Abstract
Head and Neck Pathology Consultation Trends: A Comprehensive Review of Data From 3 Years of Practice
Archives of pathology & laboratory medicine (1976), Vol.148(9), pp.E312-E312
09/01/2024
Abstract
Context: Intradepartmental consultations in surgical pathology are performed to improve diagnostic accuracy and clinical management. Analyzing consultation trends identifies challenging case types to pathologists with varying head and neck experience.
Design: We reviewed all intradepartmental consultations to 2 pathologists with head and neck subspecialty expertise in a 3-year period (January 2020 to December 2022) using a custom-built electronic system in Epic AP Beaker. Consults were categorized by level of expertise, anatomic site (n ¼ 16), preconsult diagnostic certainty level, and change to final diagnosis. We reviewed changes between preconsultation and postconsultation impressions and identified major discrepancies (defined as change in diagnostic category, eg, benign to malignant).
Results: In 567 cases and 607 consultations overall, nonexperts requested more consultations without initial diagnosis (P value ¼ .01) and consulted more frequently on thyroid cases (P value ¼.04). Expert-expert consultations frequently had no change in final diagnosis (P value ¼ .05) and occurred more frequently (P value ¼ .02) on salivary gland cases. Most anatomic sites had at least one major discrepancy (62.5%). Twenty-four major discrepancies (6.9%) were identified, with 87.5% of them in nonexpert consultations, predominantly from thyroid and squamous dysplasia.
Conclusions: Thyroid, salivary gland, and squamous dysplasia were frequently received in consultation without an initial diagnosis. Changes in the final diagnosis following consultation in thyroid cases were most likely to significantly affect patient care, and these specimens benefit from availability in expertise. However, the potential for a major change in final diagnosis following consultation exists in many other head and neck anatomic sites. An electronic consultation record is rich for quality improvement data.
Details
- Title: Subtitle
- Head and Neck Pathology Consultation Trends: A Comprehensive Review of Data From 3 Years of Practice
- Creators
- Allen ChoiAnand RajanRobert Robinson
- Resource Type
- Abstract
- Publication Details
- Archives of pathology & laboratory medicine (1976), Vol.148(9), pp.E312-E312
- Publisher
- College of American Pathologists
- ISSN
- 0003-9985
- eISSN
- 1543-2165
- Comment
- Abstracts and Case Studies From the College of American Pathologists 2024 Annual Meeting (CAP24). Arch Pathol Lab Med 1 September 2024; 148 (9): e171–e334. doi: https://doi.org/10.5858/arpa.2024-0225-AB
- Language
- English
- Date published
- 09/01/2024
- Academic Unit
- Pathology; Surgery; Oral Pathology, Radiology and Medicine
- Record Identifier
- 9984721135902771
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