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Gastrointestinal Endoscopy Oct 2020
Topics: Biopsy, Needle; Humans; Pancreatic Cyst; Pathologists
PubMed: 32964846
DOI: 10.1016/j.gie.2020.06.020 -
Nederlands Tijdschrift Voor Geneeskunde Jul 2022For many patients the pathology report plays a key role in diagnosis and treatment planning. The report is traditionally addressed to the clinician and not to the...
For many patients the pathology report plays a key role in diagnosis and treatment planning. The report is traditionally addressed to the clinician and not to the patient. Although nowadays the patient can read the report, the complex content most often is incomprehensible to him/her. In an era of shared decision-making in which the patient must be fully informed, direct communication between patient and pathologist could be of added value for successful therapeutic management. Some successful initiatives have been reported. However, in the Netherlands direct interaction between the pathologist and the patient is still rare. This article is a plea to view the pathology report from a patient's perspective and to investigate how the communication of the content can be optimized. This article discusses possibilities for practical implementation, potential benefits and bottlenecks, as a basis for starting a discussion with practitioners, pathologists and patients in the Netherlands.
Topics: Communication; Female; Humans; Male; Netherlands; Pathologists
PubMed: 35899713
DOI: No ID Found -
Abdominal Radiology (New York) Nov 2019Evaluation of primary rectal cancer specimens places the pathologist in a unique position relative to peers, as it is one of the few specimens where the report... (Review)
Review
Evaluation of primary rectal cancer specimens places the pathologist in a unique position relative to peers, as it is one of the few specimens where the report influences not just patient outcomes but also the quality of the surgical technique itself. With ever-increasing data indicating that the completeness of the mesorectal excision and adequate resection margins are critical for reduced local recurrence rates and improved clinical outcome, the pathologist is faced with the challenge of implementing methods to optimize the evaluation of primary rectal cancers.
Topics: Humans; Neoplasm Recurrence, Local; Neoplasm Staging; Pathologists; Rectal Neoplasms
PubMed: 31327042
DOI: 10.1007/s00261-019-02134-9 -
Critical Reviews in Clinical Laboratory... Jun 2024No standard tool to measure pathologist workload currently exists. An accurate measure of workload is needed for determining the number of pathologists to be hired,... (Review)
Review
No standard tool to measure pathologist workload currently exists. An accurate measure of workload is needed for determining the number of pathologists to be hired, distributing the workload fairly among pathologists, and assessing the overall cost of pathology consults. Initially, simple tools such as counting cases or slides were used to give an estimate of the workload. More recently, multiple workload models, including relative value units (RVUs), the Royal College of Pathologists (RCP) point system, Level 4 Equivalent (L4E), Work2Quality (W2Q), and the University of Washington, Seattle (UW) slide count method, have been developed. There is no "ideal" model that is universally accepted. The main differences among the models come from the weights assigned to different specimen types, differential calculations for organs, and the capture of additional tasks needed for safe and timely patient care. Academic centers tend to see more complex cases that require extensive sampling and additional testing, while community-based and private laboratories deal more with biopsies. Additionally, some systems do not account for teaching, participation in multidisciplinary rounds, quality assurance activities, and medical oversight. A successful workload model needs to be continually updated to reflect the current state of practice.Awareness about physician burnout has gained attention in recent years and has been added to the World Health Organization's International Classification of Diseases (World Health Organization, WHO) as an occupational phenomenon. However, the extent to which this affects pathologists is not well understood. According to the WHO, burnout syndrome is diagnosed by the presence of three components: emotional exhaustion, depersonalization from one's work (cynicism related to one's job), and a low sense of personal achievement or accomplishment. Three drivers of burnout are the demand for productivity, lack of recognition, and electronic health records. Prominent consequences of physician burnout are economic and personal costs to the public and to the providers.Wellness is physical and mental well-being that allows individuals to manage stress effectively and to thrive in both their professional and personal lives. To achieve wellness, it is necessary to understand the root causes of burnout, including over-work and working under stressful conditions. Wellness is more than the absence of stress or burnout, and the responsibility of wellness should be shared by pathologists themselves, their healthcare organization, and governing bodies. Each pathologist needs to take their own path to achieve wellness.
