American journal of clinical pathology
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Am. J. Clin. Pathol. · Nov 2006
Comparative StudyComparison of disagreement and amendment rates by tissue type and diagnosis: identifying cases for directed blinded review.
We sought to determine whether a group of cases that was relatively high in disagreements and subsequent amendments could be identified and targeted for blinded review. During a 4-year period, 8,916 surgical pathology and nongynecologic cytology cases were subjected to blinded review; of these, there were 616 disagreements (6.9%), 69 (0.8%) had subsequent amendments issued, and 33 (0.4%) represented false-negative errors of blinded review. Tissues with the highest amendment rates were breast (4.4%), endocrine (4%), gynecologic (1.8%), and cytology (1.3%). ⋯ Reviewing only nondiagnostic and atypical cases would have involved reviewing only 4.0% of cases and detected 14% of amendments. Reviewing all breast, gynecologic, nongynecologic cytology, and endocrine material would have involved reviewing 26.9% of cases and detected 88% of amendments. These data can be used to define material for directed blinded review that is relatively high in potential errors.