Sources of Error in Neuropathology Intraoperative Diagnosis

Meyer, Matthew J.; Keith-Rokosh, J; Reddy, Hasini; Megyesi, Joseph F.; Hammond, Robert

doi:10.1017/s0317167100010799

Cited by 6 publications

(3 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The accuracy of the SRH-based neuropathological diagnosis from the first samples analyzed at our institution (including the very first) was 87.7% (Fig. 3a ), which was close to the lower bound of the range of diagnostic accuracy (89–98%) reported for intraoperative frozen section neuropathological diagnosis [ 15 , 25 , 26 ]. It should be noted that the investigators had no prior experience with sample preparation specific to Raman imaging or SRH image interpretation.…”

Section: Discussionsupporting

confidence: 73%

“…3e ). Sampling errors were reported to be another major source of error in the conventional intraoperative neuropathological diagnosis [ 15 ]. In this study, spatially similar but not identical samples were processed in parallel for SRH and H&E. It is possible that distinct parts of the tumor were submitted to either method yet not to the other.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Neuropathological interpretation of stimulated Raman histology images of brain and spine tumors: part B

et al. 2021

View full text Add to dashboard Cite

Intraoperative histopathological examinations are routinely performed to provide neurosurgeons with information about the entity of tumor tissue. Here, we quantified the neuropathological interpretability of stimulated Raman histology (SRH) acquired using a Raman laser imaging system in a routine clinical setting without any specialized training or prior experience. Stimulated Raman scattering microscopy was performed on 117 samples of pathological tissue from 73 cases of brain and spine tumor surgeries. A board-certified neuropathologist — novice in the interpretation of SRH — assessed image quality by scoring subjective tumor infiltration and stated a diagnosis based on the SRH images. The diagnostic accuracy was determined by comparison to frozen hematoxylin–eosin (H&E)-stained sections and the ground truth defined as the definitive neuropathological diagnosis. The overall SRH imaging quality was rated high with the detection of tumor cells classified as inconclusive in only 4.2% of all images. The accuracy of neuropathological diagnosis based on SRH images was 87.7% and was non-inferior to the current standard of fast frozen H&E-stained sections (87.3 vs. 88.9%, p = 0.783). We found a substantial diagnostic correlation between SRH-based neuropathological diagnosis and H&E-stained frozen sections (κ = 0.8). The interpretability of intraoperative SRH imaging was demonstrated to be equivalent to the current standard method of H&E-stained frozen sections. Further research using this label-free innovative alternative vs. conventional staining is required to determine to which extent SRH-based intraoperative decision-making can be streamlined in order to facilitate the advancement of surgical neurooncology.

show abstract

Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Neuropathological interpretation of stimulated Raman histology images of brain and spine tumors: part B

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Univariate analysis showed that a more experienced clinician was significantly less likely to generate a false positive referral. This seems logical, and improvement in diagnostic proficiency with increasing experience has been shown before across various medical disciplines, 28 , 29 , 30 but it is a novel finding for optometry. If an inexperienced optometrist is unsure of a diagnosis, it would be unfair and potentially dangerous to criticise or discourage referral as there is a natural learning curve with experience in any profession.…”

Section: Discussionmentioning

confidence: 79%

Factors influencing accuracy of referral and the likelihood of false positive referral by optometrists in Bradford, United Kingdom

Davey

Scally

Green

et al. 2016

Journal of Optometry

View full text Add to dashboard Cite

AimsLevels of false positive referral to ophthalmology departments can be high. This study aimed to evaluate commonality between false positive referrals in order to find the factors which may influence referral accuracy.MethodsIn 2007/08, a sample of 431 new Ophthalmology referrals from the catchment area of Bradford Royal Infirmary were retrospectively analysed.ResultsThe proportion of false positive referrals generated by optometrists decreases with experience at a rate of 6.2% per year since registration (p < 0.0001). Community services which involved further investigation done by the optometrist before directly referring to the hospital were 2.7 times less likely to refer false positively than other referral formats (p = 0.007). Male optometrists were about half as likely to generate a false positive referral than females (OR = 0.51, p = 0.008) and as multiple/corporate practices in the Bradford area employ less experienced and more female staff, independent practices generate about half the number of false positive referrals (OR = 0.52, p = 0.005).ConclusionsClinician experience has the greatest effect on referral accuracy although there is also a significant effect of gender with women tending to refer more false positives. This may be due to a different approach to patient care and possibly a greater sensitivity to litigation. The improved accuracy of community services (which often refer directly after further investigation) supports further growth of these schemes.

show abstract