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The Journal of Toxicological Sciences May 1998A histopathology peer review already has become an integral part of industrial toxicologic pathology in the USA and Europe. Nevertheless, the review is unfamiliar to... (Review)
Review
A histopathology peer review already has become an integral part of industrial toxicologic pathology in the USA and Europe. Nevertheless, the review is unfamiliar to toxicologic pathologists in Japan. This report provides detailed information on convenient, useful procedures for peer review in toxicologic histopathology and describes its necessity and type. Histopathology peer review is either informal or formal. Formal review means that the target organs to be re-estimated and the reviewing pathologist's name are stated somewhere in a protocol or study report. The resolution of all diagnostic discrepancies between studies and reviewing pathologists must be clarified, and the review records need to be preserved. No audit trials need to be kept for informal peer review. Based on the purpose of the review, histopathology peer reviews may be classified into 3 major types: "complete", "problem-solving", and a "quality-monitoring" reviews. For a "Complete" review, all histopathologic findings crucial to the conclusion of the study are re-examined. A "problem-solving" review serves to re-evaluate anomalous findings. A "quality-monitoring" review is a periodical monitor of the quality of histopathologic diagnoses at pathology laboratories, particularly in toxicology contract research organizations. The procedures for histopathology peer review consist of 5 stages. At the first stage, the target organs to be reviewed are selected from the draft summary tables of the original findings diagnosed by the study pathologist, and the reviewing pathologist evaluates all selected organs. At the second stage, the study pathologist re-examines all the findings with diagnoses not accepted by the reviewing pathologist and re-considers the appropriateness of these original diagnoses. At the third stage, the study pathologist and the reviewing pathologists discuss all diagnostic differences until they reach a consensus opinion. At the fourth stage, the whole process (stage 1 to 3) of peer review of all target organs is tabulated, including the study pathologist's and reviewing pathologist's diagnoses, the study pathologist's opinions, and consensus diagnoses. At the fifth stage, Peer Review Certification is issued with the study pathologists' and reviewing pathologists' signatures. The reviewing pathologist must share the responsibility for the final diagnoses with the study pathologist. In order to gain greater credibility from regulatory agencies, a peer review performance is best made by an independent external pathologist.
Topics: Humans; Pathology; Peer Review; Toxicology
PubMed: 9617732
DOI: 10.2131/jts.23.supplementi_1 -
Clinics in Laboratory Medicine Mar 2018Like in all areas of science, it is important for funders and investigators of pathology to work together to develop a well-designed, well-executed clinical research... (Review)
Review
Like in all areas of science, it is important for funders and investigators of pathology to work together to develop a well-designed, well-executed clinical research agenda. In the first section of this article, the authors discuss how the National Institutes of Health (NIH) peer-review process applies to global health pathology research projects. Then, the authors present an illustrative sampling of NIH-funded projects with performance sites in low- and middle-income countries with 2 examples focused on cancer and anatomic pathology. Finally, the authors relate the research agenda to overarching strategic recommendations for enhancing global pathology.
Topics: Biomedical Research; Global Health; Humans; National Institutes of Health (U.S.); Neoplasms; Pathologists; Pathology; United States
PubMed: 29412883
DOI: 10.1016/j.cll.2017.10.003 -
Pathologie (Heidelberg, Germany) Sep 2022Accreditation in pathology and neuropathology in Germany is based on the requirements of the DIN EN ISO/IEC 17020 standard, which defines general requirements for the... (Review)
Review
Accreditation in pathology and neuropathology in Germany is based on the requirements of the DIN EN ISO/IEC 17020 standard, which defines general requirements for the bodies performing inspections. In Germany, the national accreditation body of the Federal Republic of Germany (DAkkS) assumes the official task of accreditation. Evaluation in this area is based on a comprehensive assessment by board-certified pathologists (inspection) and is focused on correct diagnosis. The requirement of the DIN EN ISO 15189 standard on quality and competence in medical laboratories is taken into account. In Germany, more than 100 institutes of pathology and neuropathology have successfully performed the accreditation process. Interest in accreditation has been significantly growing in recent months, especially due to changes in the European law with the "Verordnung EO 2017/746 des Europäischen Parlaments und des Rates vom 05. April 2017 über Invitro-Diagnostica".However, accreditation is a demanding process that requires very good preparation. Necessary resources for accreditation should be secured before starting the process. Important framework conditions and requirements, but also some challenges that can arise during the accreditation process, are summarized in this article.
