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Related Experiment Videos

Classification of error in anatomic pathology: a proposal for an evidence-based standard.

Elliott Foucar1

  • 1Foucell@aol.com

Seminars in Diagnostic Pathology
|April 28, 2006
PubMed
Summary

Applying a disease model to anatomic pathology errors requires a clear taxonomy. This approach helps differentiate error types, like knowledge-based interpretative errors, for effective prevention strategies.

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Area of Science:

  • Pathology
  • Medical Error Analysis
  • Diagnostic Science

Background:

  • Error in anatomic pathology (EAP) is a complex issue, often addressed without a clear understanding of its pathogenesis.
  • Historical approaches to medical and diagnostic errors have sometimes been ineffective or harmful, akin to 'bleeding and purging' or 'blaming and shaming'.

Purpose of the Study:

  • To propose a theoretically-sound taxonomic system for classifying errors in anatomic pathology.
  • To enable evidence-based categorization of individual EAP cases.
  • To distinguish between individual, small system, and large system factors contributing to diagnostic errors.

Main Methods:

  • Analogy to the medical disease model for understanding EAP.
  • Development of a valid taxonomy to group abnormalities by pathogenesis.

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  • Parsing the broad concept of 'error' into meaningful subcategories.

    • Main Results:

    • A proposed taxonomic system for classifying EAP.
    • Distinction between knowledge-based interpretative (KBI) errors and other error types (e.g., human lapses).
    • Identification of the need to differentiate individual, small system, and large system error sources.

    Conclusions:

    • A robust taxonomy is the first step in addressing EAP using a disease model.
    • Effective EAP countermeasures require understanding error pathogenesis and distinguishing error types and sources.
    • The pathology specialty group must lead the initiative for recognizing the need and implementing EAP countermeasures.