Interobserver variability in assessing dysplasia and architecture in colorectal adenomas: a multicentre Canadian study

Abstract

The improvement in interobserver agreement in classifying adenoma architecture suggests that national guidelines can be useful in disseminating knowledge, however, the variability in the diagnosis of HGD, even following guideline review suggests the need for ongoing knowledge-transfer exercises.

Interlaboratory variability in the grading of dysplasia in a nationwide cohort of colorectal adenomas

“…Osmond et al . studied interobserver agreement before and after pathologists read the Canadian guidelines for standardized reporting of adenomas . Interobserver agreement improved for the histological subtype.…”

“…This subdivision is artificial, as the development of dysplasia occurs as a continuum, rather than in discrete steps . Only slight to substantial interobserver agreement in the grading of adenomas has been described in numerous previous studies in which several pathologists assessed the same set of colorectal adenomas . The degree of variability in the grading of dysplasia in daily practice has never been studied.…”

“…17 Only slight to substantial interobserver agreement in the grading of adenomas has been described in numerous previous studies in which several pathologists assessed the same set of colorectal adenomas. [18][19][20][21][22][23][24][25][26][27][28] The degree of variability in the grading of dysplasia in daily practice has never been studied.…”

Interobserver agreement among cytopathologists in the evaluation of pancreatic endoscopic ultrasound-guided fine needle aspiration cytology specimens

“…Despite the broad utilization of this technique, data regarding to interobserver agreement among cytopathologists evaluating EUS-FNA samples of solid pancreatic lesions remain very limited. This lies in stark contrast to the extensive literature evaluating interobserver agreement among pathologists in other gastrointestinal diseases such as Barrett’s esophagus, colon polyps, and inflammatory bowel disease 26 27 28 29 30 31 32. In this study, we evaluated interobserver agreement among cytopathologists in the assessment of EUS-FNA samples of solid pancreatic lesions utilizing a novel standardized scoring system.…”

Evolution of Premalignant Disease

“…However, for many premalignant phenotypes, there is large variability in published estimates of associated cancer risk, such as the range of 0.15% to 80% for annual risk of squamous carcinoma of the skin in patients with actinic keratosis (AK), caused by factors like interobserver variability, sampling bias, and patient cohort differences (Greaves 2014). In particular, interobserver variability is an issue for nearly every premalignant diagnosis and may differ at different stages of premalignancy (Fischer et al 2004;Odze 2006;Leja et al 2013;van den Einden et al 2013;Osmond et al 2014). For example, in a study by U.S. pathologists on BE, interobserver agreement was substantial for HGD and cancer (kappa agreement score, k ¼ 0.65), but was only fair (k ¼ 0.32) and then slight (k ¼ 0.15) for LGD and indefinite for dysplasia, respectively (Montgomery 2005).…”