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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. 1Department of Medicine, Guy’s & St Thomas’ NHS Foundation Trust, London, UK
  2. 2Faculty of Life Sciences and Medicine, King’s College London, London, UK
  3. 3Department of Histopathology, Guy’s & St Thomas’ NHS Foundation Trust, London, UK
  4. 4Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, UK
  5. 5Faculty 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
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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.

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