During the IQN Path Annual General Meeting in 2017, an idea was born to identify a channel for publications relating to quality issues in pathology, that would also provide a vehicle to collate papers and interesting articles related to External Quality Assessment in Pathology, amongst other topics that touch on quality. IQN Path ASBL reached out to Virchows Archiv and were happy that the proposal was positively received. Virchows Archiv will now launch a special section entitled “Quality in Pathology”.
However, why is such an extra focus for Virchows Archiv important? What does it encompass?
Dr Han van Krieken, the President of IQN Path ASBL explains; “Pathologists are very proud of their reliability; a cancer diagnosis is almost always correct, and although there are some issues regarding grading and classification, the vast majority of patients are correctly treated thanks to very effective and cheap pathology. Furthermore, clinicians and patients generally have a great trust in pathology.”
So, what is the need for spending resources on researching quality?
“One common criticism is that quality programs are bureaucratic and cost time without delivering anything. Yet there are several reasons why a focus on quality in pathology is relevant, reasons that are partly coming from society as a whole, and partly thanks to the development of our profession. In general, our society is one of a high level of trust, meaning that citizens, and in our case patients, trust professionals and institutions. As we all know, some are trusted more (doctors, engineers) than others (politicians, journalists) but there is a gradual decline in trust. Increasingly, individuals and organizations are requested to show that they are trustworthy, not to simply tell us that they are. Whether we like it or not, we – as pathologists – are part of that society, paid by it and therefore have to show that what we do is of high quality. This has resulted in the introduction of accreditation programs, often based on ISO-norms. Such programs do not intend to increase quality, but to show it. However, a large problem in pathology is the fact that quality programs focus on the laboratory processes, with little to no focus on the actual diagnosis provided by pathologists.”
Why has this become important now?
“Pathology itself is changing too, especially living as we are in the era of precision medicine.
Given the importance of quality demonstration and assessment in pathology, there is need for a forum that enables the scientific debate on the topic. We need to better understand what we mean by “quality” in pathology, and guidance on how to have efficient quality systems with as little bureaucracy as possible. How do we improve the reliability of our testing, the quality of grading and classification where relevant? What is already good and what needs improvement? I hope that the new section in Virchow’s will provide a forum for such articles and opinion papers and can provide a home for work arising from the efforts of IQN Path ASBL.”