Paul M Speight1, Timothy J Abram2, Pierre N Floriano3, Robert James4, Julie Vick4, Martin H Thornhill5, Craig Murdoch5, Christine Freeman5, Anne M Hegarty6, Katy D'Apice6, A Ross Kerr7, Joan Phelan7, Patricia Corby8, Ismael Khouly8, Nadarajah Vigneswaran9, Jerry Bouquot9, Nagi M Demian10, Y Etan Weinstock11, Spencer W Redding12, Stephanie Rowan12, Chih-Ko Yeh12, H Stan McGuff13, Frank R Miller14, John T McDevitt15. 1. Academic Unit of Oral & Maxillofacial Pathology, University of Sheffield School of Clinical Dentistry, Sheffield, UK. 2. Rice University, Department of Bioengineering, Houston, TX, USA. 3. University of Texas MD Anderson Cancer Center, Houston, TX, USA. 4. Rho Inc., Chapel Hill, NC, USA. 5. Academic Unit of Oral & Maxillofacial Medicine & Surgery, University of Sheffield School of Clinical Dentistry, Sheffield, UK. 6. Unit of Oral Medicine, Charles Clifford Dental Hospital, Sheffield Teaching Hospitals National Health Service Foundation Trust, Sheffield, UK. 7. New York University College of Dentistry, Department of Oral and Maxillofacial Pathology, Radiology & Medicine, New York, NY, USA. 8. New York University College of Dentistry, Bluestone Center for Clinical Research, New York, NY, USA. 9. The University of Texas Health Science Center at Houston, Department of Diagnostic and Biomedical Sciences, Houston, TX, USA. 10. The University of Texas Health Science Center at Houston, Department of Oral and Maxillofacial Surgery, Houston, TX, USA. 11. The University of Texas Health Science Center at Houston, Department of Otolaryngology-Head and Neck Surgery, Houston, TX, USA. 12. The University of Texas Health Science Center at San Antonio, Department of Comprehensive Dentistry, San Antonio, TX, USA. 13. The University of Texas Health Science Center at San Antonio, Department of Pathology, San Antonio, TX, USA. 14. The University of Texas Health Science Center at San Antonio, Department of Otolaryngology-Head and Neck Surgery, San Antonio, TX, USA. 15. Rice University, Department of Bioengineering, Houston, TX, USA; Department Biomaterials, Bioengineering Institute, New York University, New York, NY, USA; Rice University, Department of Chemistry, Houston, TX, USA. Electronic address: mcdevitt@nyu.edu.
Abstract
OBJECTIVE: Interobserver agreement in the context of oral epithelial dysplasia (OED) grading has been notoriously unreliable and can impose barriers for developing new molecular markers and diagnostic technologies. This paper aimed to report the details of a 3-stage histopathology review and adjudication process with the goal of achieving a consensus histopathologic diagnosis of each biopsy. STUDY DESIGN: Two adjacent serial histologic sections of oral lesions from 846 patients were independently scored by 2 different pathologists from a pool of 4. In instances where the original 2 pathologists disagreed, a third, independent adjudicating pathologist conducted a review of both sections. If a majority agreement was not achieved, the third stage involved a face-to-face consensus review. RESULTS: Individual pathologist pair κ values ranged from 0.251 to 0.706 (fair-good) before the 3-stage review process. During the initial review phase, the 2 pathologists agreed on a diagnosis for 69.9% of the cases. After the adjudication review by a third pathologist, an additional 22.8% of cases were given a consensus diagnosis (agreement of 2 out of 3 pathologists). After the face-to-face review, the remaining 7.3% of cases had a consensus diagnosis. CONCLUSIONS: The use of the defined protocol resulted in a substantial increase (30%) in diagnostic agreement and has the potential to improve the level of agreement for establishing gold standards for studies based on histopathologic diagnosis.
