Reducing false-negative and false-positive diagnoses in anatomic pathology consultation material

Area of Science:

• Anatomic Pathology
• Diagnostic Accuracy
• Interlaboratory Consultations

Background:

• Interlaboratory consultations are prone to diagnostic disagreements, resulting in false-negative and false-positive diagnoses.
• Methods to mitigate these diagnostic errors remain under-documented.

Purpose of the Study:

• To identify specific features associated with false-negative and false-positive diagnoses in anatomic pathology.
• To explore potential preventative measures for diagnostic errors.

Main Methods:

• A retrospective review of interlaboratory consultation cases over a 9-year period was conducted.
• Identified false-negative and false-positive cases were analyzed for potential preventative strategies.

Main Results:

• 10% of 8082 consultations showed disagreements, with 0.7% false-negative and 0.3% false-positive diagnoses.
• False-negative diagnoses were more prevalent in breast, genitourinary, hematologic, and cytology specimens.
• Immunohistochemistry and second reviews were identified as potential preventative measures for 44% of false-positive and 67% of false-negative cases, respectively.

Conclusions:

• Nearly 60% of diagnostic errors in interlaboratory consultations may be preventable.
• A combination of pathological methods, including immunohistochemistry and second reviews, can enhance diagnostic accuracy.