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- Title
A study of Gleason score interpretation in different groups of UK pathologists; techniques for improving reproducibility.
- Authors
Griffiths, D. F. R.; Melia, J.; McWilliam, L. J.; Ball, R. Y.; Grigor, K.; Harnden, P.; Jarmulowicz, M.; Montironi, R.; Moseley, R.; Waller, M.; Moss, S.; Parkinson, M. C.
- Abstract
Aims: To test the effectiveness of a teaching resource (a decision tree with diagnostic criteria based on published literature) in improving the proficiency of Gleason grading of prostatic cancer by general pathologists. Methods: A decision tree with diagnostic criteria was developed by a panel of urological pathologists during a reproducibility study. Twenty-four general histopathologists tested this teaching resource. Twenty slides were selected to include a range of Gleason score groups 2–4, 5–6, 7 and 8–10. Interobserver agreement was studied before and after a presentation of the decision tree and criteria. The results were compared with those of the panel of urological pathologists. Results: Before the teaching session, 83% of readings agreed within ± 1 of the panel's consensus scores. Interobserver agreement was low (κ = 0.33) compared with that for the panel (κ = 0.62). After the presentation, 90% of readings agreed within ± 1 of the panel's consensus scores and interobserver agreement amongst the pathologists increased to κ = 0.41. Most improvement in agreement was seen for the Gleason score group 5–6. Conclusions: The lower level of agreement among general pathologists highlights the need to improve observer reproducibility. Improvement associated with a single training session is likely to be limited. Additional strategies include external quality assurance and second opinion within cancer networks.
- Subjects
UNITED Kingdom; GLEASON grading system; PATHOLOGISTS; BIOPSY; PROSTATE cancer; CANCER
- Publication
Histopathology, 2006, Vol 48, Issue 6, p655
- ISSN
0309-0167
- Publication type
Article
- DOI
10.1111/j.1365-2559.2006.02394.x