Powered by OpenAIRE graph
Found an issue? Give us feedback
image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ Dermatology Practica...arrow_drop_down
image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
Dermatology Practical & Conceptual
Article . 2019 . Peer-reviewed
Data sources: Crossref
image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
Dermatology Practical & Conceptual
Article
License: CC BY
Data sources: UnpayWall
image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
PubMed Central
Article . 2014
Data sources: PubMed Central
image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
DOAJ
Article . 2019
Data sources: DOAJ
versions View all 4 versions
addClaim

Protecting the patient is our protection

Authors: Simonetta Piana; Zoe Apalla;

Protecting the patient is our protection

Abstract

Optimization and securing of medical practices and procedures has always been very challenging in medicine. However, the real-life clinical settings continue to pose various hazards that may lead medical professionals to unintended mistakes. Pathologists feel particularly responsible and are very concerned about diagnostic discrepancies or even mistakes, since these depend on their interpretive skills and diagnostic expertise. However, a majority of mistakes in daily practice are related to laboratory procedural errors, involving transportation of the specimens, labeling, contamination, cutting, typing, and various others [1]. In contrast to general belief, errors in diagnostic interpretation account for only 25% of the overall failures in surgical pathology practice, with most of the remaining 75% resulting from defective specimens, incorrect patient identification, mislabeling and/or inadequate reports [2]. Dermatopathology is considered to be the pathology subspecialty associated with higher medico-legal risk [3]. It is well known that the most serious problems in dermatopathology emanate from the incorrect interpretation of melanocytic lesions. However, diagnostic limitations are not the only weakness in dermatopathology practice. Although underestimated, the handling of large numbers of small, similar-looking bioptic specimens results very often in unpredictable mistakes. The latter risk is scarcely reported in the literature and has rarely been investigated, since its objective quantification is not easy. There are many vulnerable steps in the routine of a pathology lab, from the initial access to the lab until the final report and communication with the patient’s physician. Errors pervade all levels of the pre-analytical, analytical, and post-analytical phases, especially in labs that accept a high volume of specimens [3]. The pre-analytical phase, from the arrival at the lab to the commencement of the analysis, is considered the most vulnerable to faults [4]. Receiving the specimen, incorporating the tissue in paraffin blocks and tissue cutting are procedures susceptible to random mistakes and should be systematically controlled [4]. It is generally accepted that the risk of mistakes increases with the number of samples and with the complexity of the required procedure to establish a definite diagnosis. The routine use of immunohistochemical techniques and the increasing interest in new biomolecular markers, which influence management decisions, complicate further this already complex scenario. The article by Weyers included in this issue analyzes the step-by-step process carried out in a pathology lab, outlining the handling of samples and the risk of specimen mix-up. According to the author, a dermatopathology lab could be likened to a factory production line, as it continuously processes and reports on many skin specimens; and in this context, lab mechanisms are particularly susceptible to faults. The author describes all the pathways a biopsy routinely takes, highlighting the pitfalls and recommending preventive strategies for every stage of the procedure. In the era of targeted therapies, when a molecular biology test can be therapeutically strategic, it is crucial to ensure the optimal quality of tissue samples by securing every diagnostic step. Addressing pathology errors and eliminating potential sources of mistakes go hand-in-hand with the right of the patients and their caregivers to a complete, correct, and timely diagnosis. Apart from the aforementioned issues, protecting the patient is also achieved by the accurate and effectivequality checks throughout the system, which in turn protects the physician against malpractice claims while working in the difficult, sometimes under-recognized, but always wonderful, job of dermatopathology.

Keywords

Editorial, RL1-803, Dermatology

  • BIP!
    Impact byBIP!
    selected citations
    These citations are derived from selected sources.
    This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    0
    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Average
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Average
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Average
Powered by OpenAIRE graph
Found an issue? Give us feedback
selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
Green
Published in a Diamond OA journal