AUCTORES
Globalize your Research
Case-Report | DOI: https://doi.org/10.31579/2692-9392/016
*Corresponding Author: Mr. Mustafa Rashid, BSc, MBChB, MRCS, Senior clinical fellow in urology, Royal Gwent Hospital, Newport, Wales, NP20 2UB.
Citation: Rashid M., Rashid M., and Thompson I., (2020) With advances in information technology can we minimise errors in histopathology?. J. Archives of Medical Case Reports and Case Study. 3(2); DOI:10.31579/2692-9392/016
Copyright: © 2020 Mustafa Rashid, This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 29 July 2020 | Accepted: 12 August 2020 | Published: 21 August 2020
Keywords: histopathology; histopathologists
Accurate patient identification is key to ensure the correct administration of therapies. Mix-up of patients’identification and lack of a failsafe system remain common factors in producing erroneous pathology reports or giving the wrong treatment to patients with potential serious ramifications. This paper illustrates the importance of accurate patients’ identification and appropriate action by the clinicians on histology reports. We document 5 cases in which mistakes happened with variable consequences despite robust clinical and laboratory safety measures.
The world health organisation has produced guidelines on ten essential objectives for safe surgery in 2009, with the first objective to ensure the operation is on the right patient and at the correct site [1]. With the introduction of the WHO surgical checklist, we can aim to reduce the incidence, but can never remove the impact, of human error in this situation. The implications can extend to jeopardise patient safety; the national patient safety quarterly summary indicated that between 2006 and 2008, 15% of cases with a patient identification error came to some form of harm [2].
Errors may happen upon sending specimens to the laboratory which can be divided into pre-analytical, analytical or post-analytical in origin [3]. The common pre-analytical mistakes are mislabelling of specimens, wrong information on request forms, and transportation problems. Analytical errors are mainly due to a mix up of specimens within the laboratory, mislabelling of slides or blocks, and misinterpretation of findings by the histopathologists. Post-analytical mishaps arise from lack of action by the clinicians on issued reports due to inadequate fail-safe systems or problems with transportation. Although there are numerous guidelines to minimise these errors, human factor remains an important source of error [3]
We report 5 cases in a histopathology department at a large district general hospital illustrating these problems. The errors highlight the difficulty of implementing advances in information technology (IT) on patients’ safety. The cases also exemplify how human error is an important part of remedying the situation.
A middle-aged woman (A) presented with labour at term. She required caesarean section and requested tubal ligation for sterilisation at the same time. The operation was uneventful and segments of both fallopian tubes were submitted for histological examination. At microscopic examination, complete cross sections of both tubes were confirmed by the Histopathologist, but in addition a fragment of tissue showing a squamous cell carcinoma was also seen! Checking both containers and request forms matched the patient’s details. Review of the macroscopic description also matched the additional fragment of tissue. The obstetrician was contacted and expressed total surprise to the finding as the pelvic and abdominal organs looked fine at surgery. Upon imaging of the whole body no external or internal tumours could be found. Attention was directed to the theatre list to check for any potential discrepancy. It transpired that on the same day an elderly woman presented with a vaginal tumour which was biopsied. The specimen was placed in a container but unfortunately was not labelled and a request form was not completed by the obstetrician or theatre staff. The sample was left in theatre. When Patient A came in for her surgical procedure the theatre staff thought that the container was empty and put one of the fallopian tubes in it together with patient A’s label and details.
The problem which faced the histopathologist and obstetrician was how to prove that the squamous cell carcinoma did not belong to patient A. Tracing the elderly woman was unhelpful as she passed away in a Nursing Home and no post mortem examination was requested. A forensic laboratory was contacted to perform DNA analysis on the specimens. A blood sample was requested on patient A by the forensic lab. Fortunately, the analysis proved successful and confirmed that the fallopian tubes belonged to patient A whereas the squamous cell carcinoma displayed a different DNA profile hence must belong to a different patient, most probably to the elderly woman.
The bill for carrying out the DNA analysis was covered by the hospital. Testing took a few weeks adding further stress to the patient.
