Premium
Use of the term “rule out” in requisition forms may cause diagnostic delays in dermatopathology practice
Author(s) -
Abdou Yara,
Lohse Christine,
Comfere Nneka I.
Publication year - 2017
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1111/ijd.13403
Subject(s) - requisition , dermatopathology , medicine , term (time) , intensive care medicine , dermatology , archaeology , history , physics , quantum mechanics
Abstract Background Timely pathologic diagnosis relies on the communication of specific clinical information in the requisition form ( RF ). Clinical information may use nonspecific terms such as “rule out”, the use of which may result in diagnostic delays and the unnecessary application of pathology stains and sections. Objective This study was designed to evaluate the relationship between use of the term “rule out” and time to diagnosis, and the use of additional pathology stains and sections in integrated and non‐integrated dermatopathology practices. Methods A retrospective double‐cohort study of 475 RF s from the integrated practice (of which 182 used the term “rule out” [ RO ] and 293 did not [ NRO ]) and 412 RF s from the non‐integrated practice ( RO , n = 126; NRO , n = 286) was performed. Results No significant differences emerged between groups of patients with, respectively, RO and NRO RF s in the integrated practice with respect to time to diagnosis, and numbers of additional tissue sections or stains applied. By contrast, the use of RF s containing the term “rule out” was associated with significantly longer times to diagnosis and higher rates of use of pathology stains and sections in comparison with NRO RF s in the non‐integrated practice. However, the study is limited by its status as a retrospective review of data sourced from a single institution. Conclusions Use of the term “rule out” in RF s may not significantly impact key care delivery outcomes in an integrated practice. However, it may cause diagnostic delays and the use of unnecessary pathology services in a non‐integrated practice.