CAP and ADASP Offer New Guideline to Improve Laboratory Testing

NORTHFIELD, ILL. —Today, the College of American Pathologists (CAP) and the Association of Directors of Anatomic and Surgical Pathology (ADASP) announced the joint release of a new evidence-based guideline to provide recommendations for secondary and timely reviews of surgical pathology and cytology cases to improve patient care. The guideline, “Interpretive Diagnostic Error Reduction in Surgical Pathology and Cytology,” has been posted as an Early Online Release publication on the Archives of Pathology & Laboratory Medicine website.

“Unlike other phases of the test cycle, the analytic phase of surgical pathology and cytology involves the inherent judgment of the pathologist at the time of slide interpretation,” said Raouf Nakhleh, MD, FCAP, guideline co-chair representing the CAP and surgical pathologist at the Mayo Clinic in Jacksonville, Florida. “To assist anatomic pathologists, we developed five high-level recommendations and expert consensus statements to formalize a process for the review of surgical pathology and cytology cases, which pathologists can implement as added quality measures into their institutions quality assurance programs.”

The key points of the guideline include:

• The analytical phase of surgical pathology and cytology involves inherent judgment of the pathologist at the time of slide interpretation. 
• The analytic process (interpretive diagnoses) checks are less formally defined than in the pre- and post-analytical phases, but may include a second review of case material, in addition to ancillary studies and clinical correlation.
• Consistent adoption of secondary and timely case reviews will help detect and prevent diagnostic interpretive errors, leading to more accurate diagnoses and improved patient care.

“We encourage pathologists to implement the new guideline recommendations to ensure optimal testing conditions and detect disagreements,” said Vania Nose, MD, PhD, co-chair of the guideline representing ADASP and associate chief of Anatomic and Molecular Pathology and director of Surgical Pathology, Massachusetts General Hospital in Boston. “Through implementation, we hope to improve the quality of patient care.”

The CAP Pathology and Laboratory Quality Center and ADASP convened an expert panel of pathologists to define the role of case reviews in surgical pathology and cytology, as part of the formalized review process. The panel reviewed more than 730 articles, examined evidence from 137 articles, and participated in a considered judgment process to formulate the final recommendations.

The CAP offers tools and resources, including a summary of the recommendations, frequently asked questions (FAQs), an infographic, and two videos (CAP/ADASP Offer New Guideline to Improve Laboratory Testing and New CAP/ADASP Guideline: Benefit to Pathologists and Patient Care) for further implementation and understanding. The two organizations plan to update the guideline as new evidence becomes available.

 About the College of American Pathologists

As the leading organization with more than 18,000 board-certified pathologists, the College of American Pathologists (CAP) serves patients, pathologists, and the public by fostering and advocating excellence in the practice of pathology and laboratory medicine worldwide. The CAP’s Laboratory Improvement Programs, initiated 65 years ago, currently has customers in more than 100 countries, accrediting 7,600 laboratories and providing proficiency testing to 20,000 laboratories worldwide. Find more information about the CAP at cap.org. Follow CAP on Twitter: @pathologists.

 About the Association of Directors of Anatomic and Surgical Pathology

Founded in 1989, the Association of Directors of Anatomic and Surgical Pathology (ADASP) is an organization made up primarily of directors of anatomic and/or surgical pathology from academic institutions. The majority of members are from the United States. Individuals who are from outside the US and who meet the membership criteria also are eligible to apply for membership in ADASP.

The association’s objectives are to: promote expertise, effective administration and productive education in the practice of administering anatomic pathology laboratories; sponsor and promote the education of pathologists and others in health care related to administration of anatomic pathology and its branches; establish and maintain appropriate relationships with other societies and groups of physicians and scientists who share professional interests with the association.

A major activity of the association is its annual meeting held in the spring on the first Saturday preceding the meeting of the United States and Canadian Academy of Pathology (USCAP). Other ADASP activities include the publication of position papers, editorials, and recommendations regarding various aspects of the practice of anatomic pathology.

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