Use of the ISUP e-learning module improves interrater reliability in prostate cancer grading

Area of Science:

• Uropathology
• Medical Education
• Cancer Diagnostics

Background:

• Prostate cancer (PCa) grading is crucial for prognosis but suffers from observer variability.
• The International Society of Urological Pathology (ISUP) 2014 classification enhanced PCa grading.
• Previous e-learning interventions reduced interobserver variability in PCa grading.

Purpose of the Study:

• To evaluate the impact of the ISUP Education web e-learning module on Gleason grading variability.
• To assess the effectiveness of e-learning in standardizing PCa grading following the ISUP 2014 classification.

Main Methods:

• 42 Dutch pathologists completed the ISUP Education Prostate Test B module, grading 10 images before and after training.
• Inter-rater reliability was assessed using linearly weighted kappa values, comparing individual pathologists to each other and to an ISUP consensus panel.
• Statistical analysis involved Wilcoxon's signed rank-test to evaluate improvements in median weighted kappas.

Main Results:

• Inter-rater reliability improved from 0.70 to 0.74 post-training (p=0.01).
• Five pathologists showed significant improvement when compared to the ISUP consensus panel.
• Pathologists with initially lower agreement demonstrated the most significant improvement.

Conclusions:

• The ISUP Prostate Test B e-learning module effectively reduces interobserver variability in prostate cancer grading.
• E-learning presents a cost-effective strategy for standardizing pathology practices in uropathology.