Zarbo R J
Department of Pathology, Henry Ford Hospital, Detroit, MI 48202.
Arch Pathol Lab Med. 1992 Nov;116(11):1113-9.
In 1991, the College of American Pathologist's Q-Probes Quality Improvement Program evaluated practices in 532 institutions for pathologic information provided in surgical pathology reports of 15,940 resected primary colorectal carcinomas. Participating institutions studied their last 30 completed cases and were from the United States (98%), Canada (1.5%), and Australia (0.4%). The influence of various institutional differences and other practice patterns were analyzed to determine factors associated with an increased institutional likelihood of providing information on pathology reports. The one practice significantly associated with increased likelihood of providing complete oncologic pathology information on eight of 11 gross and microscopic information items surveyed was the use of a standard report form or checklist. Other institutional differences bearing inconsistent associations included teaching institution status, presence of pathology residency, use of microscopic descriptions, institution bedsize category, and performance of DNA ploidy analysis. The development and adoption of a standardized report form or checklist for each case is a simple but effective means to assure report adequacy and consistent communication of oncologic pathology information. In conjunction with accompanying criteria for its accurate use, this process can be considered a practice guideline or practice parameter that can be extended to the surgical pathology examination of all resected malignant neoplasms.
1991年,美国病理学家学会的Q-Probes质量改进项目评估了532家机构对15940例原发性结直肠癌手术病理报告中病理信息的处理情况。参与机构研究了其最近完成的30个病例,这些机构来自美国(98%)、加拿大(1.5%)和澳大利亚(0.4%)。分析了各种机构差异和其他实践模式的影响,以确定与机构在病理报告中提供信息可能性增加相关的因素。在所调查的11项大体和显微镜检查信息项目中的8项上,与提供完整肿瘤病理信息可能性增加显著相关的一种做法是使用标准报告表格或清单。其他存在不一致关联的机构差异包括教学机构地位、病理住院医师培训情况、显微镜描述的使用、机构床位规模类别以及DNA倍体分析的开展情况。为每个病例制定并采用标准化报告表格或清单是确保报告充分性和肿瘤病理信息一致传达的一种简单而有效的方法。结合其准确使用的相关标准,这一过程可被视为一种实践指南或实践参数,可扩展到所有切除恶性肿瘤的手术病理检查。