M. Mireskandari, MD, Pathology Department, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
"Critical value" is a well known concept in clinical pathology laboratory. Frankly it defined as quantitative levels of analytes which are incompatible with life or severely threaten it, and accordingly needs immediate intervention. The most usual and daily examples in practice is very high or very low levels of serum potassium.
In surgical pathology most pressure on pathologists to shorten turn around time is basically economical and sources from insurance companies. They want to increase hospital beds turn over and decrease patients' hospitalization course for more benefit. Some articles and publications are suggested that pathologists should not decide on a case in stressful situations and some pathologists choose their carrier because there is no immediate need to make decision on difficult cases. But the question remained that is there any situation in surgical pathology that can be considered as an equivalent to critical values in clinical pathology? In other word is there any situation in surgical pathology that delay in reporting the diagnosis or findings can result in sever and irreversible damage to patients? If the answer is yes, what would be the conditions? How they should be defined?
Although the above questions seem critical to answer, the medical literature is very poor about it. Many textbooks in pathology represented vaguely comments about such situations, but it is very difficult to find strict guidelines that show which clinical or pathological diagnosis deserves to consider as a critical value in surgical pathology. Recently some investigators tried to define some of those situations. But the concept is remained to be defined more appropriately. This study is in continuing of a survey on a group of Iranian pathologists who requested to define their concept on critical values (or emergency situations) in surgical pathology. The results of that survey indicated that the concept of critical values in surgical pathology is very different from those represented in recent articles and a need for further work is apparent. Since iPath server has members of different specialties and different nationalities, I suppose that their comments on this topic would be a very interesting and valuable tool for comparison of different view points. Accordingly, two different questionnaires were prepared for clinicians and pathologists and only one of them would be filled. I hope by your contribution helpful information can be provided and publicized later.
How to support this study ?
This study is organised by Dr. Masoud Mireskandari, Pathology Department, Kerman University of Medical Sciences, Kerman, Iran. If you are willing to participate in this study, please download the appropriate questionaire, fill it out and email it to Masoud Mireskandari mireskandari@gmail.com| Attachment | Size |
|---|---|
| Questionnaire_English-Pathologists.doc | 25.5 KB |
| Questionnaire_English-Clinicians.doc | 25 KB |
