Abstract and Introduction
Abstract
In many departments, some cases are reviewed routinely by a second pathologist within the same department before sign-out. The value of this practice is not known. We reviewed and compared the disagreement and amendment rates for cases reviewed by 1 or more pathologists based on the results of blinded review.
A total of 8,363 cases underwent blinded review, and of these, 1,087 (13.0%) were reviewed by more than 1 pathologist before sign-out. The disagreement rate for cases reviewed by more than 1 pathologist (4.8%) was significantly lower than for cases reviewed by only 1 pathologist (6.9%; P = .004). The amendment rate decreased to 0.0% from 0.5%, but this decrease was not statistically significant (P = .12).
Review of material by a second pathologist before sign-out is associated with a lower disagreement rate. These results suggest second review of surgical pathology is of value, but the best selection of cases to be reviewed remains to be defined.
Introduction
Diagnostic accuracy is crucial in anatomic pathology, including surgical pathology and cytopathology, and remains a subject of considerable research interest. A mainstay of measuring accuracy is the review of material by a second observer. Indeed, many pathologists and pathology organizations recommend review of outside material before undertaking procedures within their own institutions. In addition, many institutions routinely review specific material a second time, most commonly material with a diagnosis of malignancy, before making an official diagnosis.
Nevertheless, although specific information concerning the value of interdepartmental consultation is available, information concerning the value of intradepartmental second review is limited. To address this, we compared the disagreement and error rates of cases that had been reviewed by only 1 pathologist or more than 1 pathologist.