Experts and gold standards in dermatopathology: qualitative and quantitative analysis of the self-assessment slide seminar at the 17th colloquium of the International Society of Dermatopathology

Détails

ID Serval
serval:BIB_CAD8D6A342CC
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Experts and gold standards in dermatopathology: qualitative and quantitative analysis of the self-assessment slide seminar at the 17th colloquium of the International Society of Dermatopathology
Périodique
American Journal of Dermatopathology
Auteur(s)
Kempf  W., Haeffner  A. C., Mueller  B., Panizzon  R. G., Burg  G.
ISSN
0193-1091 (Print)
Statut éditorial
Publié
Date de publication
10/1998
Volume
20
Numéro
5
Pages
478-82
Notes
Journal Article --- Old month value: Oct
Résumé
The diagnosis of lymphoproliferative and melanocytic skin lesions is one of the most vexing problems in dermatopathology, a problem that is compounded by the far-reaching therapeutic and psychosocial consequences of the diagnosis for both patient and physician. On the occasion of a self-assessment slide seminar held during a dermatopathology meeting, 30 unusual lymphoproliferative and melanocytic lesions, each provided with four differential diagnoses, were evaluated by "expert pathologists" and other participants ("nonexperts") of the slide seminar. The final diagnosis was pinpointed by the majority of the experts in 16 of 30 cases (56%). The group of experts returned an unanimous decision on the diagnosis in only 2 of the 30 cases (7%). In contrast to the expert group, the preferred diagnoses given by the nonexperts showed a wider range. In 20 of 30 cases (66%), the final diagnosis could only be established after consideration of clinical, histologic, immunophenotypic, and molecular features. Our findings agree with the results of recent studies indicating quite a high degree of discordance among expert pathologists. The discordance between experts and, to a higher extent, nonexperts may have some crucial consequences for dermatopathology. Full agreement on diagnosis, particularly in unusual skin lesions, cannot be achieved only by an accumulation of expertises. Instead of relying on one single finding or diagnostic procedure ("gold standard") as the main criterion upon which to base a diagnosis, the diagnoses become more reliable if based on the integration of several factors including an evaluation of clinical and histomorphologic features and immunophenotypic and molecular findings ("diagnostic elements"), particularly in the field of lymphoproliferative and melanocytic lesions. In addition, a continuous retrospective work-up of difficult or unusual cases is recommended to ensure a long-term improvement in diagnostic reliability.
Mots-clé
Biological Markers/analysis *Dermatology Humans Immunohistochemistry Molecular Biology Skin Diseases/*diagnosis/genetics/metabolism Skin Neoplasms/*diagnosis/genetics/metabolism
Pubmed
Web of science
Création de la notice
25/01/2008 16:55
Dernière modification de la notice
20/08/2019 15:45
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