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The Gold Standard Paradox in Digital Image Analysis: Manual Versus Automated Scoring as Ground Truth
Archives of Pathology & Laboratory Medicine
|May 31, 2017
Summary
Validating digital tissue image analysis (tIA) tools requires awareness of the gold standard paradox. Traditional pathologist scoring, while a gold standard, has inherent biases that tIA aims to overcome.
Area of Science:
- Pathology
- Digital Pathology
- Biomarker Analysis
Background:
- Novel therapeutics target complex cellular mechanisms, necessitating advanced biomarker evaluation.
- Digital tissue image analysis (tIA) offers quantitative methods for complex biomarker assessment.
- Analytical validity of tIA systems relies on a gold standard reference method.
Purpose of the Study:
- To discuss visual and cognitive biases in traditional pathology scoring.
- To explore how these biases impact the accuracy, sensitivity, and specificity of tIA-assisted scoring.
Main Methods:
- Review of literature on traditional subjective pathology scoring paradigms.
- Identification of known cognitive and visual traps in manual scoring.
Main Results:
- Traditional pathology scoring, while a gold standard, is subject to inherent visual and cognitive biases.
- These biases can affect the perceived accuracy of tIA tools validated against them.
Conclusions:
- Awareness of the 'gold standard paradox' is crucial for validating tIA tools.
- tIA is designed to overcome biases present in manual pathologist scoring.
- Understanding these limitations ensures robust analytical validation of tIA systems.
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