Título:Deviation Management: Key Management Subsystem Driver of Knowledge-Based Continuous Improvement in the Henry Ford Production System.
[So] Source:Am J Clin Pathol;148(4):354-367, 2017 Oct 01.
[Is] ISSN:1943-7722
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objectives: To develop a business subsystem fulfilling International Organization for Standardization 15189 nonconformance management regulatory standard, facilitating employee engagement in problem identification and resolution to effect quality improvement and risk mitigation. Methods: From 2012 to 2016, the integrated laboratories of the Henry Ford Health System used a quality technical team to develop and improve a management subsystem designed to identify, track, trend, and summarize nonconformances based on frequency, risk, and root cause for elimination at the level of the work. Results: Programmatic improvements and training resulted in markedly increased documentation culminating in 71,641 deviations in 2016 classified by a taxonomy of 281 defect types into preanalytic (74.8%), analytic (23.6%), and postanalytic (1.6%) testing phases. The top 10 deviations accounted for 55,843 (78%) of the total. Conclusions: Deviation management is a key subsystem of managers' standard work whereby knowledge of nonconformities assists in directing corrective actions and continuous improvements that promote consistent execution and higher levels of performance.
[Mh] Termos MeSH primário: Eficiência Organizacional
Patologia Cirúrgica/organização & administração
Controle de Qualidade
Gestão da Qualidade Total/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171020
[Lr] Data última revisão:
171020
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171003
[St] Status:MEDLINE
[do] DOI:10.1093/ajcp/aqx084


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[PMID]:28854347
[Au] Autor:Wang HL; Kim CJ; Koo J; Zhou W; Choi EK; Arcega R; Chen ZE; Wang H; Zhang L; Lin F
[Ti] Título:Practical Immunohistochemistry in Neoplastic Pathology of the Gastrointestinal Tract, Liver, Biliary Tract, and Pancreas.
[So] Source:Arch Pathol Lab Med;141(9):1155-1180, 2017 Sep.
[Is] ISSN:1543-2165
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:CONTEXT: - Immunomarkers with diagnostic, therapeutic, or prognostic values have been increasingly used to maximize the benefits of clinical management of patients with neoplastic diseases of the gastrointestinal tract, liver, biliary tract, and pancreas. OBJECTIVES: - To review the characteristics of immunomarkers that are commonly used in surgical pathology practice for neoplasms of the gastrointestinal tract, liver, biliary tract, and pancreas, and to summarize the clinical usefulness of immunomarkers that have been discovered in recent years in these fields. DATA SOURCES: - Data sources include literature review, authors' research data, and personal practice experience. CONCLUSIONS: - Immunohistochemistry is an indispensable tool for the accurate diagnosis of neoplastic diseases of the gastrointestinal tract, liver, biliary tract, and pancreas. Useful immunomarkers are available to help distinguish malignant neoplasms from benign conditions, determine organ origins, and subclassify neoplasms that are morphologically and biologically heterogeneous. Specific immunomarkers are also available to help guide patient treatment and assess disease aggressiveness, which are keys to the success of personalized medicine. Pathologists will continue to play a critical role in the discovery, validation, and application of new biomarkers, which will ultimately improve patient care.
[Mh] Termos MeSH primário: Biomarcadores Tumorais/análise
Neoplasias do Sistema Digestório/diagnóstico
Imuno-Histoquímica/métodos
Patologia Cirúrgica/métodos
Oncologia Cirúrgica/métodos
[Mh] Termos MeSH secundário: Neoplasias do Sistema Biliar/diagnóstico
Neoplasias Gastrointestinais/diagnóstico
Seres Humanos
Neoplasias Hepáticas/diagnóstico
Neoplasias Pancreáticas/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Biomarkers, Tumor)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170831
[St] Status:MEDLINE
[do] DOI:10.5858/arpa.2016-0489-RA


