TY - JOUR
T1 - Pathologists' use of second opinions in interpretation ofmelanocytic cutaneous lesions
T2 - Policies, practices, and perceptions
AU - Geller, Berta M.
AU - Frederick, Paul D.
AU - Knezevich, Stevan R.
AU - Lott, Jason P.
AU - Nelson, Heidi D.
AU - Titus, Linda J.
AU - Carney, Patricia A.
AU - Tosteson, Anna N.A.
AU - Onega, Tracy L.
AU - Barnhill, Raymond L.
AU - Weinstock, Martin A.
AU - Elder, David E.
AU - Piepkorn, Michael W.
AU - Elmore, Joann G.
N1 - Publisher Copyright:
© 2017 by the American Society for Dermatologic Surgery, Inc.
PY - 2018/2
Y1 - 2018/2
N2 - BACKGROUND Research examining the role of second opinions in pathology for diagnosis of melanocytic lesions is limited. OBJECTIVE To assess current laboratory policies, clinical use of second opinions, and pathologists' perceptions of second opinions for melanocytic lesions. MATERIALS AND METHODS Cross-sectional data collected from 207 pathologists in 10 US states who diagnose melanocytic lesions. The web-based survey ascertained pathologists' professional information, laboratory second opinion policy, use of second opinions, and perceptions of second opinion value for melanocytic lesions. RESULTS Laboratory policies required second opinions for 31% of pathologists and most commonly required for melanoma in situ (26%) and invasive melanoma (30%). In practice, most pathologists reported requesting second opinions for melanocytic tumors of uncertain malignant potential (85%) and atypical Spitzoid lesions (88%). Most pathologists perceived that second opinions increased interpretive accuracy (78%) and protected them from malpractice lawsuits (62%). CONCLUSION Use of second opinions in clinical practice is greater than that required by laboratory policies, especially for melanocytic tumors of uncertain malignant potential and atypical Spitzoid lesions. Quality of care in surgical interventions for atypical melanocytic proliferations critically depends on the accuracy of diagnosis in pathology reporting. Future research should examine the extent to which second opinions improve accuracy of melanocytic lesion diagnosis.
AB - BACKGROUND Research examining the role of second opinions in pathology for diagnosis of melanocytic lesions is limited. OBJECTIVE To assess current laboratory policies, clinical use of second opinions, and pathologists' perceptions of second opinions for melanocytic lesions. MATERIALS AND METHODS Cross-sectional data collected from 207 pathologists in 10 US states who diagnose melanocytic lesions. The web-based survey ascertained pathologists' professional information, laboratory second opinion policy, use of second opinions, and perceptions of second opinion value for melanocytic lesions. RESULTS Laboratory policies required second opinions for 31% of pathologists and most commonly required for melanoma in situ (26%) and invasive melanoma (30%). In practice, most pathologists reported requesting second opinions for melanocytic tumors of uncertain malignant potential (85%) and atypical Spitzoid lesions (88%). Most pathologists perceived that second opinions increased interpretive accuracy (78%) and protected them from malpractice lawsuits (62%). CONCLUSION Use of second opinions in clinical practice is greater than that required by laboratory policies, especially for melanocytic tumors of uncertain malignant potential and atypical Spitzoid lesions. Quality of care in surgical interventions for atypical melanocytic proliferations critically depends on the accuracy of diagnosis in pathology reporting. Future research should examine the extent to which second opinions improve accuracy of melanocytic lesion diagnosis.
UR - http://www.scopus.com/inward/record.url?scp=85044695341&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85044695341&partnerID=8YFLogxK
U2 - 10.1097/DSS.0000000000001256
DO - 10.1097/DSS.0000000000001256
M3 - Article
C2 - 28858936
AN - SCOPUS:85044695341
SN - 1076-0512
VL - 44
SP - 177
EP - 185
JO - Dermatologic Surgery
JF - Dermatologic Surgery
IS - 2
ER -