A study of Gleason score interpretation in different groups of UK pathologists; techniques for improving reproducibility

  1. D F R Griffiths1,
  2. J Melia1,
  3. L J McWilliam2,
  4. R Y Ball3,
  5. K Grigor4,
  6. P Harnden5,
  7. M Jarmulowicz6,
  8. R Montironi7,
  9. R Moseley8,
  10. M Waller1,
  11. S Moss1,
  12. M C Parkinson9,
  13. in collaboration with the participating pathologists listed†

Article first published online: 24 MAR 2006

DOI: 10.1111/j.1365-2559.2006.02394.x

Issue

Histopathology

Histopathology

Volume 48, Issue 6, pages 655–662, May 2006

Additional Information

How to Cite

Griffiths, D. F. R., Melia, J., McWilliam, L. J., Ball, R. Y., Grigor, K., Harnden, P., Jarmulowicz, M., Montironi, R., Moseley, R., Waller, M., Moss, S., Parkinson, M. C. and in collaboration with the participating pathologists listed (2006), A study of Gleason score interpretation in different groups of UK pathologists; techniques for improving reproducibility. Histopathology, 48: 655–662. doi: 10.1111/j.1365-2559.2006.02394.x

Author Information

  1. 1

    Department of Pathology, Cardiff University, Cardiff, Cancer Screening Evaluation Unit, Institute of Cancer Research, Sutton

  2. 2

    Department of Histopathology, Manchester Royal Infirmary, Manchester

  3. 3

    Department of Histopathology, Norfolk & Norwich University Hospital, Norwich

  4. 4

    Department of Pathology, Western General Hospital, Edinburgh

  5. 5

    Department of Histopathology, St James Hospital, Leeds

  6. 6

    present affiliation: Bostwick Laboratories, London, UK

  7. 7

    present affiliation: Institute of Pathological Anatomy and Histopathology, Polytechnic University of the Marche Region (Ancona), School of Medicine, Ancona, Italy

  8. 8

    Department of Histopathology, Addenbrooke's Hospital, Cambridge

  9. 9

    University College Hospitals and Institute of Urology, UCL, London, UK

  1. †

    List of participating consultant pathologists in Cardiff: A. M. Rashid, N. Williams, S. Polacarz, M. Lord, S. Banarjee, G. T. Smith, E. Wessels, J. K. Murphy, C. Champ, J. Shannon, R. B. Denholm, S. Kiberu, C. G. B. Simpson, G. R. Melville Jones, B. Charnley, D. Stock, G. Evans, M. Cotter, N. Nind, M. Hayes, R. Kellett, R. Williams, S. Howell, L. Murray.

*Dr David F R Griffiths MB BCh, MRCP(UK), FRCPath, Department of Pathology, School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XN, UK. e-mail: griffithsdfr@cf.ac.uk

Publication History

  1. Issue published online: 20 APR 2006
  2. Article first published online: 24 MAR 2006
  3. Date of submission 16 November 2005 Accepted for publication 3 january 2006

SEARCH

SEARCH BY CITATION

ARTICLE TOOLS

View Full Article (HTML) Get PDF (264K)

Keywords:

  • biopsy;
  • education;
  • grade;
  • prostate carcinoma;
  • reproducibility

Aims:  To test the effectiveness of a teaching resource (a decision tree with diagnostic criteria based on published literature) in improving the proficiency of Gleason grading of prostatic cancer by general pathologists.

Methods:  A decision tree with diagnostic criteria was developed by a panel of urological pathologists during a reproducibility study. Twenty-four general histopathologists tested this teaching resource. Twenty slides were selected to include a range of Gleason score groups 2–4, 5–6, 7 and 8–10. Interobserver agreement was studied before and after a presentation of the decision tree and criteria. The results were compared with those of the panel of urological pathologists.

Results:  Before the teaching session, 83% of readings agreed within ± 1 of the panel's consensus scores. Interobserver agreement was low (κ = 0.33) compared with that for the panel (κ = 0.62). After the presentation, 90% of readings agreed within ± 1 of the panel's consensus scores and interobserver agreement amongst the pathologists increased to κ = 0.41. Most improvement in agreement was seen for the Gleason score group 5–6.

Conclusions:  The lower level of agreement among general pathologists highlights the need to improve observer reproducibility. Improvement associated with a single training session is likely to be limited. Additional strategies include external quality assurance and second opinion within cancer networks.

View Full Article (HTML) Get PDF (264K)