Clinical Faceoff: Should Routine Histopathological Analysis be Performed on Specimens Obtained During Primary Arthroplasty Surgery?

摘要

The United States Institute of Medicine (IOM) has described six domains of healthcare quality [7]: Safety, effectiveness, efficiency, patient-centeredness, equity, and timeliness. But even within the same healthcare process—such as histopathological analysis of surgical specimens—different experts and experts from different backgrounds may value each of those domains somewhat differently. As a healthcare process, histopathological analysis of specimens obtained during routine arthroplasty varies widely from institution to institution. While some variation among physicians in the care of patients is inevitable (and beneficial), unexplained systemwide variation should attract our attention as a potential opportunity to improve quality. In this Clinical Faceoff on whether histopathological analysis should be performed on surgical specimens as a matter of routine after arthroplasty surgery, I am joined by two international experts with very different backgrounds: Thomas W. Bauer MD, PhD, and Ola Rolfson MD, PhD.