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Intraoperative pathology consultation: error, cause and impact.

Etienne Mahe¹, Shamim Ara, Mona Bishara

¹Hamilton Regional Laboratory Medicine Programme, Department of Pathology & Molecular Medicine, McMaster University, Hamilton, Ont., Canada. etienne.mahe@medportal.ca

Canadian Journal of Surgery. Journal Canadien De Chirurgie

|May 28, 2013

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Frozen section diagnoses show high accuracy, with only 3% of cases having discordant diagnoses. This quality assurance study confirms the reliability of frozen section analysis in surgical pathology, comparable to established literature rates.

Area of Science:

Surgical Pathology
Diagnostic Accuracy
Quality Assurance in Medicine

Background:

Intraoperative frozen section diagnosis is crucial for quality assurance.
Accurate correlation between frozen and final diagnoses is essential for patient care.

Purpose of the Study:

To evaluate the accuracy of frozen section diagnoses.
To assess the impact of discordant diagnoses on clinical management.

Main Methods:

A quality assurance review of 1207 frozen sections from 812 surgical cases.
Analysis of discordant cases using multiheaded microscopy for consensus.
Review of clinical records for adverse impacts on management.

Main Results:

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28 frozen sections (3%) were deferred.

24 discordant diagnoses (3% of cases, 2% of specimens) were identified.

Nervous system, head and neck, and lung specimens showed highest discordance rates.

Diagnostic misinterpretation was the primary cause of errors.

Potential adverse impact on clinical management occurred in 14 cases.

Conclusions:

The study provides Canadian data on frozen section accuracy.
Concordance rates are comparable to existing literature.
Frozen section diagnosis is a reliable tool in surgical pathology.