Prostatic pathology reporting in the UK: development of a national external quality assurance scheme

Histopathology
Patricia HarndenJ Melia

Abstract

To develop a baseline picture of prostatic pathology reporting in the UK, identify areas of particular difficulty and assess the feasibility of a national external quality assurance scheme based on prostatic biopsy specimens using the same format as the National Health Service breast pathology scheme, as recommended by the National Institute for Clinical Excellence. Eight expert uropathologists and 32 randomly selected pathologists participated in four circulations each of 12 cases of prostatic biopsy specimens. A fixed text proforma was developed and responses were analysed for interobserver agreement using kappa statistics. Consistency of reporting the main diagnostic categories of benign and invasive carcinoma was good (kappa values 0.77 and 0.88, respectively), but only after excluding 19% of cases for which the experts did not reach 75% agreement. Areas of difficulty included the diagnosis of high-grade prostatic intraepithelial neoplasia and small foci of cancer. Prognostic factor reporting was more variable, with lower overall kappas for the assessment of Gleason grading (experts 0.55, others 0.50), perineural invasion (experts 0.64, others 0.50) and number of positive cores (experts 0.74, others 0.61). Given the difficu...Continue Reading

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Citations

Dec 19, 2008·The American Journal of Surgical Pathology·Alain C BorczukCharles A Powell
Aug 6, 2009·Epidemiology and Infection·E I BroughtonC L Coles
Jan 11, 2011·Journal of Clinical Pathology·Karen C WrightJane Melia
Aug 13, 2011·Journal of Clinical Pathology·Karen C WrightPatricia Harnden
Sep 19, 2014·Histopathology·Jon OxleyUNKNOWN ProtecT Study Group
Jan 29, 2011·Computerized Medical Imaging and Graphics : the Official Journal of the Computerized Medical Imaging Society·Matthew D DiFrancoPadraig Cunningham

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