Patient B presented to the surgical team with abdominal pain and was diagnosed with cholelithiasis. An elective laparoscopic cholecystectomy was carried out. At registration, the receptionist typed the unit number of the patient incorrectly with one different digit, which resulted in producing labels of a different patient’s name and details (Patient X). These labels were not checked when filed in the case notes. At operation the sticky label for patient X was peeled off from the case notes of patient B and was put on the gallbladder container before submitting to histology. At the Laboratory the case was processed according to the information provided on the specimen and request form which matched and was reported by the histopathologist as chronic cholecystitis associated with cholelithiasis. A few weeks later, the surgeon sent a letter indicating that Patient X was not operated on and instead a cholecystectomy was performed on patient B with a missing histology report.
This incident was documented and relevant staff were informed to prevent the mix up from happening again.
A young woman (patient C) visited outpatient clinic with her mother for a routine cervical smear. Cervical sampling was performed by a gynaecologist and the specimen was submitted to the cytology department for assessment. The consultant histopathologist noted that the patient had a previous history of total abdominal hysterectomy. The age of the patient was also noted as 65 years but the smear showed no atrophic changes and appeared compatible with a young woman. Upon contacting the gynaecologist it became apparent that the sticky label which was used on the patient belonged to her mother! Unfortunately, both the mother and daughter had exactly the same first and surnames causing confusion at the time of registration.
It is only due to the robust procedure in cytology department where previous records of each patient have to be checked before interpreting cervical smears helped to identify and solve the problem.
A senior biomedical laboratory officer was carrying out cut up of skin specimens when was distracted and opened two containers belonging to two separate patients at the same time. To complicate the matter a frozen section specimen arrived for an urgent intraoperative diagnosis. The cut up had to be postponed but unfortunately the skin biopsies were returned to wrong containers. The cases were reported by the histopathologists as melanoma and seborrheic keratosis without knowing the earlier mix up. The dermatologist contacted the laboratory indicating that the results did not match the clinical findings. Upon conducting internal investigation the containers were correctly labelled and the laboratory officer did not recall the incident. DNA testing was requested and proved the identity of both patients and confirmed the mix up of the specimens at macroscopic examination.
A clinical incident report was filed and the importance of adhering to the cut up protocol was emphasised to the laboratory staff.
An orthopaedic surgeon biopsied a non-healing lesion on an index finger which was suspicious of squamous carcinoma. Histology confirmed the diagnosis but no further action was taken. The patient presented later with a clavicular lesion which was radiologically suspicious of metastatic tumour. Biopsy showed metastatic squamous cell carcinoma. The surgeon complained to the laboratory that the original histology report was not received. The incident was investigated and it became apparent that the histology results were sent to the patient’s ward and not to the surgeon’s secretary.
The address of the consultant was corrected on LIMS (laboratory computer system) and address of other consultants were also checked to make sure that they were correct. Although all laboratory results are digitally available on the hospital clinical portal system, the IT department and cancer services were asked if all cancerous reports could be flagged up to the clinicians automatically similar to radiology results. The directorate of surgery also implemented a new fail-safe mechanism to filter their cases.
All 5 cases illustrated the ease of human error with serious ramifications to the patients and clinicians. The pathway between a patient being registered by the healthcare system and receiving an intervention is well documented in the 1000 lives campaign [4]. This initial system of identifying the patient for the correct medical record has failed in cases 1, 2 and 3. Implementing more robust systems to accurately identify the patient in question is the aim of this campaign, but ultimately human error in this initial section can be missed despite technological advancement. In the context of human error, the realm of blood transfusion regularly makes advances in its technology but two thirds of errors remain from a simple incorrect patient identification at the bedside [5].
NHS Connecting for health in the UK and WHO Information Technology for Patient Safety Expert Working Group are both innovating new methods to improve patient care using technological advancement. The goal is to ultimately reduce any iatrogenic harm with the introduction of electronic solutions on a wider scale. So far there is no robust evidence to show that these innovations are producing a cost effective reduction in these events [6]. With the addition of the newer and more complicated identification methods, it is reasonable to assume that this can produce a new platform for human error to present itself. The national patient safety agency had been informed by the Head of the Royal Colleges of the mainstay of the medical workforces that there is inconsistent training on patient identification, and that staff are uncertain on the correct or most accurate way to identify a patient. [7].
