Browsing by Author "Longo, Isabel"

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    Impact of Skin Biopsy and Clinical-Pathologic Correlation in Dermatology Inpatient Consults
    (Springer Nature, 2022-08-29) Wells, Amy; Harmel, Allison; Smith, Kristin N.; Beers, Paula; Qiu, Yingjie; Datta, Susmita; Schoch, Jennifer J.; De Benedetto, Anna; Longo, Isabel; Motaparthi, Kiran; Biostatistics and Health Data Science, Richard M. Fairbanks School of Public Health
    Background: While studies of hospital dermatology have demonstrated diagnostic discordance between primary teams and dermatology consultants, little is known about the impact of biopsy and clinical-pathologic correlation (CPC) in consultation. This study compares biopsy performance based on diagnostic discordance and evaluates the impact of CPC on the diagnosis. Methods: This was a retrospective review of 376 dermatologic consultations at a single academic medical center between July 1, 2017, and June 27, 2018. Results: Biopsy was significantly less likely to be performed when the diagnosis by the referring primary team was unspecified (p < 0.001). In 24 percent of cases, the diagnosis based on histopathology alone differed from the diagnosis reached by formal CPC consensus review with either potential or significant impact on management. Conclusion: Dermatologists who perform inpatient consultations and rely on hospital-based pathology services may consider a consensus review for CPC. Requests to perform a biopsy may be interpreted as a request for diagnostic assistance rather than pressure to perform a procedure.