Quality in Cancer Diagnosis
Quality in Cancer Diagnosis
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DOI：
10.3322/caac.20068
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发表时间：
2010-05-01
影响因子：
254.7
通讯作者：
Grzybicki, Dana M.
中科院分区：
文献类型：
--
作者：
Raab, Stephen S.;Grzybicki, Dana M.
提高肿瘤病理学诊断的质量是极其重要的，因为在2010年将被诊断为癌症的大约160万患者中的绝大多数是通过对组织样本的病理解释来确定诊断的。数以百万计的患者获得了组织样本，以排除癌症和没有癌症。大多数关于肿瘤病理学诊断质量的研究都集中在患者的安全性上，并记录了在诊断测试的临床和病理实验室测试阶段发生的各种错误原因。肿瘤病理学诊断错误的报告频率取决于几个因素，如定义和检测方法，范围从1%到15%。大多数诊断错误不会造成严重损害，尽管高达50%的错误会以附加测试或诊断延迟的形式造成轻微到中度的损害。临床医生通过有效的测试排序、提供准确和中肯的临床信息、获取高质量的标本、及时跟踪测试结果、就潜在的不一致诊断进行有效沟通，以及在特定情况下倡导对病理诊断的第二意见等途径，在减少差错方面发挥了重要作用。《加州癌症杂志》，2010；60：139-165。(C)2010年美国癌症协会。
Improving the quality of oncologic pathology diagnosis is immensely important as the overwhelming majority of the approximately 1.6 million patients who will be diagnosed with cancer in 2010 have their diagnoses established through the pathologic interpretation of a tissue sample. Millions more patients have tissue samples obtained to rule out cancer and do not have cancer. The majority of studies on the quality of oncologic pathology diagnoses have focused on patient safety and have documented a variety of causes of error that occur in the clinical and pathology laboratory testing phases of diagnostic testing. The reported frequency of a diagnostic error made by oncologic pathology depends on several factors, such as definitions and detection methods, and ranges from 1% to 15%. The large majority of diagnostic errors do not result in severe harm, although mild to moderate harm in the form of additional testing or diagnostic delays occurs in up to 50% of errors. Clinical practitioners play an essential role in error reduction through several avenues such as effective test ordering, providing accurate and pertinent clinical information, procuring high-quality specimens, providing timely follow-up on test results, effectively communicating on potentially discrepant diagnoses, and advocating second opinions on the pathology diagnosis in specific situations. CA Cancer J Clin 2010;60:139-165. (c) 2010 American Cancer Society, Inc.