How trustworthy is a diagnosis in head and neck surgical pathology? A consideration of diagnostic discrepancies (errors)

A comprehensive consideration of the categorization, causes, detection and consequences of diagnostic discrepancies (errors) in surgical pathology (SP) can be uncomfortable for both clinicians and pathologists, and probably explains why the topic is rarely discussed outside case conferences and multidisciplinary team meetings. In recent years, audit and quality assurance programs have become an integral part of SP and have raised awareness amongst pathologists and resulted in the introduction of various safeguards such as participation in accreditation and national external quality assurance schemes. Most clinicians are less well acquainted with the causes and detection of errors in SP. Furthermore, pathologists may use subtle differences in terminology to convey diagnostic uncertainty but these may be overlooked by clinicians looking for a definitive diagnosis before formulating a treatment plan, and this oversight provides further potential for misunderstanding or error. This editorial aims to summarize the detection and frequency of diagnostic discrepancies; the types of diagnostic discrepancies and their relative frequency; and to outline the consequences for the patient, relatives, and the pathology and clinical/surgical teams.