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Vincent R. Hunt, MD; John Murphy, MD; Larry Culpepper, MD, MPH
Brown University Memorial Hospital of Rhode Island Pawtucket

JAMA. 1991;265(17):2192.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Stern et al¹ suggest that a cost-effective method of quality assurance can be developed by analyzing the records of pathological specimens stored in computer databases. They point out pitfalls with their study, such as the potential for selection bias, because of their inability to ascertain the universe from which specimens were obtained or the number of patients with seborrheic keratoses who were treated appropriately. Also, information supplied by the referring physician on the pathology reporting form was not standardized, and the diverse specialties represented by the physician participants makes it difficult to characterize the nature of the patient population studied.

The authors dealt with issues of selection bias by conducting an "informal poll," from which they concluded that the direction of the bias for dermatologists would understate the accuracy calculated in their study. For other specialties, they imply that there is less potential for bias because . . . [Full Text PDF of this Article]

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