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PubMed2002

Speech-language pathologists: leading the way with outcomes data.

Diminishing resources and the need to justify cost effectiveness and efficacy of treatment have made it critical to illustrate the value and benefits of providing speech-language pathology services to adults with cognitive, communication, and swallowing disorders. Using the American Speech-Language-Hearing Association's National Outcomes Measurement System, this article explains how SLPs demonstrate the worthiness of their treatment to home care patients.

Adult↗
PubMed2003

Symposium part 3: Should pathologists diagnose endocervical preneoplastic lesions "less than" adenocarcinoma in situ?: Point.

The insufficient state of knowledge concerning the biology of endocervical glandular lesions is compounded by the lack of universal diagnostic criteria for recognizing endocervical glandular dysplasia. This study addressed the issue of diagnostic reproducibility of noninvasive endocervical glandular lesions and tested the proposed new scoring scheme designed to improve this reproducibility. We have shown that the application of this scheme has significantly improved interobserver agreement in all diagnostic categories. Moreover, the results of this study lend support to the recommendation not to diagnose endocervical glandular dysplasia in the clinical setting, although this category can be still reliably separated out for research purposes. Application of our scoring scheme will bring uniformity to the diagnosis of noninvasive endocervical glandular lesions and allow the study of a precursor to endocervical adenocarcinoma

Adenocarcinoma↗
PubMed2003

Symposium part 4: Should pathologists diagnose endocervical preneoplastic lesions "less than" adenocarcinoma in situ?: Counterpoint.

Adenocarcinoma in situ (AIS) is the acknowledged precursor to most cases of invasive adenocarcinoma of the cervix. However, diagnostic terminology for lesions that do not fulfill all of the published criteria for AIS has not been standardized. Some have used the terms "glandular dysplasia" or " atypical hyperplasia" for purported antecedents of AIS, whereas others have adopted the term "cervical intraepithelial glandular neoplasia" (CIGN) for the entire spectrum of endocervical atypicality including AIS, with subcategories of "low-grade" and "high-grade" CIGN. In this article the appropriateness of using these terms in diagnostic reports (versus the use of AIS to include some or most of the lesions encompassed by them, with nonspecific terminology for the remainder) is examined in the light of the relevant objective studies bearing on this question. An opinion is offered favoring the latter approach.

Adenocarcinoma↗