INTRAEXAMINER AND INTEREXAMINER RELIABILITY IN THE DIAGNOSIS OF ORAL EPITHELIAL DYSPLASIA
INTRAEXAMINER AND INTEREXAMINER RELIABILITY IN THE DIAGNOSIS OF ORAL EPITHELIAL DYSPLASIA
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DOI：
10.1016/s1079-2104(05)80201-x
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发表时间：
1995-08-01
影响因子：
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通讯作者：
CUSHING, M
中科院分区：
文献类型：
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作者：
ABBEY, LM;KAUGARS, GE;CUSHING, M
目标。病理学家对“异型增生”的定义各不相同。这项研究是为了检验这一假设，即有经验的口腔病理学家在诊断上皮异型增生方面是一致的。6名获得委员会认证的口腔病理学家检查了120例口腔活检标本，这些标本显示单纯角化过度到严重异型增生。没有给出临床信息，通过组织形态学判断是否存在异型增生。检查人员的诊断与每个病例的注销诊断进行了比较。几个月后，每位考官查看了60张重新标记的幻灯片，而不是原来的120张。将每一诊断结果与第一轮诊断结果进行比较。与诊断符合率平均为50.5%(在一个组织学分级内为90.4%)。检查者与自己的诊断符合率为50.8%(在一个组织学分级内为92.4%)。与原始诊断相比，区分异型增生和非异型增生的符合率为81.5%。区分异型增生与非异型增生的符合率为80.3%。在有经验的委员会认证的口腔病理学家之间准确、可重复地诊断口腔上皮异型增生是很难实现的。
Objectives. Pathologists differ in their definition of ''dysplasia.'' This study was done to test the hypothesis that experienced oral pathologists are consistent in diagnosing epithelial dysplasia.Study Design. Six board-certified oral pathologists examined 120 oral biopsies exhibiting simple hyperkeratosis to severe dysplasia. No clinical information was given, and presence of dysplasia was judged by histomorphology. Examiners' diagnoses were compared with sign-out diagnoses for each case. Months later, each examiner Viewed 60 relabeled slides from the original 120. Each diagnosis was compared with the diagnosis in the first round.Results. Exact agreement with the sign-out diagnosis averaged 50.5% (within one histologic grade 90.4%). Examiners agreed exactly with their own diagnoses 50.8% of the time (within one histologic grade 92.4%). Agreement distinguishing dysplasia from no dysplasia compared with original sign-out diagnosis was 81.5%. Agreement with themselves distinguishing dysplasia from no dysplasia was 80.3%.Conclusions. Accurate reproducible agreement among experienced board-certified oral pathologists diagnosing oral epithelial dysplasia is difficult to achieve.