Abstract
Objective: We sought to determine the interobserver reliability of the histopathologic diagnosis of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) (keratinocyte carcinomas) in the setting of a Department of Veteran Affairs multicenter chemoprevention study. Methods: Interobserver concordance was assessed by blinded review of histopathologic slides by study dermatopathologists. Results: Overall interobserver agreement between the two dermatopathogists was κ = 0.69 (95% confidence interval [CI] 0.67-0.69). The dermatopathologists' interobserver agreement was highest for basal cell carcinoma at κ = 0.88 (95% CI 0.84-0.91) and for a diagnostic category in the SCC-actinic keratosis spectrum at κ = 0.80 (95% CI 0.73-0.86). The largest disagreements between the two reference dermatopathologists were regarding the categories of invasive SCC at κ = 0.62 (95% CI 0.52-0.72), SCC in situ at κ = 0.42 (95% CI 0.29-0.56), and actinic keratosis at κ = 0.51 (95% CI 0.40-0.62). Agreement between the local pathologists and central reference dermatopathologists were similar to the agreement between the central dermatopathologists. The morphea subtype of basal cell carcinoma was the only reliably diagnosed subtype (κ = 0.79, 95% CI 0.51-1.00), and tumor depth was reliably measured. Limitations: A limitation of this study was the use of only two reference dermatopathologists. Conclusion: Because of the impact on physician decision making and patient care, researchers and clinicians need to be aware of reliability of histopathology results, particularly pertaining to the SCC and actinic keratosis spectrum.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 279-284 |
| Number of pages | 6 |
| Journal | Journal of the American Academy of Dermatology |
| Volume | 57 |
| Issue number | 2 |
| DOIs | |
| State | Published - Aug 2007 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Dermatology
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Reliability of the histopathologic diagnosis of keratinocyte carcinomas. / Jagdeo, Jared; Weinstock, Martin A.; Piepkorn, Michael; Bingham, Stephen F.
In: Journal of the American Academy of Dermatology, Vol. 57, No. 2, 08.2007, p. 279-284.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Reliability of the histopathologic diagnosis of keratinocyte carcinomas
AU - Jagdeo, Jared
AU - Weinstock, Martin A.
AU - Piepkorn, Michael
AU - Bingham, Stephen F.
PY - 2007/8
Y1 - 2007/8
N2 - Objective: We sought to determine the interobserver reliability of the histopathologic diagnosis of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) (keratinocyte carcinomas) in the setting of a Department of Veteran Affairs multicenter chemoprevention study. Methods: Interobserver concordance was assessed by blinded review of histopathologic slides by study dermatopathologists. Results: Overall interobserver agreement between the two dermatopathogists was κ = 0.69 (95% confidence interval [CI] 0.67-0.69). The dermatopathologists' interobserver agreement was highest for basal cell carcinoma at κ = 0.88 (95% CI 0.84-0.91) and for a diagnostic category in the SCC-actinic keratosis spectrum at κ = 0.80 (95% CI 0.73-0.86). The largest disagreements between the two reference dermatopathologists were regarding the categories of invasive SCC at κ = 0.62 (95% CI 0.52-0.72), SCC in situ at κ = 0.42 (95% CI 0.29-0.56), and actinic keratosis at κ = 0.51 (95% CI 0.40-0.62). Agreement between the local pathologists and central reference dermatopathologists were similar to the agreement between the central dermatopathologists. The morphea subtype of basal cell carcinoma was the only reliably diagnosed subtype (κ = 0.79, 95% CI 0.51-1.00), and tumor depth was reliably measured. Limitations: A limitation of this study was the use of only two reference dermatopathologists. Conclusion: Because of the impact on physician decision making and patient care, researchers and clinicians need to be aware of reliability of histopathology results, particularly pertaining to the SCC and actinic keratosis spectrum.
AB - Objective: We sought to determine the interobserver reliability of the histopathologic diagnosis of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) (keratinocyte carcinomas) in the setting of a Department of Veteran Affairs multicenter chemoprevention study. Methods: Interobserver concordance was assessed by blinded review of histopathologic slides by study dermatopathologists. Results: Overall interobserver agreement between the two dermatopathogists was κ = 0.69 (95% confidence interval [CI] 0.67-0.69). The dermatopathologists' interobserver agreement was highest for basal cell carcinoma at κ = 0.88 (95% CI 0.84-0.91) and for a diagnostic category in the SCC-actinic keratosis spectrum at κ = 0.80 (95% CI 0.73-0.86). The largest disagreements between the two reference dermatopathologists were regarding the categories of invasive SCC at κ = 0.62 (95% CI 0.52-0.72), SCC in situ at κ = 0.42 (95% CI 0.29-0.56), and actinic keratosis at κ = 0.51 (95% CI 0.40-0.62). Agreement between the local pathologists and central reference dermatopathologists were similar to the agreement between the central dermatopathologists. The morphea subtype of basal cell carcinoma was the only reliably diagnosed subtype (κ = 0.79, 95% CI 0.51-1.00), and tumor depth was reliably measured. Limitations: A limitation of this study was the use of only two reference dermatopathologists. Conclusion: Because of the impact on physician decision making and patient care, researchers and clinicians need to be aware of reliability of histopathology results, particularly pertaining to the SCC and actinic keratosis spectrum.
UR - http://www.scopus.com/inward/record.url?scp=34447281502&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=34447281502&partnerID=8YFLogxK
U2 - 10.1016/j.jaad.2007.03.021
DO - 10.1016/j.jaad.2007.03.021
M3 - Article
C2 - 17482716
AN - SCOPUS:34447281502
VL - 57
SP - 279
EP - 284
JO - Journal of the American Academy of Dermatology
JF - Journal of the American Academy of Dermatology
SN - 0190-9622
IS - 2
ER -