How much reproducibility do we need in human and veterinary pathology?

Area of Science:

• Pathology
• Medical Diagnostics
• Observer Variability

Background:

• Reproducibility and repeatability are critical for reliable pathology diagnoses, impacting patient care, therapy, prognosis, and prophylaxis.
• Current literature inconsistently addresses observer variation (inter- and intra-observer) as a diagnostic challenge in pathology.
• High diagnostic accuracy requires maximal repeatability, reproducibility, and validated methodologies compared to a gold standard.

Discussion:

• Pathology diagnostic reproducibility is influenced by laboratory sample preparation and, crucially, by the visual information processing within the diagnostician's brain.
• Reproducibility in pathology must be considered at multiple levels: individual (epistemological, organoleptic), inter-observer, and intra-observer variation.
• Formal/technological and normative aspects also contribute to the overall reproducibility of diagnostic processes.

Key Insights:

• Observer variation significantly impacts the reliability of diagnoses made from macroscopic and microscopic samples.
• The central nervous system's role in interpreting visual information is a primary determinant of diagnostic reproducibility.
• A multi-level approach is necessary to understand and improve diagnostic reproducibility in pathology.

Outlook:

• This manuscript aims to stimulate critical reflection among pathology experts regarding diagnostic reproducibility.
• Further research should focus on quantifying and mitigating observer variation in pathology.
• Implementing standardized protocols and training can enhance the consistency and reliability of pathology diagnoses.