TABLE 1.
Training and Experience of Participating Pathologists Overall and by Whether or Not Their Laboratory Has a Second Opinion Policy
| Pathologist Training and Experience | Total n (col %) | No Policy n (row %) | Policy* n (row %) | p† |
|---|---|---|---|---|
| Total | 207 (100) | 142 (69) | 65 (31) | |
| Affiliation with academic medical center | .49 | |||
| No | 148 (71) | 104 (70) | 44 (30) | |
| Yes, adjunct/affiliated | 38 (18) | 23 (61) | 15 (40) | |
| Yes, primary appointment | 21 (10) | 15 (71) | 6 (29) | |
| Residency training | .29 | |||
| Pathology only | 186 (90) | 125 (88) | 61 (94) | |
| Dermatology only | 17 (8) | 13 (9) | 4 (6) | |
| Both pathology and dermatology | 4 (2) | 4 (3) | 0 (0) | |
| Board certified and/or fellowship trained in dermatopathology‡ | .29 | |||
| Yes | 81 (39) | 59 (73) | 22 (27) | |
| No | 126 (61) | 83 (66) | 43 (34) | |
| Laboratory group practice size | .33 | |||
| <5 Pathologists | 140 (68) | 93 (66) | 47 (34) | |
| ≥5 Pathologists | 67 (32) | 49 (73) | 18 (27) | |
| Percent of caseload interpreting MSLs | .25 | |||
| <10 | 90 (43) | 56 (62) | 34 (38) | |
| 10–24 | 79 (38) | 57 (72) | 22 (28) | |
| 25–49 | 29 (14) | 21 (72) | 8 (28) | |
| ≥50 | 9 (5) | 8 (89) | 1 (11) | |
| In a typical month, how many MSLs do you receive from pathologist colleagues seeking a second opinion? | .46 | |||
| None | 52 (25) | 40 (77) | 12 (23) | |
| 1–9 | 60 (29) | 38 (63) | 22 (37) | |
| 10–24 | 63 (30) | 43 (68) | 20 (32) | |
| ≥25 | 32 (16) | 21 (66) | 11 (34) | |
| In a typical month, for how many MSLs do you request a second opinion? | .008 | |||
| None | 22 (11) | 19 (86) | 3 (14) | |
| 1 | 54 (26) | 43 (80) | 11 (20) | |
| 2–4 | 41 (20) | 30 (73) | 11 (27) | |
| 5–9 | 40 (19) | 22 (55) | 18 (45) | |
| ≥10 | 50 (24) | 28 (56) | 22 (44) | |
| For what percentage of MSLs is your final assessment that the diagnosis is borderline or uncertain? | .86 | |||
| None | 21 (10) | 16 (76) | 5 (24) | |
| 1 | 52 (25) | 33 (64) | 19 (37) | |
| 2–4 | 41 (20) | 28 (68) | 13 (32) | |
| 5–9 | 58 (28) | 41 (71) | 17 (29) | |
| ≥10 | 35 (17) | 24 (69) | 11 (31) | |
| Are you considered an expert in MSLs by colleagues? | .16 | |||
| No | 119 (57) | 77 (65) | 42 (35) | |
| Yes | 88 (43) | 65 (74) | 23 (26) |
Percentages might not add up to 100 because of rounding.
*
Policy was dichotomized to “no policy” (includes “not applicable” and coverage of 0%) versus having a policy requiring a second opinion for at least 1 among 9 diagnoses of melanoma (in which percentage of cases requiring a second opinion was >0%).
†
p-value for difference between “no policy” and “policy” using the Chi-square test.
‡
This category consists of physicians with single or multiple fellowships that include dermatopathology. Also includes physicians with single or multiple board certifications that include dermatopathology.
MSLs, melanocytic skin lesions.