Diagnostic Reproducibility: What Happens When the Same Pathologist Interprets the Same Breast Biopsy Specimen at Two Points in Time?
[ABSTRACT READ IN FULL at the Europe PMC core record; full text NOT READ, subscription required] Jackson, S. L., Frederick, P. D., Pepe, M. S., Nelson, H. D., Weaver, D. L., Allison, K. H., Carney, P. A., Geller, B. M., Tosteson, A. N. A., Onega, T., & Elmore, J. G. (2017). 'Diagnostic Reproducibility: What Happens When the Same Pathologist Interprets the Same Breast Biopsy Specimen at Two Points in Time?' Annals of Surgical Oncology, 24(5), 1234-1241. doi:10.1245/s10434-016-5695-0. THE SINGLE MOST VALUABLE PAPER IN THE FILE, and its title is practically the title of the article. Design, verbatim: 'Pathologists from eight U.S. states independently interpreted 60 breast specimens, one glass slide per case, on two occasions separated by at least 9 months.' Participation: '49 interpreted glass slides in both study phases, resulting in 2940 interpretations.' Intra-observer agreement between the two phases, verbatim: '92% (95% CI 88-95) for invasive breast cancer, 84% (81-87) for ductal carcinoma-in-situ, 53% (47-59) for atypia, and 84% (81-86) for benign without atypia.' Inter-observer agreement at baseline on the same material: '89% (84-92) for invasive cancer, 79% (76-81) for ductal carcinoma-in-situ, 43% (41-45) for atypia, and 77% (74-79) for benign without atypia.' THE CONCLUSION IS THE ARTICLE'S THESIS, verbatim: 'Interpretive agreement between two time points by the same individual pathologist was low for atypia and was similar to observed rates of agreement for atypia between different pathologists. Physicians and patients should be aware of the diagnostic challenges associated with a breast biopsy diagnosis of atypia when considering treatment and surveillance decisions.' On the hard call, your own earlier self is 53 per cent and a different expert is 43 per cent: the second opinion from the same person is only ten percentage points better than the second
[ABSTRACT READ IN FULL at the Europe PMC core record; full text NOT READ, subscription required] Jackson, S. L., Frederick, P. D., Pepe, M. S., Nelson, H. D., Weaver, D. L., Allison, K. H., Carney, P. A., Geller, B. M., Tosteson, A. N. A., Onega, T., & Elmore, J. G. (2017). 'Diagnostic Reproducibility: What Happens When the Same Pathologist Interprets the Same Breast Biopsy Specimen at Two Points in Time?' Annals of Surgical Oncology, 24(5), 1234-1241. doi:10.1245/s10434-016-5695-0. THE SINGLE MOST VALUABLE PAPER IN THE FILE, and its title is practically the title of the article. Design, verbatim: 'Pathologists from eight U.S. states independently interpreted 60 breast specimens, one glass slide per case, on two occasions separated by at least 9 months.' Participation: '49 interpreted glass slides in both study phases, resulting in 2940 interpretations.' Intra-observer agreement between the two phases, verbatim: '92% (95% CI 88-95) for invasive breast cancer, 84% (81-87) for ductal carcinoma-in-situ, 53% (47-59) for atypia, and 84% (81-86) for benign without atypia.' Inter-observer agreement at baseline on the same material: '89% (84-92) for invasive cancer, 79% (76-81) for ductal carcinoma-in-situ, 43% (41-45) for atypia, and 77% (74-79) for benign without atypia.' THE CONCLUSION IS THE ARTICLE'S THESIS, verbatim: 'Interpretive agreement between two time points by the same individual pathologist was low for atypia and was similar to observed rates of agreement for atypia between different pathologists. Physicians and patients should be aware of the diagnostic challenges associated with a breast biopsy diagnosis of atypia when considering treatment and surveillance decisions.' On the hard call, your own earlier self is 53 per cent and a different expert is 43 per cent: the second opinion from the same person is only ten percentage points better than the second
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Jackson, S. L., Frederick, P. D., Pepe, M. S., Nelson, H. D., Weaver, D. L., Allison, K. H., Carney, P. A., Geller, B. M., Tosteson, A. N. A., Onega, T., & Elmore, J. G. (2017). Diagnostic Reproducibility: What Happens When the Same Pathologist Interprets the Same Breast Biopsy Specimen at Two Points in Time? Annals of Surgical Oncology, 24(5), 1234-1241. doi:10.1245/s10434-016-5695-0