Correlation of workload with disagreement and amendment rates in surgical pathology and nongynecologic cytology

In gynecologic cytology, workload limits are imposed as a surrogate to limit error rates. Whether workload correlates with error rates in surgical pathology and nongynecologic cytology is not known. We reviewed and compared the disagreement and amendment rates based on blinded review for 5 pathologists with the number of cases reviewed during that same period. A total of 2,659 general surgical pathology and nongynecologic cytology cases underwent blinded review. There were 105 disagreements identified and 28 amendments issued. Workload varied from 455 to 649 cases per month. Neither the disagreement nor the amendment rate correlated with total workload during the period of the study (Pearson rank correlation r = 0.58 and 0.12, respectively). There is no correlation between workload and disagreement or amendment rates. Workload seems to be a poor surrogate for error rates in the range of workload examined in this study. Such data suggest that workload limits would have no effect at limiting or reducing error rates in surgical pathology or nongynecologic cytology.