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the checklist

Sunday,  03/02/08  09:44 PM

I've been meaning to post this for a while...  The New Yorker published a great article in their Annals of Medicine called The Checklist, by Atul Gawande.  The article describes how an emergency room physician named Peter Pronovost created simple checklists for routine emergency room procedues, and how use of these checklists has has a dramatic reduction in unforced errors.

 "If a new drug were as effective at saving lives as Peter Pronovost’s checklist, there would be a nationwide marketing campaign urging doctors to use it."

It makes me wonder about the value of checklists in Pathology.  Many labs use checklists, either formally or informally, and there are some "standard" checklists in existence, such as the one found in the College of American Pathologists' Breast Cancer Protocol.

Aperio is in the process of running several clinical trials comparing digital pathology to conventional microscopy, for particular diagnosis situations (tissue type, preparation, etc.).  As part of these studies, it is necessary to devise a way of recording a diagnosis, in such a way that it can be objectively compared.  After reading The Checklist, it occured to me that perhaps the very act of recording the diagnois, by means of a checklist, might make the diagnosis itself more consistent and accurate.