  4 / 1587 MEDLINE  
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[PMID]:28686499
[Au] Autor:Farahani N; Liu Z; Jutt D; Fine JL
[Ti] Título:Pathologists' Computer-Assisted Diagnosis: A Mock-up of a Prototype Information System to Facilitate Automation of Pathology Sign-out.
[So] Source:Arch Pathol Lab Med;141(10):1413-1420, 2017 Oct.
[Is] ISSN:1543-2165
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:CONTEXT: - Pathologists' computer-assisted diagnosis (pCAD) is a proposed framework for alleviating challenges through the automation of their routine sign-out work. Currently, hypothetical pCAD is based on a triad of advanced image analysis, deep integration with heterogeneous information systems, and a concrete understanding of traditional pathology workflow. Prototyping is an established method for designing complex new computer systems such as pCAD. OBJECTIVE: - To describe, in detail, a prototype of pCAD for the sign-out of a breast cancer specimen. DESIGN: - Deidentified glass slides and data from breast cancer specimens were used. Slides were digitized into whole-slide images with an Aperio ScanScope XT, and screen captures were created by using vendor-provided software. The advanced workflow prototype was constructed by using PowerPoint software. RESULTS: - We modeled an interactive, computer-assisted workflow: pCAD previews whole-slide images in the context of integrated, disparate data and predefined diagnostic tasks and subtasks. Relevant regions of interest (ROIs) would be automatically identified and triaged by the computer. A pathologist's sign-out work would consist of an interactive review of important ROIs, driven by required diagnostic tasks. The interactive session would generate a pathology report automatically. CONCLUSIONS: - Using animations and real ROIs, the pCAD prototype demonstrates the hypothetical sign-out in a stepwise fashion, illustrating various interactions and explaining how steps can be automated. The file is publicly available and should be widely compatible. This mock-up is intended to spur discussion and to help usher in the next era of digitization for pathologists by providing desperately needed and long-awaited automation.
[Mh] Termos MeSH primário: Interpretação de Imagem Assistida por Computador/métodos
Patologia Cirúrgica/métodos
Fluxo de Trabalho
[Mh] Termos MeSH secundário: Neoplasias da Mama/diagnóstico
Feminino
Seres Humanos
Software
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171020
[Lr] Data última revisão:
171020
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170708
[St] Status:MEDLINE
[do] DOI:10.5858/arpa.2016-0214-OA


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[PMID]:28605400
[Au] Autor:Roma AA; Liu X; Patil DT; Xie H; Allende D
[Ad] Endereço:Department of Anatomic Pathology, University of California San Diego, San Diego, CA.
[Ti] Título:Proposed Terminology for Anal Squamous Lesions: Its Application and Interobserver Agreement Among Pathologists in Academic and Community Hospitals.
[So] Source:Am J Clin Pathol;148(1):81-90, 2017 Jul 01.
[Is] ISSN:1943-7722
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objectives: To analyze interobserver reproducibility and compare practice patterns between academic and community settings of Lower Anogenital Squamous Terminology (LAST). Methods: In total, 132 anal biopsy slides were revised as well as p16 immunostains. Results: LAST was used in 49% of cases (academic center, 68%; satellite hospitals [community practice setting], 32%). After pathology review and consensus interpretation, 23 (17%) case diagnoses were reclassified: eight (34.8%) cases (benign or low-grade squamous intraepithelial lesion [LSIL]) were upgraded to high-grade squamous intraepithelial lesion (HSIL) (p16 confirmed ordered during review); four (17.4%) cases originally classified as HSIL were downgraded to LSIL (p16 originally ordered in one case). There was no significant difference in discrepancies between original and consensus diagnosis in the community vs academic setting or by subspecialty (gynecological vs gastrointestinal). Overall interobserver agreement among reviewers was substantial (κ = 0.63) and improved with the use of p16 immunostain in challenging cases (κ = 0.71; P < .001). Conclusions: This new terminology is not yet uniformly used by pathologists in anal/perianal biopsy specimens; this two-tier system has a good interobserver agreement and is further improved with p16 use in appropriate cases.
[Mh] Termos MeSH primário: Neoplasias do Ânus/diagnóstico
Carcinoma de Células Escamosas/diagnóstico
Terminologia como Assunto
[Mh] Termos MeSH secundário: Neoplasias do Ânus/patologia
Biomarcadores Tumorais
Carcinoma de Células Escamosas/patologia
Hospitais Comunitários
Seres Humanos
Imuno-Histoquímica
Variações Dependentes do Observador
Patologistas
Patologia Cirúrgica
Padrões de Prática Médica
Reprodutibilidade dos Testes
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers, Tumor)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171009
[Lr] Data última revisão:
171009
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170613
[St] Status:MEDLINE
[do] DOI:10.1093/ajcp/aqx044


