Showing papers by "Stephen S. Raab published in 2008"
TL;DR: This document summarizes the indications for performing an FNA of a nodule discovered by physical examination or an imaging study; the indicationsfor using ultrasound versus palpation for guidance when performing a thyroid FNA; the issues surrounding informed consent for thyroid F NA; and the information required on a requisition form that accompanies a thyroidFNA specimen.
Abstract: The National Cancer Institute (NCI) sponsored the NCI Thyroid Fine-Needle Aspiration (FNA) State of the Science Conference on October 22-23, 2007 in Bethesda, MD. The 2-day meeting was accompanied by a permanent informational website and several on-line discussions between May 1 and December 15, 2007 (http://thyroidfna.cancer.gov). This document summarizes the indications for performing an FNA of a nodule discovered by physical examination or an imaging study; the indications for using ultrasound versus palpation for guidance when performing a thyroid FNA; the issues surrounding informed consent for thyroid FNA; and the information required on a requisition form that accompanies a thyroid FNA specimen. (http://thyroidfna.cancer.gov/pages/info/agenda/)
109 citations
TL;DR: A nonconcurrent cohort study at a large institution that practices subspecialty surgical pathology sign-out to compare the effectiveness and usefulness of error detection using a targeted 5% random review process and a focused review process found focused review detects a higher proportion of errors and may be more effectively used for design of error reduction initiatives.
Abstract: Different error detection methods yield different error proportions and have variable benefits for surgical pathology divisions with limited resources. We performed a nonconcurrent cohort study at a large institution that practices subspecialty surgical pathology sign-out to compare the effectiveness and usefulness of error detection using a targeted 5% random review process and a focused review process. Pathologists reviewed 7,444 cases using a targeted 5% random review process and 380 cases using a focused review process. The numbers of errors detected by the targeted 5% random and focused review processes were 195 (2.6% of reviewed cases) and 50 (13.2%), respectively (P < .001). The numbers of major errors for the targeted 5% random and focused review processes was 27 (0.36%) and 12 (3.2%), respectively (P < .001). Focused review detects a higher proportion of errors and may be more effectively used for design of error reduction initiatives.
47 citations
TL;DR: Long-term monitoring of cytologic-histologic correlation is associated with improvement in cytologic/ histologic correlation performance and the length of participation in the Q-Tracks program was associated with improved performance.
Abstract: Context.—The use of Papanicolaou (Pap) test cytologic-histologic correlation in quality improvement activities is not well studied. Objective.—To determine if continuous monitoring of correlation data improves performance. Design.—Participants in the College of American Pathologists Q-Tracks program (213 laboratories) self-reported the number of Pap test–histologic biopsy correlation discrepancies every quarter for up to 8 years. A mixed linear model determined if the length of participation in the Q-Tracks program was associated with improved performance. Main outcome measures were predictive value of a positive Pap test, Pap test sensitivity, sampling sensitivity, and proportion of positive histologic diagnoses following a Pap test diagnosis of atypical squamous cells or atypical glandular cells. Results.—Institutions evaluated 287 570 paired Pap test– histologic correlation specimens and found 98 424 (34.2%) true-positive Pap test correlations, 19 006 (6.6%) false-positive Pap test correlation...
27 citations
TL;DR: Disseminating Lean methods across a group of clinicians resulted in improved Pap test quality and diagnostic accuracy, with a statistically significant decrease in the mean proportion of Pap tests lacking a transformation zone component.
Abstract: Objective.To determine if the implementation of Lean methods resulted in improved Pap test quality and diagnostic accuracy in 5 clinician practices.Materials and Methods.We performed a 1-year case-control study that included 5,384 control (preintervention) and 5,442 case (postintervention) w
20 citations
TL;DR: It is proposed that data linking error to patient outcome are critical for developing quality improvement initiatives targeting errors that cause patient harm in addition to using methods of root cause analysis, beyond those traditionally used in cytologic-histologic correlation, to assist in the development of error reduction and quality improvement plans.
17 citations
Journal Article•
9 citations
TL;DR: An anatomic pathology error database was designed and constructed that was used to benchmark institutional frequencies, causes and outcomes of error and showed high variability in practice, which led to error reduction initiatives that were implemented in practices.
2 citations
1 citations