Critical Values in Anatomic Pathology?(Editorial)

Critical Values in Anatomic Pathology?(Editorial)

In the May 2006 ARCHIVES, the companion articles “Critical Values in Anatomic Pathology” by Drs Silverman and Pereira, (1) and “Communicating Critical Values in Anatomic Pathology” by Drs LiVolsi and Leung, (2) set forth for examination and discussion by the pathologist community, with the prospect of adoption and endorsement of the College of American Pathologists, a set of guidelines to inform clinicians of surgical pathologic and cytopathologic diagnoses that, because of their life-threatening nature, may require the clinician’s immediate attention. Several reports on the progression of such guidelines are evident. (1-7) Silverman and Pereira, 1 Pereira et al, (4,5) and the Association of Directors of Anatomic and Surgical Pathology (6,7) have recently proposed possible critical value situations in surgical pathology and cytology; LiVolsi (3) and LiVolsi and Leung (2) have examined methods for effective communication of the values. The authors’ proposal is consistent with the general trend toward the use of guidelines in health care. The College of American Pathologists has endorsed guidelines for anatomic pathology practice; for example, its recent joint publication with the American Society of Clinical Oncology of recommendations for HER2 testing in breast cancer patients. (8) But the use of guidelines is a recent phenomenon in anatomic pathology; as such, the use of guidelines should be carefully considered, and proposed guidelines should be crafted as well as possible in order to avoid unintended consequences of their acceptance and use. The authors’ proposal is a good opportunity to evaluate some issues that may arise, including some medical-legal issues. CRITICAL VALUES

Critical Values in Anatomic Pathology?(Editorial)

Critical Values in Anatomic Pathology?(Editorial) | | 4.5