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Understanding interobserver variability of pathologists to improve oral epithelial dysplasia grading
Grace Tze Ern Ng1, Sarah Carmen Phang1, Kae Shyang Yu1
1UWA Dental School, The University of Western Australia, Nedlands, Western Australia, Australia.
Oral Diseases
|July 23, 2024
Summary
Pathologist experience and continuing education impact oral epithelial dysplasia (OED) grading. Understanding variations in feature interpretation and clinical information use can improve OED diagnostic reliability.
Area of Science:
- Oral pathology
- Histopathology
- Diagnostic accuracy
Background:
- Interobserver variability in oral epithelial dysplasia (OED) grading affects diagnostic reliability.
- Standardizing OED assessment is crucial for patient management and treatment decisions.
Purpose of the Study:
- To investigate the factors contributing to interobserver variability in OED grading.
- To identify potential strategies for enhancing the consistency and reproducibility of OED diagnoses.
Main Methods:
- A global survey of 132 histopathology specialists using a pre-validated 31-item questionnaire.
- Quantitative and qualitative data collection on OED grading practices and feature interpretation.
Main Results:
- Most pathologists use a three-tier grading system; experience and continuing education improve recognition of key features.
- Loss of epithelial cell cohesion was the most reliable feature, while irregular stratification and rete ridges were least reliable.
- Clinical information and second opinions are frequently used in OED grading.
Conclusions:
- The frequency of reporting OED and participation in continuing education significantly influence grading accuracy.
- Discrepancies in the prognostic value of histological features and the use of clinical data contribute to interobserver variability in OED assessment.
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