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[PMID]:28582484
[Au] Autor:Cloetingh D; Schmidt RA; Kong CS
[Ad] Endereço:Department of Pathology, Stanford University School of Medicine, Stanford, CA.
[Ti] Título:Comparison of Three Methods for Measuring Workload in Surgical Pathology and Cytopathology.
[So] Source:Am J Clin Pathol;148(1):16-22, 2017 Jul 01.
[Is] ISSN:1943-7722
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objectives: Pathologist workload in the United States has traditionally been measured by relative value units (RVUs), which is often criticized for providing an inaccurate estimate of actual work. This study compares three methods for measuring workload. Methods: Surgical pathology and cytopathology workload for 1 representative month at Stanford Health Care was assessed using three different methods: RVUs, Royal College of Pathologists (RCP) point system, and University of Washington-Seattle (UW) slide count method. Results: Pearson linear regression analysis showed a strong positive correlation of RVUs with the RCP (0.93, P < .01) and UW (0.86, P < .01) systems. The correlation between the RCP and UW systems was weaker (0.70, P = .05). The RCP system rated gastrointestinal, genitourinary, and breast workload lower than the RVU system while medical liver/renal and cytology were valued higher. The UW system overvalued breast workload. Conclusions: RCP is the most advanced and well-developed system for evaluating workload. It provides more weight for higher complexity specimens, while RVUs favor specialties with higher volume of small specimens, and slide counts favor specialties with extensively sampled large specimens.
[Mh] Termos MeSH primário: Eficiência Organizacional
Patologia Clínica
Patologia Cirúrgica
Carga de Trabalho
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171009
[Lr] Data última revisão:
171009
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170606
[St] Status:MEDLINE
[do] DOI:10.1093/ajcp/aqx022


  7 / 1587 MEDLINE  
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[PMID]:28557613
[Au] Autor:Stalsberg H; Adjei EK; Owusu-Afriyie O; Isaksen V
[Ad] Endereço:From the Department of Pathology, University of Tromsø (Dr Stalsberg), and the Department of Pathology, University Hospital of North Norway (Drs Stalsberg and Isaksen), Tromsø, Norway; and the Department of Pathology, Komfo Anokye Teaching Hospital, Kumasi, Ghana (Drs Adjei and Owusu-Afriyie).
[Ti] Título:Sustainable Development of Pathology in Sub-Saharan Africa: An Example From Ghana.
[So] Source:Arch Pathol Lab Med;141(11):1533-1539, 2017 Nov.
[Is] ISSN:1543-2165
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:CONTEXT: - Pathology services are poorly developed in Sub-Saharan Africa. Komfo Anokye Teaching Hospital in Kumasi, Ghana, asked for help from the pathology department of the University Hospital of North Norway, Tromsø. OBJECTIVE: - To reestablish surgical pathology and cytology in an African pathology department in which these functions had ceased completely, and to develop the department into a self-supporting unit of good international standard and with the capacity to train new pathologists. DESIGN: - Medical technologists from Kumasi were trained in histotechnology in Norway, they were returned to Kumasi, and they produced histologic slides that were temporarily sent to Norway for diagnosis. Two Ghanaian doctors received pathology training for 4 years in Norway. Mutual visits by pathologists and technologists from the 2 hospitals were arranged for the introduction of immunohistochemistry and cytology. Pathologists from Norway visited Kumasi for 1 month each year during 2007-2010. Microscopes and immunohistochemistry equipment were provided from Norway. Other laboratory equipment and a new building were provided by the Ghanaian hospital. RESULTS: - The Ghanaian hospital had a surgical pathology service from the first project year. At 11 years after the start of the project, the services included autopsy, surgical pathology, cytopathology, frozen sections, and limited use of immunohistochemistry, and the department had 10 residents at different levels of training. CONCLUSIONS: - A Ghanaian pathology department that performed autopsies only was developed into a self-supported department with surgical pathology, cytology, immunohistochemistry, and frozen section service, with an active residency program and the capacity for further development that is independent from assistance abroad.
[Mh] Termos MeSH primário: Fortalecimento Institucional
Pessoal de Laboratório Médico/educação
Modelos Econômicos
Modelos Educacionais
Serviço Hospitalar de Patologia/recursos humanos
Patologia Clínica/educação
Patologia Cirúrgica/educação
[Mh] Termos MeSH secundário: África ao Sul do Saara
Autopsia/economia
Autopsia/instrumentação
Autopsia/normas
Fortalecimento Institucional/economia
Técnicas Citológicas/economia
Técnicas Citológicas/instrumentação
Técnicas Citológicas/normas
Países em Desenvolvimento
Secções Congeladas/economia
Secções Congeladas/instrumentação
Secções Congeladas/normas
Gana
Custos Hospitalares
Hospitais de Ensino/economia
Hospitais de Ensino/recursos humanos
Hospitais Universitários
Seres Humanos
Imuno-Histoquímica/economia
Imuno-Histoquímica/instrumentação
Imuno-Histoquímica/normas
Internato e Residência/economia
Internato e Residência/recursos humanos
Internato e Residência/normas
Pessoal de Laboratório Médico/economia
Noruega
Serviço Hospitalar de Patologia/economia
Serviço Hospitalar de Patologia/normas
Patologia Clínica/economia
Patologia Clínica/recursos humanos
Patologia Clínica/normas
Patologia Cirúrgica/economia
Patologia Cirúrgica/recursos humanos
Patologia Cirúrgica/normas
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170531
[St] Status:MEDLINE
[do] DOI:10.5858/arpa.2016-0498-OA


