A Multinational, Internet-Based Assessment of Observer Variability in the Diagnosis of Serrated Colorectal Polyps
Open Access
- 1 June 2007
- journal article
- research article
- Published by Oxford University Press (OUP) in American Journal of Clinical Pathology
- Vol. 127 (6), 938-945
- https://doi.org/10.1309/nxdb6fmte9x5cd6y
Abstract
This Internet-based quiz (http://kathrin.unibas.ch/polyp/) tested the diagnostic variability of 168 pathologists in the diagnosis of 20 colorectal polyps on 3 representative images, including hyperplastic polyps (HPs), traditional serrated adenomas (TSAs), sessile serrated adenomas (SSAs), and tubulovillous adenomas (TVAs). Interobserver variability for each of the 20 lesions was significant and was most pronounced for SSAs. Correct answers were independent of the participant’s experience with TVAs, HPs, and TSAs. Participants with gastrointestinal subspecialty training and those who had read a reference article on serrated polyps gave a significantly higher percentage of correct answers for SSAs. The nomenclature used for serrated polyps was generally inconsistent. Our results suggest significant shortcomings in the routine H&E diagnosis of serrated colorectal polyps. A diagnostically unifying concept for lesions of the serrated neoplasia pathway, standardization of nomenclature, training of pathologists, and possibly development of ancillary techniques are of paramount importance for accurate patient management.Keywords
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