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Utility of an infectious and tropical disease histopathology diagnostic review service
  1. Sum Yu Pansy Yue1,
  2. Sebastian B Lucas2,3,
  3. Michael Brown4,5,
  4. Peter L Chiodini4,5,
  5. Stephen L Walker4,5,
  6. Ula Mahadeva2,3
  1. 1 Department of Medicine, Guy’s & St Thomas’ NHS Foundation Trust, London, UK
  2. 2 Faculty of Life Sciences and Medicine, King’s College London, London, UK
  3. 3 Department of Histopathology, Guy’s & St Thomas’ NHS Foundation Trust, London, UK
  4. 4 Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, UK
  5. 5 Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
  1. Correspondence to Dr Ula Mahadeva, Department of Histopathology, Guy's & St Thomas' NHS Foundation Trust, London SE1 7EH, UK; Ula.Mahadeva{at}gstt.nhs.uk

Abstract

Aim To assess the utility of a London-based infectious and tropical disease histopathology diagnostic review service.

Methods The original and specialist review histopathology reports of 457 samples from over 3 years of referrals were compared retrospectively.

Results Overall 329 (72.0%) showed no significant difference; 34 (7.4%) showed a non-clinically significant difference; and 94 (20.6%) showed a clinically significant difference. Of the 94 clinically significant discrepancies, 46 (48.9%) were incorrectly suspected infections; 19 (20.2%) were missed infections; 8 (8.5%) were different infections; and in 20 (21.3%), the specialist review yielded more specific identification of an organism or a more correct assessment of its viability.

Conclusions A review of histopathology cases by an infectious disease (ID) histopathology referral centre has yielded a 20.6% clinically significant error rate. Measures to improve training in ID histopathology in the UK are discussed.

  • histopathology
  • infections
  • clinical infectious diseases
  • diagnostics
  • laboratory management

https://doi.org/10.1136/jclinpath-2020-206546

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    Footnotes

    • Handling editor Dhirendra Govender.

    • Contributors SYPY: data acquisition, analysis and interpretation; manuscript writing and approval. SBL, MB, PLC and SLW: data interpretation, manuscript writing and approval. UM: study design; data acquisition, analysis and interpretation; manuscript writing and approval. No figures of tables from another publication.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests UM has 1.0 Programmed Activity funded by the Hospital for Tropical Diseases.

    • Patient consent for publication Not required.

    • Ethics approval Ethics approval was not necessary as this was a quality improvement service evaluation project and not a research study.

    • Provenance and peer review Not commissioned; externally peer reviewed.