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[PMID]:28447899
[Au] Autor:Wright JR
[Ad] Endereço:From the Department of Pathology & Laboratory Medicine and Pediatrics, University of Calgary, Alberta, Canada.
[Ti] Título:The American College of Surgeons, Minimum Standards for Hospitals, and the Provision of High-Quality Laboratory Services.
[So] Source:Arch Pathol Lab Med;141(5):704-717, 2017 May.
[Is] ISSN:1543-2165
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:CONTEXT: - The first major project of the American College of Surgeons (Chicago, Illinois), founded in 1913, was implementing Minimum Standards for Hospitals. The 1918 standard (1) established medical staff organizations in hospitals; (2) restricted membership to licensed practitioners in good standing; (3) mandated that the medical staff work with hospital administration to develop and adopt regulations and policies governing their professional work; (4) required standardized, accessible medical records; and (5) required availability of diagnostic and therapeutic facilities. One hundred years ago, these were radical expectations. OBJECTIVES: - To describe the origin, "marketing," and voluntary adoption of the 1918 standards, and to describe how the evolution of those standards profoundly affected laboratory medicine after 1926. DESIGN: - Available primary and secondary historical sources were reviewed. RESULTS: - The college had no legal mandate, so it used a highly consultative approach, funded by its membership and the Carnegie Foundation (New York, New York), to establish the Minimum Standards, followed by a nonthreatening mechanism to determine which hospitals met them. Simultaneously, the college educated the public to fuel their expectations. Compliance by more than 100-bed hospitals in the United States and Canada, although entirely voluntary, rose from negligible when first implemented in 1918 to more than 90% in only a few years. From 1922 to 1926, the American Society for Clinical Pathology (Chicago, Illinois) worked creatively with the college to establish Minimum Standards for "adequate" laboratory services. CONCLUSIONS: - The birth and implementation of this program exemplifies how a consultative approach with full engagement of grassroots stakeholders facilitated a voluntary, rapid, sweeping North America-wide change-management process. This program eventually evolved into the Joint Commission (Oakbrook Terrace, Illinois).
[Mh] Termos MeSH primário: Hospitais/história
Laboratórios/história
Patologia Clínica/história
Patologia Cirúrgica/história
[Mh] Termos MeSH secundário: American Medical Association
História do Século XX
Hospitais/normas
Seres Humanos
Laboratórios/normas
Estados Unidos
[Pt] Tipo de publicação:HISTORICAL ARTICLE; JOURNAL ARTICLE; PORTRAITS
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170811
[Lr] Data última revisão:
170811
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE
[do] DOI:10.5858/arpa.2016-0348-HP


