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PubMed1992

Research by pathologists not funded by external grant agencies: a success story.

The paradigm of pathology research as an endeavor among grant-funded principal investigators resulting in first-author publications is unsupported by quantitative examination of author profiles extracted from the scientific literature. Publications in six pathology journals (Modern Pathology, American Journal of Surgical Pathology, Human Pathology, Acta Cytologica, Archives of Pathology and Laboratory Medicine, and American Journal of Clinical Pathology) and three general science journals (Science, New England Journal of Medicine, and Proceedings of the U.S. National Academy of Sciences) were reviewed. Twenty articles per journal from each of three years (1987, 1989, and 1991) were examined (a total of 520 articles). Of these, 295 articles were first-authored by a member of a department of pathology. Of the 295 articles first-authored by a member of a pathology department, 47 (16%) articles listed competitive grant support. Of the grant-supported articles, 20 articles listed NIH support, but only four had an NIH-supported principle investigator as the first author of the article. Unfunded research represented the vast majority (84%) of work produced by pathologists. A review of the ISI Citation Index showed that those articles written by funded pathologists averaged 8.7 (S.D. 7.8) citations per article, compared to 10.4 (S.D. 12.1) citations per article for unfunded pathologists. Results suggest that unfunded research accounts for the majority of pathology research activity as well as their resulting literature citations.

Authorship↗

PubMedDate not supplied

[Brazilian Ph.D. speech-language pathologist and audiologists: analysis of thesis material according to the field of practice and programs].

BACKGROUND: Ph.D. programs in Speech-Language and Hearing Science. AIM: to bring to date the concluded doctorate thesis of Brazilian speech-language and hearing pathologists, until December of 2003. CONCLUSION: from the profile analysis of the concluded doctorate thesis of Brazilian speech-language pathologists, it is possible to conclude that in the period between 1976, when the first thesis was concluded, to December of 2003, a total of 203 thesis elaborated by Ph.D. speech-language and hearing pathologists were found (in its majority women), in the areas of Hearing, Language, Voice and Oralfacial Myofunctional system.

Audiology↗

PubMed2004

Postgraduate education in laboratory medicine and certification/re-certification of clinical pathologists in Taiwan.

The Taiwan Society of Clinical Pathologists (TSCP) plays a central role in postgraduate education of laboratory medicine and the certification/re-certification of clinical pathologists in Taiwan. For the certification of clinical pathologists, TSCP establishes "Guidelines and Scope of Resident Training" and "Standards for Training Hospitals in Clinical Pathology(CP)", administers board examinations, and issues board certifications/re-certifications. There are two types of CP resident training programs, including a straight CP program with 3 years of CP training for a CP certificate and a combined program with 3 years of Anatomic Pathology training and 2 years of CP training for both the CP and AP certificates. The core curriculum for CP training includes: (1) Clinical Chemistry (at least 4 months), (2) Clinical Microscope with Parasitology (at least 3 months), (3) Clinical Hematology (at least 4 months), and (4) Clinical Microbiology with Clinical Virology (at least 4 months), (5) Immunohematology and Blood Banking (Transfusion Medicine) (at least 3 months), (6) Clinical Serology and Immunology(at least 4 months), and (7) Laboratory Management (at least 2 months). The curriculum for third-year training is not specified and may be in any field. In recent years, the board examination has emphasized the topics of Molecular Biology and Laboratory Informatics. The TSCP has also established an accreditation and inspection program for the CP resident raining hospitals. Each accredited CP training hospital is required to have a detailed teaching protocol of CP training. Quotas are assigned according to the available CPs of the accredited hospitals. The accreditation period is 3 years. Through sponsoring scientific and educational programs, the TSCP offers credit hours of education in laboratory medicine, which are required for re-certification of CPs in Taiwan. The members of the TSCP meet at least twice a year for scientific presentations and seminars. In addition, two to four symposia, offering 8 credit hours each, are held each year in various subspecialties of CP. In 2003, 22 hospitals were accredited as CP training hospitals for a total quota of 26. Until 2003, the TSCP had certified 116 CPs. At the present time, only 103 certified CPs are actively practicing laboratory medicine. Re-certification requires 100 credit hours of continuing education. The requirements for board certification and re-certification are the two main driving forces for CPs in Taiwan to seek continuing education. Our model of education for CPs has proven to be effective. The number of practicing CPs increased from 21 (one per 3,083 beds) in 1991 to 103 (one per 929 beds) in 2002. Most of the CPs are associated with medical centers(62/103, 60.2%) and regional hospitals(38/103, 36.9%).

