Pathologists Should Retain Their Individuality!

Medline, Paul B.

doi:10.1097/00000478-200011000-00018

Cited by 7 publications

(2 citation statements)

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“…‘Individuality’ in pathology has been raised previously 17. Interestingly, some support the notion that individuality is good for pathology 18, whereas others counter this, stressing that individuality has to be a potential source of error in pathology 19. Where we feel this needs real reconciliation is in defining standards for teaching and training in diagnostic pathology, where clear diagnostic processes need to be communicated to young trainee/resident pathologists.…”

Section: Variation and Individuality In Pathologymentioning

confidence: 99%

Do we see what we think we see? The complexities of morphological assessment

Hamilton

Diest

Williams

et al. 2009

The Journal of Pathology

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Reliable pathological interpretation is vital to so many aspects of tissue-based research as well as being central to patient care. Understanding the complex processes involved in decision-making is the starting point to improve both diagnostic reproducibility and the definition of diagnostic groups that underpin our experiments. Unfortunately, there is a paucity of research in this field and it is encouraging to see The Journal of Pathology publishing work in this area. This review attempts to highlight the opportunities that exist in this field and the technologies that are now available to support this type of research. Key amongst these are the use of decision analysis tools such as inference networks, and virtual microscopy that allows us to simulate diagnostic decision-making. These tools have roles, not only in studying the subtleties of diagnostic decision-making, but also in delivering new methods of training and proficiency testing. Research which helps us to better understand what we see, why we see it, and standardizing interpretative reasoning in pathological classification is essential for improving the wide range of activities that pathologists support, including clinical diagnosis, teaching, training, and experimental research.

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Section: Variation and Individuality In Pathologymentioning

confidence: 99%

Do we see what we think we see? The complexities of morphological assessment

Hamilton

Diest

Williams

et al. 2009

The Journal of Pathology

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“…91 Furthermore, although it does not seem to be a controversial position that our immunoperoxidase staining techniques should be standardized, 92,93 suppressing our diagnostic creative urges is a surprisingly controversial topic. [94][95][96][97][98] Finally, it must be admitted that no matter how much attention is directed at preventing error, errors will continue to occur. An Albuquerque pathologist summed up this dilemma when he concluded after reviewing a diagnostic error that "what I learned from this case is that I should not have come to work that day.…”

Section: What Are the Main Barriers To Error-free Medicine?mentioning

confidence: 99%

Error in Anatomic Pathology

Foucar

2001

Pathology Patterns Reviews

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Error in anatomic pathology is a topic that is currently making the difficult transition from a problem peculiar to a subset of poorly trained or otherwise inadequate pathologists to a problem shared by the specialty of pathology. This transition will involve a number of difficult steps, including sorting error from both inherent diagnostic uncertainty andfrom variations in practice patterns from which no evidence-based best practice has emerged. Identification of error will require scientifically valid diagnostic gold standards, and in those areas of diagnosis without such a standard, the identification of and response to error will continue to be heavily influenced by hindsight bias and subjective opinion. The pathologist, like other physicians, has limited options to "make things right" following a significant error The silver lining is that many errors have the potential to prompt changes that will prevent future patient harm. Unfortunately, a dysfunctional legal system that values punishment and transfer of assets over future improvements in health care has wrung much of the positive potential out of error, leaving only the damaged patient and damaged pathologist.

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Standardized categorical reporting of cytopathology results

Grapsa¹,

Politi²

2013

Diagnostic Cytopathology

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Since the success of the Bethesda nomenclature system in standardizing Pap smear results, there has been growing interest in adopting Bethesda-like standardized categorical formats in areas of nongynecologic cytopathology. Standardized categorical reporting may have several advantages over descriptive reporting, in enhancing cytopathologist-clinician communication and inter-institutional exchange of information, providing better guidance for treatment planning, and facilitating statistical analysis for research purposes or quality control studies. On the other hand, descriptive reporting may be more effective as a tool of communication between cytopathologists, may better express the uncertainty of the observer in diagnostically difficult and equivocal cases and may better serve the purposes of training and continuing education of cytopathologists. Future studies on the pros and cons of the different reporting systems used in cytopathology may provide further insight on these issues. The most problematic areas need to be identified and optimal solutions decided. Despite the ongoing debate on the optimal reporting format in cytopathology, there is general agreement on the need for high quality cytology reports (whether descriptive or standardized) in terms of their diagnostic accuracy, clarity and clinical value.

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Pathologists Should Retain Their Individuality!

Cited by 7 publications

References 0 publications

Do we see what we think we see? The complexities of morphological assessment

Do we see what we think we see? The complexities of morphological assessment

Error in Anatomic Pathology

Standardized categorical reporting of cytopathology results

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