Topics: Humans; Workload; Burnout, Professional; Pathologists
PubMed: 38809116
DOI: 10.1080/10408363.2023.2285284 -
Cancer Cytopathology Dec 2020
Topics: COVID-19; Humans; Interdisciplinary Communication; Interpersonal Relations; Pandemics; Pathologists; Pathology, Clinical; Physical Distancing; Referral and Consultation; SARS-CoV-2; Telepathology
PubMed: 33125190
DOI: 10.1002/cncy.22379 -
American Journal of Clinical Pathology Sep 2022The aim of this study was to assess expectations of performance that exist in the marketplace for entry-level pathologists' assistants (PathAs), defined as recent...
OBJECTIVES
The aim of this study was to assess expectations of performance that exist in the marketplace for entry-level pathologists' assistants (PathAs), defined as recent graduates of a pathologists' assistant program on their first day of employment.
METHODS
A voluntary, anonymous survey was distributed to pathologist and PathA members of the American Society for Clinical Pathology by email. We assessed 98 professional activities of PathAs using a 5-point scale of expectations based on levels of trust placed in them. We also collected demographic information.
RESULTS
A total of 728 participants responded to this survey, including 280 pathologists and 448 PathAs. We classified 98 activities according to expectations: independent performance (20/98), developing independence (48/98), and not expected of PathAs (5/98). Some activities (25/98) were indeterminate yet likely represent areas of developing independence.
CONCLUSIONS
This study demonstrates an expectation for entry-level PathAs to perform some activities included in the scope of practice independently but eventually to develop independent proficiency for most professional activities. A minority of activities were identified as responsibilities that are not expected of PathAs. Entry-level PathAs, therefore, remain "works in progress," with an expectation for independent performance of core activities while developing abilities in many areas of professional practice.
Topics: Humans; Motivation; Pathologists; Pathology, Clinical; Surveys and Questionnaires; United States
PubMed: 35760554
DOI: 10.1093/ajcp/aqac065 -
Archives of Pathology & Laboratory... Aug 2019Fatal dermatologic diseases and ones with high morbidity can occur in the inpatient setting. In such cases, prompt and accurate assessment of a bedside skin biopsy is... (Review)
Review
CONTEXT.—
Fatal dermatologic diseases and ones with high morbidity can occur in the inpatient setting. In such cases, prompt and accurate assessment of a bedside skin biopsy is required. This may be challenging for many pathologists who are not familiar with the complexity of skin pathology and skin terminology within the fields of dermatopathology and dermatology.
OBJECTIVE.—
To provide the pathologist with a practical, up-to-date, and "must-know" reference guide on dermatologic urgencies and emergencies from a real-world perspective, highlighting diagnostic pearls, diagnostic pitfalls, and commonly encountered practice gaps. This review will focus on key diseases with which every pathologist should be familiar, including angioinvasive fungal infections, Stevens-Johnson syndrome/toxic epidermal necrolysis, staph-scalded-skin syndrome, acute graft-versus-host disease, bullous pemphigoid, calciphylaxis, Sweet syndrome and its histiocytoid variant, pyoderma gangrenosum, and leukocytoclastic vasculitis, as well as those in their clinical and histopathologic differential.
DATA SOURCES.—
This review is based on peer-reviewed literature and our personal experiences with these diseases at major academic institutions, including one where a large number of stem cell transplants are performed. This review is unique as it represents collaborative expert opinion from both a dermatopathology and a dermatology standpoint.
CONCLUSIONS.—
This review outlines the critical role that the pathologist plays in the outcomes of patients with dermatologic urgencies and emergencies. Improved patient care will result from prompt and accurate histopathologic diagnoses as well as an open line of communication with the dermatologist.