Accreditation↗

PubMed1950

Pathology and the pathologist in the cancer program.

Cancer as one of the most important human diseases does not present as formidable a problem as infectious disease did a century ago. The diversified cancer program, combining voluntary and governmental agencies in support of research, education and coordinated teamwork in the clinical care of the patient, presents a varied although unified approach to the problem that has never before been available for the study of any single human disease. Pathology, with its applied methods from the basic sciences, has a singular role in the scientific aspect of the cancer program. Representing a new specialty in medicine and embodying an inquiring approach to the study of human disease, pathology has a leading role to play. The pathologist, assuming the new role of "pathologist-physician" brings to the clinical care of the cancer patient the most precise methods of cancer diagnosis. The "pathologist-physician" should be a pivotal member of the "clinical team" in the immediate diagnosis, care and treatment of the cancer patient.

Humans↗

PubMedDate not supplied

Overview of the laboratory accreditation programme of the College of American Pathologists.

Although Saudi medical laboratories have developed enormously over the past 25 years, the absence of a national body for medical laboratory accreditation has meant the number of accredited laboratories (seven) remains low. Of these, five are accredited by the College of American Pathologists' Laboratory Accreditation Program (LAP)--the 'gold standard' of laboratory accreditation. It requires successful performance in the College of American Pathologists' proficiency testing programme as well as passing on-site inspections carried out by practising laboratory technicians, after which the laboratory is accredited for a 2-year period. This article gives an insight into the current situation of laboratory accreditation in Saudi Arabia and an updated overview of the process involved in obtaining laboratory accreditation from the College of American Pathologists.

Accreditation↗

PubMed1992

What will the pathologist be doing in 2001? Speculations of a hospital practitioner.

The 21st century looms ahead, and physicians are increasingly anxious about what the practice of medicine will be like in the future. Pathologists, like other physicians, are holding conferences and writing papers in an attempt to predict what lies ahead. From the perspective of one community pathologist, the future looks bright as far as work opportunities. The jobs that will need to be filled will include familiar ones and numerous new tasks. There will be plenty of jobs; but will there be enough skilled pathologists to fill these positions? The answer depends on our ability to attract the needed physicians into pathology and to give them the needed variety of skills to survive in a new work environment.

Education↗

PubMed1992

Next-generation technologies. Impact on the work load of the pathologist.

Technologies emerging and evolving in the 1990s, particularly in molecular biology, therapeutics, computerization, and information management, will alter the type of work and work load of the pathologist. In general, new technologies will increase the work load of pathologists. However, the extent to which new medical technologies affect pathology will be modulated by socioeconomic factors, given the relationship between new technology and increased medical costs. Pathologists may choose to embrace many new technologies and should play an active role in technology assessment to ensure the appropriate use of new diagnostic procedures.

Pathology↗

PubMed1991

Interinstitutional comparison of frozen-section consultation. A College of American Pathologists Q-Probe study of 79,647 consultations in 297 North American institutions.

In 1989, the College of American Pathologists Q-Probes Quality Assurance Program studied intraoperative frozen-section consultations performed in 297 institutions with mean bed size of 316 (range, 0 to 1351 beds) in North America during 5 consecutive months. The aggregate database was composed of 933,751 surgical cases (mean, 3144 per institution); 52,464 frozen-section cases (mean, 177); and 79,647 individual frozen sections performed (mean, 268). The rate of frozen sections per all surgical case accessions was 5.6% (cases with frozen section) and 7.3% (individual frozen sections performed), with an average of 1.5 frozen sections per case. Frozen-section rate increased proportional to bed size, from less than 5% in institutions with bed size below 150 to 15% in institutions with bed size above 600. Of all frozen sections performed, 4.2% were deferred. Deferrals to paraffin sections in pathologists' opinions were 92.6% appropriate, 1.2% inappropriate, and 6.2% not stated. When frozen-section diagnoses were compared with permanent section diagnoses, there was a 98.3% diagnostic concordance, adjusted for deferred diagnoses, but including the performance of frozen sections on mammographically directed biopsy specimens with no gross abnormalities in 80% of institutions. This practice accounted for 11.8% of the discordant frozen-section diagnoses. The reasons for diagnostic discordances were gross tissue sampling (44.8%); misinterpretation (40%); sectioning (12.7%); inadequate history (5.6%); staining (1.5%); labeling (0.5%); and other (3%). Assessment of diagnostic discordance on patient outcomes by the reviewing pathologist showed that patient management was unaffected in 74%, minimally affected in 20%, and greatly affected in 2.5%.

