Open AccessDevelopment of benchmark quality criteria for assessing whole‐endoscopy Barrett's esophagus biopsy cases
Author(s) -
Wel MJ,
Duits LC,
Klaver E,
Pouw RE,
Seldenrijk CA,
Offerhaus GJA,
Visser M,
Kate FJW,
Tijssen JG,
Bergman JJGHM,
Meijer SL
Publication year - 2018
Publication title -
ueg journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 35
eISSN - 2050-6414
pISSN - 2050-6406
DOI - 10.1177/2050640618764710
Subject(s) - medicine , gold standard (test) , dysplasia , medical diagnosis , barrett's esophagus , biopsy , endoscopy , esophagus , radiology , medical physics , surgery , cancer , adenocarcinoma
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.