Measuring and reporting errors in surgical pathology - Lessons from gynecologic cytology

Substantial improvements in measuring and reporting errors in gynecologic c ytology have been made during the last decade. Measuring and reporting erro rs in surgical pathology recently has gained renewed interest. However revi ew of current literature demonstrates mistakes in how these data are measur ed and reported. Error rates have been reported from review of consecutive material, biopsy material, and consultation material and range from 0.25% t o 43%. Errors have been divided into anatomic regions and specimen types an d separated according to their clinical significance. However; to be compar able, errors must be reported in reference to the incidence of disease and not to overall caseload. Blinding and reviewer error have been addressed on ly rarely, and the true incidence of errors is almost certainly higher than reported. "Gold standards" are not well defined In addition, available dat a strongly suggest that the greatest source of error is with false-negative diagnoses, which are detected only rarely by review of consultation materi al. Most of these issues have been addressed in the gynecologic cytology li terature. Errors in surgical pathology are more common than generally belie ved, and efforts should be made to define methods that allow appropriate in terlaboratory comparisons.