Biopsy↗

PubMed1990

[Postgraduate instruction and certification in the system of the continuing education of pathologists].

The experience in changing pathology service, postgraduate training and attestation in the system of continuous education of pathologists is presented. The authors analysed different ways of pathologist training: specialization in subinternship, internship and clinical internship, short-term courses, at places of work and outpatient problem seminars, etc. The four-year program of pathologist training is suggested.

Certification↗

PubMed1986

[Diagnostic variations among eight pathologists in the histologic classification of lung cancer].

In order to estimate the magnitude of variations among pathologists in histological diagnoses of lung cancer, eight doctors were asked to independently diagnose 73 preparations of the lung (16 biopsied cancers, 27 resected specimens, 21 autopsied specimens and nine benign autopsied cases). The rates of correct diagnoses by the pathologists ranged from 81.7% to 100%, averaging 91.8%. There was no significant difference between the lowest rate and mean or median of the rates. The variation of the diagnosis tended to be more prominent in large cell carcinoma than in adenocarcinoma or small cell and squamous cell carcinoma. It was suggested that the diagnostic criteria for large cell carcinoma varied to some extent among pathologists.

Adenocarcinoma↗

PubMed1987

Inter- and intra-pathologist variability in the diagnosis of gestational trophoblastic neoplasia.

All 190 cases of gestational trophoblastic neoplasia diagnosed in the Baltimore metropolitan area from 1975-1982 were identified. Histologic slides were requested and reviewed independently by two pathologists who agreed upon uniform criteria for the diagnosis of hydatidiform (complete) mole, invasive mole, and choriocarcinoma. A representative sample of the slides was selected and resubmitted to one of the study pathologists for a second review. The inter- and intra-pathologist variability in the diagnosis of gestational trophoblastic neoplasia was calculated using the kappa statistic (K). Our findings indicated that the variability in the diagnosis of gestational trophoblastic neoplasia was low whereas that for the related tumor of incomplete mole was high.

Choriocarcinoma↗

PubMed1988

Survey of special practices associated with College of American Pathologists proficiency testing in the Commonwealth of Pennsylvania.

A questionnaire concerned with special practices associated with proficiency testing was sent to the Chemistry Supervisor, Hematology Supervisor, and Chief Pathologist of 190 Pennsylvania hospital laboratories. Responses were received from 156 hospitals (82.1%) and included responses from 131 chemistry supervisors, 108 hematology supervisors, and 92 chief pathologists. The vast majority of respondents (85% to 95%) indicated moderate to great pressure to score acceptably. The survey showed a high prevalence of special practices, including analysis of controls just prior to survey specimens (23% to 42%), analysis in duplicate on a single instrument (52% to 88%), analysis on more than one instrument (17% to 31%), analysis on two or more separate days (20% to 39%), and delay of testing until an instrument is "working better" (24% to 34%). Approximately 63% of chemistry results and 72% of hematology results are reported as averages or medians. Pathologists consistently reported a lower prevalence of special practices than did laboratory supervisors. These high prevalences of special practices associated with proficiency testing specimens have important implications for proficiency testing programs.

Academies and Institutes↗

PubMed1985

The role of the pathologist in the surgical treatment of hyperparathyroidism.