  9 / 1587 MEDLINE  
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[PMID]:28395052
[Au] Autor:Khalifa MA; Salama S; Vogel RI; Klein ME; Richter J; Pulver T; Mullany SA; Winterhoff B
[Ad] Endereço:From the Department of Laboratory Medicine and Pathology.
[Ti] Título:Assessment of the Intraoperative Consultation Service Rendered by General Pathologists in a Scenario Where a Well-Defined Decision Algorithm Is Followed.
[So] Source:Am J Clin Pathol;147(3):322-326, 2017 Mar 01.
[Is] ISSN:1943-7722
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objectives: Intraoperative consultation (IOC) remains an area of general practice even within subspecialized pathology departments. This study assesses the IOCs rendered in a general pathology setting where surgeons integrate these results in a well-defined algorithm, developed with the input of specialized pathologists. Methods: The surgical decisions to perform lymphadenectomy in patients with endometrial adenocarcinoma operated on at our institution between January 2003 and June 2015 as a result of the IOC assessment of tumor size, histologic grade, and depth of invasion in the hysterectomy specimen were analyzed. Results: Frozen section (FS) was examined in 801 cases. In comparison to permanent section analysis, FS International Federation of Gynecology and Obstetrics (FIGO) grade had an overall accuracy of 0.95 (95% confidence interval [CI], 0.93-0.98). The FS depth of invasion had an overall accuracy of 0.92 (95% CI, 0.89-0.94). FIGO grade was not documented in 47.8%, the depth of myometrial invasion in 45.2%, and tumor size in 41.8% of the pathology reports. Conclusions: The high omission rate of the needed parameters by the general pathologists would question their overall understanding of the paradigm shift intended by this algorithm. Possible explanations of this phenomenon and potential solutions are discussed.
[Mh] Termos MeSH primário: Algoritmos
Cuidados Intraoperatórios/normas
Estadiamento de Neoplasias/normas
Patologia Cirúrgica/normas
[Mh] Termos MeSH secundário: Carcinoma Endometrioide/patologia
Carcinoma Endometrioide/cirurgia
Neoplasias do Endométrio/patologia
Neoplasias do Endométrio/cirurgia
Feminino
Secções Congeladas
Seres Humanos
Excisão de Linfonodo
Patologia Cirúrgica/métodos
Encaminhamento e Consulta/normas
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170414
[Lr] Data última revisão:
170414
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170411
[St] Status:MEDLINE
[do] DOI:10.1093/ajcp/aqw223


  10 / 1587 MEDLINE  
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[PMID]:28371845
[Au] Autor:Layfield LJ; Hammer RD; Frazier SR; Esebua M; Bivin WW; Laziuk K; Nguyen VT; Johannesen E; Schmidt RL
[Ad] Endereço:Department of Pathology and Anatomical Sciences, University of Missouri, Columbia.
[Ti] Título:Impact of Consensus Conference Review on Diagnostic Disagreements in the Evaluation of Cervical Biopsy Specimens.
[So] Source:Am J Clin Pathol;147(5):473-476, 2017 May 01.
[Is] ISSN:1943-7722
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objectives: To determine the impact of consensus conferences on the frequency of discrepant cases in a surgical pathology practice. Methods: The percentage of discrepancies in cases reviewed at a weekly consensus conference was calculated for the first and last months of a 13-month period. Both interrater agreement and agreement with the consensus diagnoses were assessed. A total of 309 diagnoses were performed for the first month and 518 for the last month. Both absolute and chance-corrected agreement were calculated for each period. Results: Absolute agreement rate increased from 91.2% in the first month to 98.2% in the final month. Chance-corrected agreement increased from 0.80 in the first month to 0.97 in the final month. Conclusions: The consensus conference technique appears to be a useful method to reduce intradepartmental diagnostic discrepancies. Both absolute and chance-corrected agreement are improved by using consensus conferences.
[Mh] Termos MeSH primário: Conferências de Consenso como Assunto
Patologia Cirúrgica/normas
Neoplasias do Colo do Útero/diagnóstico
[Mh] Termos MeSH secundário: Biópsia
Feminino
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170404
[St] Status:MEDLINE
[do] DOI:10.1093/ajcp/aqx024



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