Topics: Acute Disease; Biopsy; Dermatology; Graft vs Host Disease; Hematopoietic Stem Cell Transplantation; Humans; Pathologists; Pathology, Clinical; Skin; Skin Diseases
PubMed: 30785787
DOI: 10.5858/arpa.2018-0239-RA -
American Journal of Clinical Pathology Mar 2023Hirschsprung disease (HD) is a congenital condition defined by the absence of ganglion cells in the distal-most portion of the gastrointestinal tract. Biopsies and... (Review)
Review
OBJECTIVES
Hirschsprung disease (HD) is a congenital condition defined by the absence of ganglion cells in the distal-most portion of the gastrointestinal tract. Biopsies and resections for HD can be adrenaline inducing for the general surgical pathologist because specimens are infrequent; HD is 1 of only a few neuroanatomic diseases that general surgical pathologists diagnose; numerous preanalytic factors (eg, biopsy adequacy, surgeon sampling protocol, processing artifacts) can affect histologic interpretation; and most importantly, the diagnosis has high stakes.
METHODS
We provide a comprehensive overview of the background, relevant clinical procedures, and pathologic assessment of HD. Grossing and frozen section protocols, an algorithmic approach to diagnosis, and histologic pearls and pitfalls are also discussed.
RESULTS
Evaluation and recognition of the features of HD have evolved significantly in the past 2 decades with the discovery of the value of calretinin immunohistochemistry in the late 2000s and the recent development of straightforward and reproducible histologic criteria for identification of the HD transition zone.
CONCLUSIONS
These advancements have substantially improved the pathologist's ability to reliably evaluate for HD. Nonetheless, as with any high-stakes surgical pathology specimen, clear communication with the clinical team is essential.
Topics: Humans; Infant; Hirschsprung Disease; Pathologists; Rectum; Biopsy; Immunohistochemistry; Calbindin 2
PubMed: 36565211
DOI: 10.1093/ajcp/aqac141 -
Nature Communications Jan 2024Highly multiplexed protein imaging is emerging as a potent technique for analyzing protein distribution within cells and tissues in their native context. However,...
Highly multiplexed protein imaging is emerging as a potent technique for analyzing protein distribution within cells and tissues in their native context. However, existing cell annotation methods utilizing high-plex spatial proteomics data are resource intensive and necessitate iterative expert input, thereby constraining their scalability and practicality for extensive datasets. We introduce MAPS (Machine learning for Analysis of Proteomics in Spatial biology), a machine learning approach facilitating rapid and precise cell type identification with human-level accuracy from spatial proteomics data. Validated on multiple in-house and publicly available MIBI and CODEX datasets, MAPS outperforms current annotation techniques in terms of speed and accuracy, achieving pathologist-level precision even for typically challenging cell types, including tumor cells of immune origin. By democratizing rapidly deployable and scalable machine learning annotation, MAPS holds significant potential to expedite advances in tissue biology and disease comprehension.
Topics: Humans; Pathologists; Machine Learning; Diagnostic Imaging; Proteomics
PubMed: 38167832
DOI: 10.1038/s41467-023-44188-w -
Virchows Archiv : An International... Nov 2020The vast increase of technical, diagnostic, and treatment possibilities and deepened understanding of molecular biology has revolutionized diagnosis and treatment of...
The vast increase of technical, diagnostic, and treatment possibilities and deepened understanding of molecular biology has revolutionized diagnosis and treatment of cancer and thus has great impact on pathology. Different professionals are responsible for proper evaluation of the results and their translating into an accurate diagnosis and appropriate treatment. Next to expertise, a close interaction between clinical molecular biologists, pathologists, and oncologists is required; it is crucial that these professionals speak "the same language." Key to this is communication skills and creating possibilities for collaboration in a meaningful context. Here, we present an interprofessional, educational workshop model and we describe the parameters that contribute to effective learning by specialists.
Topics: Attitude of Health Personnel; Clinical Competence; Congresses as Topic; Cooperative Behavior; Education, Medical, Continuing; Humans; Inservice Training; Interprofessional Relations; Learning; Oncologists; Pathologists; Specialization; Staff Development
PubMed: 32270299
DOI: 10.1007/s00428-020-02803-x