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Improved cytodiagnostics and quality of patient care through double reading of selected cases by an expert cytopathologist

Double reading may be a valuable tool for improving the quality of patient care by restoring diagnostic errors before final sign-out, but standard double reading would significantly increase costs of pathology. The aim of this study was to assess the added value of routine double reading of defined...

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Autores principales: Kuijpers, Chantal C. H. J., Visser, Mike, Sie-Go, Daisy M. D. S., de Leeuw, Henk, de Rooij, Mathilda J., van Diest, Paul J., Jiwa, Mehdi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4460278/
https://www.ncbi.nlm.nih.gov/pubmed/25775953
http://dx.doi.org/10.1007/s00428-015-1738-3
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author Kuijpers, Chantal C. H. J.
Visser, Mike
Sie-Go, Daisy M. D. S.
de Leeuw, Henk
de Rooij, Mathilda J.
van Diest, Paul J.
Jiwa, Mehdi
author_facet Kuijpers, Chantal C. H. J.
Visser, Mike
Sie-Go, Daisy M. D. S.
de Leeuw, Henk
de Rooij, Mathilda J.
van Diest, Paul J.
Jiwa, Mehdi
author_sort Kuijpers, Chantal C. H. J.
collection PubMed
description Double reading may be a valuable tool for improving the quality of patient care by restoring diagnostic errors before final sign-out, but standard double reading would significantly increase costs of pathology. The aim of this study was to assess the added value of routine double reading of defined categories of clinical cytology specimens by specialized cytopathologists. Specialized cytopathologists routinely re-diagnosed blinded defined categories of clinical cytology specimens that had been signed out by routine pathologists from January 2012 up to December 2013. Major and minor discordance rates between initial and expert diagnoses were determined, and both diagnoses were validated by comparison with same-site histological follow-up. Initial and expert diagnoses were concordant in 131/218 specimens (60.1 %). Major and minor discordances were present in 28 (12.8 %) and 59 (27.1 %) specimens, respectively. Pleural fluid, thyroid and urine specimens showed the highest major discordance rates (19.4, 19.2 and 16.7 %, respectively). Histological follow-up (where possible) supported the expert diagnosis in 95.5 % of specimens. Our implemented double reading strategy of defined categories of cytology specimens showed major discordance in 12.8 % of specimens. The expert diagnosis was supported in 95.5 % of discordant cases where histological follow-up was available. This indicates that this double reading strategy is worthwhile and contributes to better cytodiagnostics and quality of patient care, especially for suspicious pleural fluid, thyroid and urine specimens. Our results emphasize that cytopathology is a subspecialization of pathology and requires specialized cytopathologists.
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spelling pubmed-44602782015-06-12 Improved cytodiagnostics and quality of patient care through double reading of selected cases by an expert cytopathologist Kuijpers, Chantal C. H. J. Visser, Mike Sie-Go, Daisy M. D. S. de Leeuw, Henk de Rooij, Mathilda J. van Diest, Paul J. Jiwa, Mehdi Virchows Arch Original Article Double reading may be a valuable tool for improving the quality of patient care by restoring diagnostic errors before final sign-out, but standard double reading would significantly increase costs of pathology. The aim of this study was to assess the added value of routine double reading of defined categories of clinical cytology specimens by specialized cytopathologists. Specialized cytopathologists routinely re-diagnosed blinded defined categories of clinical cytology specimens that had been signed out by routine pathologists from January 2012 up to December 2013. Major and minor discordance rates between initial and expert diagnoses were determined, and both diagnoses were validated by comparison with same-site histological follow-up. Initial and expert diagnoses were concordant in 131/218 specimens (60.1 %). Major and minor discordances were present in 28 (12.8 %) and 59 (27.1 %) specimens, respectively. Pleural fluid, thyroid and urine specimens showed the highest major discordance rates (19.4, 19.2 and 16.7 %, respectively). Histological follow-up (where possible) supported the expert diagnosis in 95.5 % of specimens. Our implemented double reading strategy of defined categories of cytology specimens showed major discordance in 12.8 % of specimens. The expert diagnosis was supported in 95.5 % of discordant cases where histological follow-up was available. This indicates that this double reading strategy is worthwhile and contributes to better cytodiagnostics and quality of patient care, especially for suspicious pleural fluid, thyroid and urine specimens. Our results emphasize that cytopathology is a subspecialization of pathology and requires specialized cytopathologists. Springer Berlin Heidelberg 2015-03-17 2015 /pmc/articles/PMC4460278/ /pubmed/25775953 http://dx.doi.org/10.1007/s00428-015-1738-3 Text en © The Author(s) 2015 https://creativecommons.org/licenses/by/4.0/ Open Access This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
spellingShingle Original Article
Kuijpers, Chantal C. H. J.
Visser, Mike
Sie-Go, Daisy M. D. S.
de Leeuw, Henk
de Rooij, Mathilda J.
van Diest, Paul J.
Jiwa, Mehdi
Improved cytodiagnostics and quality of patient care through double reading of selected cases by an expert cytopathologist
title Improved cytodiagnostics and quality of patient care through double reading of selected cases by an expert cytopathologist
title_full Improved cytodiagnostics and quality of patient care through double reading of selected cases by an expert cytopathologist
title_fullStr Improved cytodiagnostics and quality of patient care through double reading of selected cases by an expert cytopathologist
title_full_unstemmed Improved cytodiagnostics and quality of patient care through double reading of selected cases by an expert cytopathologist
title_short Improved cytodiagnostics and quality of patient care through double reading of selected cases by an expert cytopathologist
title_sort improved cytodiagnostics and quality of patient care through double reading of selected cases by an expert cytopathologist
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4460278/
https://www.ncbi.nlm.nih.gov/pubmed/25775953
http://dx.doi.org/10.1007/s00428-015-1738-3
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