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A study of Gleason score interpretation in different groups of UK pathologists; techniques for improving reproducibility
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. and Parkinson, M. C. (2006-05) A study of Gleason score interpretation in different groups of UK pathologists; techniques for improving reproducibility. Histopathology, 48 6: 655-692.
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| Author(s) |
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.
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| Title |
A study of Gleason score interpretation in different groups of UK pathologists; techniques for improving reproducibility
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| Journal name |
Histopathology
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| Publication date |
2006-05
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| Volume number |
48
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| Issue number |
6
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| ISSN |
0309-0167: 1365-2559
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| Start page |
655
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| End page |
692
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| Total pages |
38
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| Place of publication |
Oxford
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| Publisher |
Blackwell
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| Language |
eng
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| Subject |
010402 Biostatistics
111706 Epidemiology
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| 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.
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| Keyword(s) |
Histology, Pathological
biopsy
education
grade
prostate carcinoma
reproducibility
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