A new study out of the University of California, San Francisco supports the use of second opinions by oral and maxillofacial pathologists, particularly in diagnosing head and neck cancers (Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, March 19, 2010).
While several studies have documented the benefits of second opinions in diagnostic pathology, the effect of second opinion requests made by physician pathologists to oral and maxillofacial pathologists has not been well studied, the researchers wrote. Among disease sites, the head and neck can be a particularly problematic area for pathologists, prompting frequent second opinion requests.
To study the referral patterns of physician pathologists to a referral center for oral and maxillofacial pathology and to assess changes in diagnosis following second opinion, the researchers retrospectively reviewed 142 consecutive pathology consultation requests over a two-year period.
They reviewed the demographic, clinical, and pathologic data from both the submitted reports and corresponding second opinion reports. In addition, each diagnosis was reviewed to determine if agreement, minor disagreement, or major disagreement occurred between the original and the second opinion.
The most common diagnostic categories sent for second opinion were dysplasia/carcinoma, odontogenic cysts, and odontogenic tumors. In the 135 cases in which agreement could be assessed, 46 cases had differences in diagnostic opinion between the initial diagnosis and the second opinion. Minor disagreements occurred in 24 cases and major disagreements in 22 cases.
"Importantly, major disagreements identified here would have resulted in significant differences in patient evaluation and management," the researchers noted.
The study findings support the positive impact of second-opinion surgical pathology for lesions in the maxillofacial complex, they concluded.
Copyright © 2010 DrBicuspid.com
