Agreement and error rates using blinded review to evaluate surgical pathology of biopsy material
Agreement and error rates using blinded review to evaluate surgical pathology of biopsy material
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DOI：
10.1309/dcxaxfvcchvhyu41
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发表时间：
2003-06-01
影响因子：
3.5
通讯作者：
Gould, EW
中科院分区：
文献类型：
--
作者：
Renshaw, AA;Cartagena, N;Gould, EW
盲法回顾已被证明是一个很好的方法来发现分歧和错误，提高性能在妇科细胞学。初步研究表明它可能在外科病理学上有价值。我们回顾了5000例在不知道原始诊断或病史的情况下连续门诊手术病理活检病例，并将结果与原始诊断的结果进行了比较。91.12%的病例完全吻合。手术病理活检材料的盲法回顾技术的敏感性超过99%，未能识别异常的19例。尽管存在显著水平的诊断不一致（444例），主要是由于诊断阈值的差异（292例），但导致原始报告改变的诊断（真正的错误）仅存在于5例中，只有4例具有临床意义。这一具有临床意义的错误率为0.08%，明显低于之前公布的错误率。盲法评价是一种敏感（99%）且有效的方法，可识别手术病理活检材料中的分歧和错误。盲法评价中发现的相对较高的不一致率加上极低的错误率突出了非盲法评价中潜在的偏倚。
Blinded review has been shown to be an excellent method to detect disagreements and errors and improve performance in gynecologic cytology. Preliminary studies suggest it may be valuable in surgical pathology.We reviewed 5,000 sequential outpatient surgical pathology biopsy cases without knowledge of the original diagnosis or history and compared the results with those of the original diagnosis.Complete agreement was obtained in 91.12% of cases. The technique of blinded review of surgical pathology biopsy material had a sensitivity of more than 99%, failing to identify an abnormality in 19 cases. Although there was a significant level of diagnostic disagreement (444 cases), primarily due to differences in diagnostic thresholds (292 cases), diagnoses that resulted in a change in the original report (true errors) were present in only 5 cases, and only 4 were clinically significant. This clinically significant error rate of 0.08% is significantly lower than previously published error rates.Blinded review is a sensitive (99%) and effective method to identify areas of disagreement and errors in surgical pathology biopsy material. The relatively high rate of disagreement found with blinded review coupled with the very low rate of error highlights the substantial potential for bias in nonblinded reviews.