Topics: Academies and Institutes; Accreditation; Certification; Germany; Neuropathology
PubMed: 35925314
DOI: 10.1007/s00292-022-01097-x -
American Journal of Clinical Pathology Oct 2011Mass spectrometry is an analytic technique with high specificity and a growing presence in laboratory medicine. Various types of mass spectrometers are being used in an... (Review)
Review
Mass spectrometry is an analytic technique with high specificity and a growing presence in laboratory medicine. Various types of mass spectrometers are being used in an increasing number of clinical laboratories around the world, and, as a result, significant improvements in assay performance are occurring rapidly in areas such as toxicology, endocrinology, and biochemical genetics. This review serves as a basic introduction to mass spectrometry, its uses, and associated challenges in the clinical laboratory and ends with a brief discussion of newer methods with the greatest potential for clinical diagnostics.
Topics: Humans; Laboratories; Mass Spectrometry; Pathology, Clinical
PubMed: 21917684
DOI: 10.1309/AJCPW0TA8OBBNGCK -
Journal of Medical Internet Research Apr 2023There is increasing interest in the use of artificial intelligence (AI) in pathology to increase accuracy and efficiency. To date, studies of clinicians' perceptions of... (Review)
Review
BACKGROUND
There is increasing interest in the use of artificial intelligence (AI) in pathology to increase accuracy and efficiency. To date, studies of clinicians' perceptions of AI have found only moderate acceptability, suggesting the need for further research regarding how to integrate it into clinical practice.
OBJECTIVE
The aim of the study was to determine contextual factors that may support or constrain the uptake of AI in pathology.
METHODS
To go beyond a simple listing of barriers and facilitators, we drew on the approach of realist evaluation and undertook a review of the literature to elicit stakeholders' theories of how, for whom, and in what circumstances AI can provide benefit in pathology. Searches were designed by an information specialist and peer-reviewed by a second information specialist. Searches were run on the arXiv.org repository, MEDLINE, and the Health Management Information Consortium, with additional searches undertaken on a range of websites to identify gray literature. In line with a realist approach, we also made use of relevant theory. Included documents were indexed in NVivo 12, using codes to capture different contexts, mechanisms, and outcomes that could affect the introduction of AI in pathology. Coded data were used to produce narrative summaries of each of the identified contexts, mechanisms, and outcomes, which were then translated into theories in the form of context-mechanism-outcome configurations.
RESULTS
A total of 101 relevant documents were identified. Our analysis indicates that the benefits that can be achieved will vary according to the size and nature of the pathology department's workload and the extent to which pathologists work collaboratively; the major perceived benefit for specialist centers is in reducing workload. For uptake of AI, pathologists' trust is essential. Existing theories suggest that if pathologists are able to "make sense" of AI, engage in the adoption process, receive support in adapting their work processes, and can identify potential benefits to its introduction, it is more likely to be accepted.
CONCLUSIONS
For uptake of AI in pathology, for all but the most simple quantitative tasks, measures will be required that either increase confidence in the system or provide users with an understanding of the performance of the system. For specialist centers, efforts should focus on reducing workload rather than increasing accuracy. Designers also need to give careful thought to usability and how AI is integrated into pathologists' workflow.
Topics: Humans; Artificial Intelligence; Narration; Machine Learning; Pathology
PubMed: 37093631
DOI: 10.2196/38039 -
Seminars in Diagnostic Pathology Jul 2015The success of fine-needle aspiration (FNA) biopsy in the evaluation of head and neck (H&N) masses has already been established. Herein we outline the most recent... (Review)
Review
The success of fine-needle aspiration (FNA) biopsy in the evaluation of head and neck (H&N) masses has already been established. Herein we outline the most recent advancement for the pathologist who performs traditional palpation-guided FNA (PGFNA) in the H&N while also incorporating ultrasound-guided FNA (UGFNA) into their practice. We provide an overview of the educational and training opportunities in H&N ultrasound and UGFNA with emphasis on the advantages and limitations for the pathologist. Throughout are useful clinical and technical pearls, many of which may also interest those who practice PGFNA, including local anesthesia use and FNA procedures in pediatric patients.
Topics: Anatomic Landmarks; Clinical Competence; Credentialing; Education, Medical, Graduate; Endoscopic Ultrasound-Guided Fine Needle Aspiration; Head and Neck Neoplasms; Humans; Palpation; Pathology; Predictive Value of Tests
PubMed: 25677264
DOI: 10.1053/j.semdp.2014.12.010 -
Clinics in Laboratory Medicine Dec 2012This article reflects on my nearly 40 years providing clinical and laboratory genetic services. It reviews the evolution of laboratory and genetic testing from their... (Review)
Review
This article reflects on my nearly 40 years providing clinical and laboratory genetic services. It reviews the evolution of laboratory and genetic testing from their grant-supported academic research to current complexities. Changes in the economic and academic landscape parallel technological innovations in laboratory testing. My career trajectory parallels the newer trend of genetic testing. I began in academics, working as a student and postdoctoral fellow in academic laboratories that also provided clinical testing services. Next came time in a small molecular laboratory performing diagnosis and testing services. My current position is with a national commercial laboratory company.
