Hernandez, Marisol

Context.— In 2016, the College of American Pathologists published an evidence-based guideline to develop recommendations for interpretive diagnostic error reduction in anatomic pathology. New evidence, together with evolving practice environments and the continued adoption of digital technologies, including artificial intelligence, has prompted a review of the guideline. Objective.— To assess evidence published since the release of the original guideline and update evidence-based recommendations for the reduction of diagnostic errors. Design.— The College of American Pathologists, in collaboration with the Association of Directors of Anatomic and Subspecialty Pathology, convened a panel of experts to update the 2016 evidence-based guideline. A systematic literature review was conducted to address 4 key questions. Using the Grading of Recommendations Assessment, Development and Evaluation approach, recommendations were created based on the available evidence, certainty of that evidence, and key judgments as defined in the Grading of Recommendations Assessment, Development and Evaluation framework. Results.— Two strong recommendations and 4 good practice statements were established for the reduction of diagnostic error. Conclusions.— The expert panel recommends that anatomic pathologists implement procedures for the review of pathology cases to detect and correct potential interpretive errors to improve patient outcomes.

Context.— Treatments are available for common forms of systemic amyloidosis that show promise for extending and improving the quality of life for patients. Early diagnosis and accurate identification of amyloid fibril type are crucial for successful treatment, but the diagnosis and workup of amyloidosis is inconsistent among pathologists and laboratories. Thus, the goal of this guideline is to offer recommendations for proper testing and workup for amyloidosis to optimize patient care. Objective.— To establish evidence-based recommendations for appropriate laboratory testing to detect amyloidosis and identify the specific amyloidogenic protein. Design.— The College of American Pathologists convened a panel of experts to develop recommendations following the standards established by the National Academy of Medicine for developing trustworthy clinical practice guidelines. The panel conducted a systematic literature review addressing 6 key questions. Using the Grading of Recommendations Assessment, Development and Evaluation framework, recommendations were created based on the available evidence, certainty of that evidence, and key judgments as defined in the framework. Results.— Four conditional recommendations and 3 good practice statements were established to provide guidance for proper testing and workup of amyloidosis. Conclusions.— This guideline summarizes the available evidence on the diagnosis and workup of systemic amyloidosis in tissue samples, including the challenges and limitations of common approaches and techniques. Recommendations for pathologists and laboratories receiving these samples are provided.