title: The effect of interinstitution anatomic pathology consultation on patient care.
abstract: OBJECTIVE
  To determine the effect of routine interinstitution anatomic pathology consultation on patient evaluation and treatment.
  
  
  METHODS
  All interinstitution anatomic pathology consultation diagnoses made during a 1-year period were compared with the original pathologic diagnoses. Patients with discrepant diagnoses were evaluated after an interval of 1 year to determine the correct clinical diagnosis. The relevance of the pathologic consultation to furthering medical evaluation and treatment was determined from a review of the medical record and when necessary from consultation with the patient's physician.
  
  
  METHODS
  Patients referred to a university hospital.
  
  
  METHODS
  We determined the number of patients with discrepant pathologic diagnoses and whether these diagnoses changed the planned surgical procedure, chemotherapy, radiation therapy, or medical evaluation.
  
  
  RESULTS
  Seventy-one (9.1%) discrepant diagnoses were identified among the 777 patients. Of these 71 patients, 45 (63%) demonstrated a change in therapy or clinical evaluation as a result of the interinstitution anatomic pathology consultation. In five of these patients the consultation diagnosis was in error. There was a significantly greater percentage of discordant diagnoses among the cytology and fine-needle aspiration biopsies (21%) as compared with the surgical pathology specimens (7.8%; P < .001).
  
  
  CONCLUSIONS
  Routine interinstitution anatomic pathology consultation resulted in a change in patient evaluation or treatment in 45 (5.8%) of the 777 cases reviewed. Our interinstitution anatomic pathology consultation policy appears to provide useful diagnostic information, which should contribute to improved patient care. However, when a discrepancy is identified, additional consultation or evaluation should be considered.
authors.affiliation: Department of Pathology, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey 17033, USA.
authors.forename: A B
authors.initials: AB
authors.lastname: Abt
authors.forename: L G
authors.initials: LG
authors.lastname: Abt
authors.forename: G J
authors.initials: GJ
authors.lastname: Olt
mesh_terms: D001706:Biopsy; D005260:Female; D006291:Health Policy; D006801:Humans; D008297:Male; D010340:Pathology, Surgical; D010347:Patient Care Planning; D011785:Quality Assurance, Health Care; D012017:Referral and Consultation