Evaluation of the Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis (MPATH-Dx) classification scheme for diagnosis of cutaneous melanocytic neoplasms: Results from the International Melanoma Pathology Study Group
| Autor: | David E. Elder, George X. Xu, Lori Lowe, Raymond L. Barnhill, Birgitta Schmidt, Jason P. Lott, Lisa M. Reisch, Joann G. Elmore, Paul D. Frederick, Jane L. Messina, Stevan R. Knezevich, Michael W. Piepkorn, Martin C. Mihm, Ge A. Zhao, Gilles Landman, Sook Jung Yun, Martin G. Cook, Emily Y. Chu, Christopher R. Shea, Joost van den Oord, Rosalie Elenitsas, Lyn M. Duncan, Pedram Gerami, Michael S. Rabkin |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Pathology Skin Neoplasms BI-RADS Dermatology Article 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Terminology as Topic medicine Nevus Humans Medical diagnosis Melanoma business.industry Middle Aged medicine.disease Confidence interval Inter-rater reliability Categorization 030220 oncology & carcinogenesis Dysplastic nevus Melanocytes Female business Kappa |
| Zdroj: | Journal of the American Academy of Dermatology. 75(2) |
| ISSN: | 1097-6787 |
| Popis: | Background Pathologists use diverse terminology when interpreting melanocytic neoplasms, potentially compromising quality of care. Objective We sought to evaluate the Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis (MPATH-Dx) scheme, a 5-category classification system for melanocytic lesions. Methods Participants (n = 16) of the 2013 International Melanoma Pathology Study Group Workshop provided independent case-level diagnoses and treatment suggestions for 48 melanocytic lesions. Individual diagnoses (including, when necessary, least and most severe diagnoses) were mapped to corresponding MPATH-Dx classes. Interrater agreement and correlation between MPATH-Dx categorization and treatment suggestions were evaluated. Results Most participants were board-certified dermatopathologists (n = 15), age 50 years or older (n = 12), male (n = 9), based in the United States (n = 11), and primary academic faculty (n = 14). Overall, participants generated 634 case-level diagnoses with treatment suggestions. Mean weighted kappa coefficients for diagnostic agreement after MPATH-Dx mapping (assuming least and most severe diagnoses, when necessary) were 0.70 (95% confidence interval 0.68-0.71) and 0.72 (95% confidence interval 0.71-0.73), respectively, whereas correlation between MPATH-Dx categorization and treatment suggestions was 0.91. Limitations This was a small sample size of experienced pathologists in a testing situation. Conclusion Varying diagnostic nomenclature can be classified into a concise hierarchy using the MPATH-Dx scheme. Further research is needed to determine whether this classification system can facilitate diagnostic concordance in general pathology practice and improve patient care. |
| Databáze: | OpenAIRE |
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