Topics: Clinical Laboratory Techniques; Humans; Medical Laboratory Science; Pathology, Clinical
PubMed: 23078665
DOI: 10.1016/j.cll.2012.07.003 -
Turk Patoloji Dergisi May 2011The purpose of this study is to understand the status of Pathology in Iraq evaluating health problems in the country. Pathologists in Iraq are at the top of the level of...
The purpose of this study is to understand the status of Pathology in Iraq evaluating health problems in the country. Pathologists in Iraq are at the top of the level of scientific knowledge and professional responsibility. Although there are adequate modern equipment, lack of chemicals and experienced technical service inadequacies are evident. Special stains and immunohistochemistry are performed only in some of the private laboratories. Consultation is often carried out within the department, but external consultations are less frequent. In terms of specialized training, highly motivated, knowledgeable rotators and residents are available. Technical personnel, even though not sufficient in number, have got adequate professional training and skills. There are many problems in running quality control programs in the laboratories. As a result, the progress in the health system of Iraq, and therefore the status of pathology discipline, are of great importance for the development of the country. Foreign pathologists as a volunteer or a staff will provide the objective points of identifying the problems and will help to find a solution.
Topics: Humans; Iraq; Pathology, Surgical; Workforce
PubMed: 21630209
DOI: 10.5146/tjpath.2011.01071 -
Advances in Anatomic Pathology Mar 2016Because of the unique systems and skills involved in patient care by the pathologist, it is challenging to design and implement relevant training in patient safety for... (Review)
Review
Because of the unique systems and skills involved in patient care by the pathologist, it is challenging to design and implement relevant training in patient safety for pathology trainees. We propose a patient safety curriculum for anatomic pathology (AP) residents based on our institutional experience. The Hospital of the University of the Pennsylvania employs a self-reporting safety database. The occurrences from July 2013 to June 2015 recorded in this system that involved the division of AP were reviewed and cataloged as preanalytic, analytic, and postanalytic. The distribution of these occurrences was then used to create a framework for curriculum development in AP. We identified areas in which trainees are involved in the identification and prevention of common patient safety errors that occur in our AP department. Using these data-proven target areas, and employing current Accreditation Council for Graduate Medical Education recommendations and patient safety literature, a strategy for delivering relevant patient safety training is proposed. Teaching patient safety to pathology trainees is a challenging, yet necessary, component of AP training programs. By analyzing the patient safety errors that occur in the AP department, relevant and actionable training can be developed. This provides quality professional development and improves overall performance as trainees are integrated into laboratory systems.
Topics: Internship and Residency; Pathology; Patient Safety
PubMed: 26849817
DOI: 10.1097/PAP.0000000000000108 -
Diagnostic Cytopathology Jan 2023Cytology samples are widely used to diagnose various infectious diseases by detection and identification of causative infectious agents, including bacteria, fungi, and... (Review)
Review
BACKGROUND
Cytology samples are widely used to diagnose various infectious diseases by detection and identification of causative infectious agents, including bacteria, fungi, and viruses. The role of cytopathology in infectious disease has expanded tremendously in the past decades with the advances in molecular techniques. Molecular diagnostic methods, compared to conventional methods, have shown improved patient outcome, reduction in cost, and shortened hospital stay times. The aim of this article is to review molecular testing in cytology samples for diagnosis of infectious diseases.
METHODS
The literature search for molecular testing in common cytology samples for diagnosis of infectious diseases was performed. The findings of the studies were summarized. The common cytology samples included in this article were gynecologic specimens, cerebrospinal fluid, bronchoalveolar lavage, and urine samples.
CONCLUSIONS
There are a number of molecular diagnostic tests that are available to be used in common cytology samples to detect infectious agents. Each test has its own advantages and limitations. It is our hope that upon reading this review article, the readers will have better understanding of molecular diagnostic testing of infectious diseases utilizing commonly sampled cytology specimens in daily practice.
Topics: Female; Humans; Pathology, Molecular; Cytology; Communicable Diseases
PubMed: 36263664
DOI: 10.1002/dc.25064