Exhaled Nitric Oxide For The Diagnosis Of Asthma In Adults And Children: A Systematic Review.

nosis)) AND discordance[Title/Abstract]) AND lymphoma)) OR ((lymphoma[Title]) AND pathology[Title]). The pooled major discordance frequency was calculated using Neyeloff, Fuchs and Moreira’s Excel random effects model (2012). Weighted averages using a random-effects model are reported with 95% confidence intervals with continuity correction. Results: Eight (8) articles evaluating and differentiating minor and major second-opinion discordance in lymphoma diagnosis were included in this study. Major discordance is defined as diagnostic discrepancy between the preliminary or final diagnosis and second-opinion review that is determined by the study authors could have an impact on patient management. The proportion of discordance that was major ranged from 4.27% to 20.00%. The pooled proportion of major discordance was 9.10% (95% CI 5.86%-12.35%) in a pooled sample of 5,322 lymphoma patients. Only 1 study, a published abstract, analyzed the actual patient impact of discordant pathological results through chart review, determining 2.9% of patients were over-treated, under-treated, had significant change in treatment or incorrect treatment due to diagnostic error (Kukreti et al., 2006). ConClusions: Diverse methodologies led to considerably variable estimates; however, this meta-analysis revealed that an estimated 9.10% of lymphoma diagnoses could be incorrect to the point of impacting patient treatment management.