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Why won’t the pathologist give me a diagnosis? Interpreting uncertainty in head and neck pathology reports

  • I.S. Stephens-LaBorde
    Correspondence
    Corresponding author. Fax: +44 0114 2717894.
    Affiliations
    Unit of Oral and Maxillofacial Pathology, Floor E, The School of Clinical Dentistry, University of Sheffield, 19 Claremont Crescent, Sheffield S10 2TA, United Kingdom
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  • D.J Brierley
    Affiliations
    Unit of Oral and Maxillofacial Pathology, Floor E, The School of Clinical Dentistry, University of Sheffield, 19 Claremont Crescent, Sheffield S10 2TA, United Kingdom
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Published:October 26, 2021DOI:https://doi.org/10.1016/j.bjoms.2021.10.009

      Abstract

      Pathology reports often contain elements of uncertainty, and communication between clinicians and pathologists is paramount for providing the best patient care. Surveys were given to pathology service-users and pathologists to ascertain confidence levels regarding certain phrases used in pathology reports. A focus group then met with pathologists to gain insight into why certain phrases are used and the challenges that are faced in presenting an uncertain diagnosis. Whilst most of the phrases were interpreted similarly between service-users and pathologists, some elicited more variation in confidence than others, suggesting that the message conveyed in pathology reports is not always interpreted the way it is intended to be.

      Keywords

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      References

        • Bracamonte E.
        • Gibson B.A.
        • Klein R.
        • et al.
        Communicating uncertainty in surgical pathology reports: a survey of staff physicians and residents at an academic medical center.
        Acad Pathol. 2016; 3 (2374289516659079)
        • Mullin M.H.
        • Brierley D.J.
        • Speight P.M.
        Second opinion reporting in head and neck pathology: the pattern of referrals and impact on final diagnosis.
        Oral Surg Oral Med Oral Pathol Oral Radiol. 2015; 119: 656-660
        • Galloway M.
        • Taiyeb T.
        The interpretation of phrases used to describe uncertainty in pathology reports.
        Patholog Res Int. 2011; 2011656079
        • Lindley S.W.
        • Gillies E.M.
        • Hassell L.A.
        Communicating diagnostic uncertainty in surgical pathology reports: disparities between sender and receiver.
        Pathol Res Pract. 2014; 210: 628-633
        • Idowu M.O.
        • Wiles A.
        • Wan W.
        • et al.
        Equivocal or ambiguous terminologies in pathology: focus of continuous quality improvement?.
        Am J Surg Pathol. 2013; 37: 1722-1727
        • Brierley D.J.
        • Farthing P.M.
        • Zijlstra-Shaw S.
        How consultants determine diagnostic competence in histopathology trainees.
        J Clin Pathol. 2019; 72: 622-629
      1. Cancer datasets and tissue pathways. The Royal College of Pathologists. Available from URL: https://www.rcpath.org/profession/guidelines/cancer-datasets-and-tissue-pathways.html# (last accessed 3 January 2022).