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Pathologists can get it right the first time
  1. Murali Varma1,
  2. W Glenn McCluggage2,
  3. Varsha Shah3,
  4. Daniel M Berney4
  1. 1 Cellular Pathology, University Hospital of Wales, Cardiff, UK
  2. 2 Pathology, Royal Group of Hospitals Trust, Belfast, UK
  3. 3 Cellular Pathology, Royal Gwent Hospital, Newport, Newport, UK
  4. 4 Molecular Oncology, Queen Mary University of London, London, London, UK
  1. Correspondence to Dr Murali Varma, Cellular Pathology, University Hospital of Wales, Cardiff CF14 4XW, UK; wptmv{at}


It is established good practice for histopathologists to obtain a second opinion in difficult cases. However, it is becoming more common for histology material to be reviewed either at the time of reporting (double-reporting) or as part of the preparation for multidisciplinary team meetings. Routine histological review does not provide ‘value for money’ and could even increase the risk of diagnostic error. The focus should be on error prevention as opposed to error detection. If pathologists get it right the first time, then there would be less need for ‘double checking’. Increased subspecialisation could increase diagnostic confidence and reduce error rates. Double-reporting and retrospective review should be limited to selected cases. We describe a protocol for clearly recording the process and outcome of such reviews.

  • pathology
  • surgical
  • diagnosis
  • neoplasms
  • quality assurance
  • health care

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  • Handling editor Runjan Chetty.

  • Contributors The first draft was written by MV. All authors contributed to subsequent revisions of the manuscript.

  • 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 None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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