Development of benchmark quality criteria for assessing whole-endoscopy Barrett's esophagus biopsy cases.

Abstract:

Background:Dysplasia in Barrett's esophagus (BE) biopsies is associated with low observer agreement among general pathologists. Therefore, expert review is advised. We are developing a web-based, national expert review panel for histological review of BE biopsies. Objective:The aim of this study was to create benchmark quality criteria for future members. Methods:Five expert BE pathologists, with 10-30 years of BE experience, weekly handling 5-10 cases (25% dysplastic), assessed a case set of 60 digitalized cases, enriched for dysplasia. Each case contained all slides from one endoscopy (non-dysplastic BE (NDBE), n = 21; low-grade dysplasia (LGD), n = 20; high-grade dysplasia (HGD), n = 19). All cases were randomized and assessed twice followed by group discussions to create a consensus diagnosis. Outcome measures: percentage of 'indefinite for dysplasia' (IND) diagnoses, intra-observer agreement, and agreement with the consensus 'gold standard' diagnosis. Results:Mean percentage of IND diagnoses was 8% (3-14%) and mean intra-observer agreement was 0.84 (0.66-1.02). Mean agreement with the consensus diagnosis was 90% (95% prediction interval (PI) 82-98%). Conclusion:Expert pathology review of BE requires the scoring of a limited number of IND cases, consistency of assessment and a high agreement with a consensus gold standard diagnosis. These benchmark quality criteria will be used to assess the performance of other pathologists joining our panel.

authors

van der Wel MJ,Duits LC,Klaver E,Pouw RE,Seldenrijk CA,Offerhaus G,Visser M,Ten Kate F,Tijssen JG,Bergman J,Meijer SL

doi

10.1177/2050640618764710

subject

Has Abstract

pub_date

2018-07-01 00:00:00

pages

830-837

issue

6

eissn

2050-6406

issn

2050-6414

pii

10.1177_2050640618764710

journal_volume

6

pub_type

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