OBJECTIVE: Interobserver agreement in the context of oral epithelial dysplasia (OED) grading has been notoriously unreliable and can impose barriers for developing new molecular markers and diagnostic technologies. This paper aimed to report the details of a 3-stage histopathology review and adjudication process with the goal of achieving a consensus histopathologic diagnosis of each biopsy. STUDY DESIGN: Two adjacent serial histologic sections of oral lesions from 846 patients were independently scored by 2 different pathologists from a pool of 4. In instances where the original 2 pathologists disagreed, a third, independent adjudicating pathologist conducted a review of both sections. If a majority agreement was not achieved, the third stage involved a face-to-face consensus review. RESULTS: Individual pathologist pair κ values ranged from 0.251 to 0.706 (fair-good) before the 3-stage review process. During the initial review phase, the 2 pathologists agreed on a diagnosis for 69.9% of the cases. After the adjudication review by a third pathologist, an additional 22.8% of cases were given a consensus diagnosis (agreement of 2 out of 3 pathologists). After the face-to-face review, the remaining 7.3% of cases had a consensus diagnosis. CONCLUSIONS: The use of the defined protocol resulted in a substantial increase (30%) in diagnostic agreement and has the potential to improve the level of agreement for establishing gold standards for studies based on histopathologic diagnosis.
Authors: D J Brothwell; D W Lewis; G Bradley; I Leong; R C K Jordan; D Mock; J L Leake Journal: Community Dent Oral Epidemiol Date: 2003-08 Impact factor: 3.383
Authors: A M Lessells; R A Burnett; J R Goodlad; S R Howatson; S Lang; F D Lee; K M McLaren; S Ogston; A J Robertson; J G Simpson; G D Smith; H B Tavadia; F Walker Journal: J Pathol Date: 2002-09 Impact factor: 7.996
Authors: L M Abbey; G E Kaugars; J C Gunsolley; J C Burns; D G Page; J A Svirsky; E Eisenberg; D J Krutchkoff; M Cushing Journal: Oral Surg Oral Med Oral Pathol Oral Radiol Endod Date: 1995-08
Authors: G J Kelloff; C W Boone; J A Crowell; S G Nayfield; E Hawk; W F Malone; V E Steele; R A Lubet; C C Sigman Journal: J Cell Biochem Suppl Date: 1996
Authors: Timothy J Abram; Pierre N Floriano; Nicolaos Christodoulides; Robert James; A Ross Kerr; Martin H Thornhill; Spencer W Redding; Nadarajah Vigneswaran; Paul M Speight; Julie Vick; Craig Murdoch; Christine Freeman; Anne M Hegarty; Katy D'Apice; Joan A Phelan; Patricia M Corby; Ismael Khouly; Jerry Bouquot; Nagi M Demian; Y Etan Weinstock; Stephanie Rowan; Chih-Ko Yeh; H Stan McGuff; Frank R Miller; Surabhi Gaur; Kailash Karthikeyan; Leander Taylor; Cathy Le; Michael Nguyen; Humberto Talavera; Rameez Raja; Jorge Wong; John T McDevitt Journal: Oral Oncol Date: 2016-07-20 Impact factor: 5.337
Authors: Melody T Tan; Jean G Wu; Juan Luis Callejas-Valera; Richard A Schwarz; Ann M Gillenwater; Rebecca R Richards-Kortum; Nadarajah Vigneswaran Journal: Int J Exp Pathol Date: 2020-05-21 Impact factor: 1.925
Authors: M P McRae; A R Kerr; M N Janal; M H Thornhill; S W Redding; N Vigneswaran; S K Kang; R Niederman; N J Christodoulides; D A Trochesset; C Murdoch; I Dapkins; J Bouquot; S S Modak; G W Simmons; J T McDevitt Journal: J Dent Res Date: 2020-11-12 Impact factor: 6.116
Authors: Hans Prakash Sathasivam; Ralf Kist; Syed Haider; Max Robinson; Philip Sloan; Peter Thomson; Michael Nugent; John Alexander Journal: Br J Cancer Date: 2021-05-10 Impact factor: 7.640
Authors: Lester D R Thompson; Sarah G Fitzpatrick; Susan Müller; Ellen Eisenberg; Jasbir D Upadhyaya; Mark W Lingen; Nadarajah Vigneswaran; Sook-Bin Woo; Indraneel Bhattacharyya; Elizabeth A Bilodeau; Roman Carlos; Mohammed N Islam; Marino E Leon; James S Lewis; Kelly R Magliocca; Haresh Mani; Mitra Mehrad; Bibianna Purgina; Mary Richardson; Bruce M Wenig; Donald M Cohen Journal: Head Neck Pathol Date: 2021-01-07
Authors: Edward Odell; Hans Edmund Eckel; Ricard Simo; Miquel Quer; Vinidh Paleri; Jens Peter Klussmann; Marc Remacle; Elisabeth Sjögren; Cesare Piazza Journal: Eur Arch Otorhinolaryngol Date: 2020-10-13 Impact factor: 2.503