Appropriately extensive surgical treatment of hyperparathyroidism depends upon accurate assessment of the extent of disease. We have believed that such assessement is the responsibility of the surgeon because at random biopsy with light microscopy the pathologist may not be able to differentiate adenoma from hyperplasia or even normal from abnormal glands. To test this hypothesis, three pathologists reviewed 50 unlabelled slides of parathyroid tissue and attempted to correlate them with clinical diagnoses which were based upon widely accepted criteria. They were asked to identify each slide as adenoma or hyperplasia, or both, or normal using whatever criteria they wished. A specific diagnosis of adenoma was correct in 35 and 83 per cent of interpretations and of hyperplasia in 38 and 60 per cent of interpretations. The less specific diagnosis of adenoma or hyperplasia (that is, abnormal tissue) was correct in 78 to 100 per cent. A diagnosis of normal was correct in 71 to 78 per cent. Adenoma was most likely confused with hyperplasia; hyperplasia was equally mistaken for adenoma or normal. We conclude that with random, subtotal specimens taken at biopsy (simulating intraoperative conditions) differentiation of adenoma from hyperplasia of the parathyroid gland is poor. Differentiation of normal from abnormal parathyroid tissue also is unreliable. Because the consequences of misdiagnosis are severe, pathologists should not be asked to make specific diagnoses intraoperatively but only to distinguish the parathyroid tissue from the nonparathyroid tissue.

Adenoma↗

PubMed1984

[M.N. Nikiforov and the Moscow school of pathologists (on the 125th anniversary of his birth)].

The paper is devoted to the well-known Russian pathologist M. N. Nikiforov (1858-1915), the chief of the chair of pathology in the Moscow University (1857-1915). M. N. Nikiforov was a scientist who created a school of pathologists; he was the author of the first fundamental textbook of pathology in Russian, the founder of the Moscow scientific society of pathologists.

History, 19th Century↗

PubMed1983

Recognition and management of child abuse by the surgical pathologist.

Child abuse is well recognized by most primary care physicians, radiologists, and forensic pathologists. However, the surgical pathologist may also become involved in child abuse cases. This is illustrated by two cases. In addition to recognition of child abuse, the surgical pathologist must be aware of his legal responsibilities.

Abdomen, Acute↗

PubMed1980

Domiciliary visits by pathologists: an evaluation.

DOMICILIARY VISITS BY PATHOLOGISTS MAY CONFER BENEFITS OF VARIOUS KINDS: enabling many illnesses to be managed safely at home rather than by admission to hospital or attendance at the outpatient department; reassurance of patients, relatives, and family practitioners; the mutual education of family practitioners and pathologists; and the improvement of outcome of disease by early investigation.An analysis of the financially definable costs and benefits of 1,182 domiciliary visits by two pathologists during an eight-year period shows that the savings are much greater than the costs.

Child↗

PubMed1981

Proposal for a national autopsy data bank: a potential major contribution of pathologists to the health care of the nation.

This report highlights the salient deliberations of the Anatomic Pathology Committee of the College of American Pathologists (CAP) and of its consultants and advisors in formulating a proposal for the establishment of a National Autopsy Data Bank (NADB). It has constituted the major thrust of this Committee for the past five years and is presented in considerable detail in order to familiarize the pathology community and other interested parties with the plan, which, if implemented, would enable pathologists to contribute even further to the health care of the nation while concomitantly realizing benefits both individually and collectively. In order for the proposal to culminate in an optimally functioning NADB, the support and participation of a majority of, if not all, pathologists with autopsy responsibilities would be needed. Goals, objectives, justification, and merits, background, legal considerations, pilot studies, and management plans are discussed and the singular advantages that could accrue with implementation are delineated. If achieved, it would be the first time that any medical discipline or organization would have amassed such kinds of accurate biomedical information potentially so useful to so many for so little.

Autopsy↗

PubMed1995

Practice guidelines for autopsy pathology. Autopsy procedures for brain, spinal cord, and neuromuscular system. Autopsy Committee of the College of American Pathologists.

The Autopsy Committee of The College of American Pathologists has prepared this guideline in conjunction with representatives of other organizations to assist pathologists in autopsy procedures for brain, spinal cord, and neuromuscular system. The guideline is to be regarded as being primarily an educational tool. Application of these recommendations on autopsy reporting is to be made on the basis of the judgment of the pathologist engaged in a specific case.

Alzheimer Disease↗