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Use of Term 'Rule Out' May Delay Dermatopathology Diagnosis

Use on requisition form linked to longer time to diagnosis, increased use of pathology stains, sections

woman looking through the microscope

TUESDAY, Nov. 1, 2016 (HealthDay News) -- In an non-integrated dermatopathology practice, use of the term "rule out" on the requisition form (RF) may cause diagnostic delays and use of unnecessary pathology services, according to a study published online Oct. 25 in the International Journal of Dermatology.

Yara Abdou, M.D., from the Mayo Clinic in Rochester, Minn., and colleagues conducted a retrospective double-cohort study involving 475 RFs from an integrated dermatopathology practice (182 used the term "rule out" [RO] and 293 did not [NRO]) and 412 RFs from a non-integrated dermatopathology practice (126 RO and 286 NRO).

The researchers found that in the integrated practice there were no significant differences for RO and NRO patients with respect to time to diagnosis and numbers of additional tissue sections or stains applied. In the non-integrated practice, use of RFs containing the term RO correlated with significantly longer times to diagnosis and higher rates of pathology stains and sections used, compared to NRO RFs.

"Use of the term 'rule out' in RFs may not significantly impact key care delivery outcomes in an integrated practice," the authors write. "However, it may cause diagnostic delays and the use of unnecessary pathology services in a non-integrated practice."

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