Variation among pathologists' treatment suggestions for melanocytic lesions: A survey of pathologists

Background The extent of variability in treatment suggestions for melanocytic lesions made by pathologists is unknown. Objective We investigated how often pathologists rendered suggestions, reasons for providing suggestions, and concordance with national guidelines. Methods We conducted a cross-sect...

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Veröffentlicht in:	Journal of the American Academy of Dermatology 2017-01, Vol.76 (1), p.121-128
Hauptverfasser:	Lee, Kachiu C., MD, Peacock, Sue, MSc, Weinstock, Martin A., MD, PhD, Zhao, Ge Alice, MD, PhD, Knezevich, Stevan R., MD, PhD, Elder, David E., MB ChB, FRCPA, Barnhill, Raymond L., MD, MSc, Piepkorn, Michael W., MD, PhD, Reisch, Lisa M., PhD, Carney, Patricia A., PhD, Onega, Tracy, PhD, Lott, Jason P., MD, MHS, MSHP, Elmore, Joann G., MD, MPH
Format:	Artikel
Sprache:	eng
Schlagworte:	atypical nevi Clinical Competence Cross-Sectional Studies Dermatology dermatopathology dysplastic nevi Female Guideline Adherence - statistics & numerical data Humans Liability, Legal Male melanocytic lesions melanoma Melanoma - pathology Melanoma - therapy melanoma in situ Middle Aged Nevus, Pigmented - pathology Nevus, Pigmented - therapy Pathologists - education Pathologists - statistics & numerical data Practice Guidelines as Topic Practice Patterns, Physicians' - standards Practice Patterns, Physicians' - statistics & numerical data Self Efficacy Skin Neoplasms - pathology Skin Neoplasms - therapy treatment United States
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Zusammenfassung:	Background The extent of variability in treatment suggestions for melanocytic lesions made by pathologists is unknown. Objective We investigated how often pathologists rendered suggestions, reasons for providing suggestions, and concordance with national guidelines. Methods We conducted a cross-sectional survey of pathologists. Data included physician characteristics, experience, and treatment recommendation practices. Results Of 301 pathologists, 207 (69%) from 10 states (California, Connecticut, Hawaii, Iowa, Kentucky, Louisiana, New Jersey, New Mexico, Utah, and Washington) enrolled. In all, 15% and 7% reported never and always including suggestions, respectively. Reasons for offering suggestions included improved care (79%), clarification (68%), and legal liability (39%). Reasons for not offering suggestions included referring physician preference (48%), lack of clinical information (44%), and expertise (29%). Training and caseload were associated with offering suggestions ( P
ISSN:	0190-9622 1097-6787
DOI:	10.1016/j.jaad.2016.07.029