Diagnostic 'Errors' in a Single Urogenital Pathology Unit

Abstract

To understand better the factors that contribute to diagnostic errors in urogenital pathology units, as part of our ongoing research into urogenital cancers, from a consecutive series of 6304 histologic reports for the years 2003 to 2006 we selected for review those containing more than one evident error. We reviewed 1746 urogenital histopathologic diag- noses, 1459 (83.56%) referred to biopsies and 287 (16.43%) to surgical specimens. Of the 1746 reports reviewed, 1643 diagnoses (94.10%) were in agreement and 103 (5.89%) in disagreement with the reviewer's rating. Among these 103 di- agnoses, 77 (70.75%) had justifiable and 27 (26.21%) unjustifiable discordances. Of these 27 discordances, 23 were un- justifiable discordances containing errors with consequences that affected patient management. The poor diagnostic effi- ciency found in a single anatomopathological unit raises concern and suggests considerable room for improvement. Effi- ciency could be substantially improved if pathological services strictly applied the existing international measures for quality control.