Raab Stephen S, Grzybicki Dana M, Mahood Laura K, Parwani Anil V, Kuan Shih-Fan, Rao Uma N
Department of Pathology, University of Colorado Denver, Aurora, CO 80045, USA.
Am J Clin Pathol. 2008 Dec;130(6):905-12. doi: 10.1309/AJCPPIA5D7MYKDWF.
Different error detection methods yield different error proportions and have variable benefits for surgical pathology divisions with limited resources. We performed a nonconcurrent cohort study at a large institution that practices subspecialty surgical pathology sign-out to compare the effectiveness and usefulness of error detection using a targeted 5% random review process and a focused review process. Pathologists reviewed 7,444 cases using a targeted 5% random review process and 380 cases using a focused review process. The numbers of errors detected by the targeted 5% random and focused review processes were 195 (2.6% of reviewed cases) and 50 (13.2%), respectively (P < .001). The numbers of major errors for the targeted 5% random and focused review processes was 27 (0.36%) and 12 (3.2%), respectively (P < .001). Focused review detects a higher proportion of errors and may be more effectively used for design of error reduction initiatives.
不同的错误检测方法会产生不同的错误比例,对于资源有限的外科病理科而言,其益处也各不相同。我们在一家开展亚专科手术病理签出工作的大型机构进行了一项非同期队列研究,以比较采用5%目标随机抽检流程和重点抽检流程进行错误检测的有效性和实用性。病理学家采用5%目标随机抽检流程审查了7444例病例,采用重点抽检流程审查了380例病例。5%目标随机抽检流程和重点抽检流程检测出的错误数量分别为195例(占审查病例的2.6%)和50例(占13.2%)(P < .001)。5%目标随机抽检流程和重点抽检流程检测出的主要错误数量分别为27例(0.36%)和12例(3.2%)(P < .001)。重点抽检能检测出更高比例的错误,可能更有效地用于减少错误措施的设计。