In cases no. 1, 2 and 3 the information technology actually worked in identifying the patients but unfortunately protocols were not followed to check the patients’ details. The cases illustrated how simple errors can be made, but without effective fail-safe mechanisms these mistakes can be extrapolated far enough down the line to potentially risk patient care. The availability of print-off sticky labels has made administrative processes quicker but could allow for complacency and carelessness. The current guidance from JPAC and NHS Evidence on blood transfusion for example, is that all patient identification should be done electronically, to reduce risk and save cost [8]. In this setting, labels produced electronically via handheld devices linked to wristbands or Q.R codes at the bedside could feasibly remove this error but would not bypass the problem of generating the wrong wristband/QR code in the first place [9].
With the reduction of the cost of information technology there is increasing demand to use it across the world [6]. In the United Kingdom the NHS implemented guidelines to minimise errors which include: usage of a unique NHS identification number, pre-printed sticky labels of patient’s details, electronic requesting of tests, documentation of incidents, clinical audits, investigation by special agencies and accreditation by authorised intuitions (ref 10). The current NHS number was introduced in its current format in 1996 which consists of 9 digits identifying the patient and 10th digit for confirming the validity of the NHS number. However, hospitals tend to use additional CRN numbers, and radiology and pathology departments generate their own episode numbers adding further confusion and increasing the chance of transcription errors. As indicated pre-printed sticky labels, which can be stored in the hospital case notes for quick usage, are not immune from human errors when used on the wrong patient.
Current studies showed that electronic requests for laboratory tests can improve patient’s safety but again are not free from mistakes [7]. Clinical audits are helpful in generating information to minimise errors by identifying the pattern of mistakes and the individuals involved [11]. There are independent specialised agencies such as the National Patient Safety Agency and Health Care Safety Investigation Branch (2) which can help in these sensitive investigations.
It is essential to address the root cause of errors by educating laboratory staff, increasing awareness, reducing risk factors, identifying fatigue due to long working hours, changing of working practice, participating in quality controls and documentation of near misses [10].
The Royal Colleges issued numerous guidelines to the clinicians for best practice in their speciality. The Royal College of Pathologists recommended contacting the clinicians for unexpected results which is nicely illustrated in cases no. 1 and 3 [12].
In case no. 4 the error was different and highlighted the importance of adhering to the laboratory rules of not dealing with two cases at the same time on grossing of specimens. Although it was human error which caused the mix up of patients the individual involved did not recall the existence of the incident. Using bare coded containers and electronic request forms can help in all steps of laboratory processing and interpretation. Luckily DNA testing is available which is useful to solve the problem in cases no. 1 and 4.
For case no. 5 there were no issues with the identification process of the patient yet the system failed to deliver the histology result to the clinician. Amongst the lessons learnt in this case is to use advances in information technology to generate an effective failsafe system to filter outstanding awaiting action. Cancer services were also asked if all histological diagnoses of malignant conditions could be flagged up electronically to the relevant clinicians, similar to the failsafe system used for radiology and blood sciences laboratory abnormal results.
None of the cases described were due to misinterpretation of the findings by the histo- pathologists which is an additional known cause for laboratory errors [11]. Carrying out peer review of difficult cases with other histopathologists, participating in multidisciplinary meetings with the clinicians and radiologists, and referral of cases for expert opinion help to minimise these errors [10 and 11]. Again, advances in IT is transforming this practice by helping the histopathologists to engage in these activities from their office via video-link or using digital images. This process became essential during Covid 19 crisis.
Despite advances in technology, there is little available evidence to remove the element of human error in patient identification. Groups such as the WHO and Connecting for Health are pioneering new electronic methods that can incorporate into common practise to aid accurate identification of the patient. Until more failsafe methods can be added without over-burdening the workload in the system, there will always remain the room for human mistakes in patient identification risking their safety. The five cases above demonstrate simple relatable errors that could easily occur even with modern technology.
Conflicting interests
The Authors declare that there is no conflict of interest.
This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Cases were obtained from archives of histopathology department. Consents were not sought as patients were anonymized.
Our institution does not require ethical approval for reporting individual cases.
Dr Mustafa Rashid wrote the paper. Dr Majid Rashid provided the cases and reviewed the manuscript. Dr Ian Thompson reviewed the manuscript.
We would like to thank Mrs Elaine Pilley for typing the manuscript.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
