Journal article
Clinical impact and frequency of anatomic pathology errors in cancer diagnoses
Cancer, Vol.104(10), pp.2205-2213
2005
DOI: 10.1002/cncr.21431
PMID: 16216029
Abstract
Background: To the authors' knowledge, the frequency and clinical impact of errors in the anatomic pathology diagnosis of cancer have been poorly characterized to date.
Methods: The authors examined errors in patients who underwent anatomic pathology tests to determine the presence or absence of cancer or precancerous lesions in four hospitals. They analyzed 1 year of retrospective errors detected through a standardized cytologic-histologic correlation process (in which patient same-site cytologic and histologic specimens were compared). Medical record reviews were performed to determine patient outcomes. The authors also measured the institutional frequency, cause (i.e., pathologist interpretation or sampling), and clinical impact of diagnostic cancer errors.
Results: The frequency of errors in cancer diagnosis was found to be dependent on the institution (P < 0.001) and ranged from 1.79-9.42% and from 4.87-11.8% of all correlated gynecologic and nongynecologic cases, respectively. A statistically significant association was found between institution and error cause (P < 0.001); the cause of errors resulting from pathologic misinterpretation ranged from 5.0-50.7% (the remainder were due to clinical sampling). A statistically significant association was found between institution and assignment of the clinical impact of error (P < 0.001); the aggregated data demonstrated that for gynecologic and nongynecologic errors, 45% and 39%, respectively, were associated with harm. The pairwise kappa statistic for interobserver agreement on cause of error ranged from 0.118-0.737.
Conclusions: Errors in cancer diagnosis are reported to occur in up to 11.8% of all reviewed cytologic-histologic specimen pairs. To the authors' knowledge, little agreement exists regarding whether pathology errors are secondary to misinterpretation or poor clinical sampling of tissues and whether pathology errors result in serious harm.
Details
- Title: Subtitle
- Clinical impact and frequency of anatomic pathology errors in cancer diagnoses
- Creators
- Stephen S Raab - University of PittsburghDana Marie Grzybicki - University of PittsburghJanine E Janosky - University of PittsburghRichard J Zarbo - Henry Ford Health SystemFrederick A Meier - Henry Ford Health SystemChris Jensen - University of IowaStanley J Geyer - Pennsylvania Hospital
- Resource Type
- Journal article
- Publication Details
- Cancer, Vol.104(10), pp.2205-2213
- DOI
- 10.1002/cncr.21431
- PMID
- 16216029
- NLM abbreviation
- Cancer
- ISSN
- 0008-543X
- eISSN
- 1097-0142
- Publisher
- Wiley-Liss
- Language
- English
- Date published
- 2005
- Academic Unit
- Pathology
- Record Identifier
- 9984186505802771
Metrics
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