Is There a Way for Pathologists to Decrease Interobserver Variability in the Diagnosis of Dysplasia?
2005; American Medical Association; Volume: 129; Issue: 2 Linguagem: Inglês
10.5858/2005-129-174-itawfp
ISSN1543-2165
Autores Tópico(s)Gastroesophageal reflux and treatments
ResumoAbstract Many obstacles interfere with our efforts to screen patients with Barrett esophagus. Probably the largest is choosing the appropriate patient group for screening. Beyond this problem, sampling error on the part of endoscopists is probably more serious a problem than observer variation among pathologists reviewing patient samples. Pathologists agree well on lesions that merit close follow-up or other intervention (high-grade dysplasia and invasive carcinoma), although interobserver agreement between pathologists interpreting lesser lesions is not good. This lack of agreement is not likely to improve substantially, and many adjunct markers are being sought in an attempt to identify patients with lesions of lower grades that are most likely to progress, allowing doctors to identify patients who would benefit from upgraded surveillance.
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