Interpathologist diagnostic agreement for non–small cell lung carcinomas using current and recent classifications

William K. Funkhouser, D. Neil Hayes, Dominic T. Moore, W. Keith Funkhouser, Jason P. Fine, Hee Joon Jo, Nana Nikolaishvilli-Feinberg, Mervi Eeva, Juneko E. Grilley-Olson, Peter M. Banks, Paolo Graziano, Elizabeth L. Boswell, Goran Elmberger, Kirtee Raparia, Craig F. Hart, Lynette M. Sholl, Norris J. Nolan, Karen J. Fritchie, Ersie Pouagare, Timothy C. Allen & 10 others Keith E. Volmar, Paul Williams Biddinger, Daniel T Kleven, Michael J. Papez, Deborah V. Spencer, Natasha Rekhtman, Mari Mino-Kenudson, Lida Hariri, Brandon Driver, Philip T. Cagle

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Context.—Measurement of interpathologist diagnostic agreement (IPDA) should allow pathologists to improve current diagnostic criteria and disease classifications. Objectives.—To determine how IPDA for pathologists’ diagnoses of non–small cell lung carcinoma (NSCLC) is affected by the addition of a set of mucin and immunohistochemical (IHC) stains to hematoxylin-eosin (H&E) alone, by recent NSCLC reclassifications, by simplification of these classifications, and by pathologists’ practice location, pulmonary pathology expertise, practice duration, and lung carcinoma case exposure. Design.—We used a Web-based survey to present core images of 54 NSCLC cases to 22 practicing pathologists for diagnosis, initially as H&E only, then as H&E plus mucin and 4 IHC stains. Each case was diagnosed according to published 2004, 2011, and 2015 NSCLC classifications. Cohen’s kappa was calculated for the 231 pathologist pairs as a measure of IPDA. Results.—Twenty-two pathologists diagnosed 54 NSCLC cases by using 4 published classifications. IPDA is significantly higher for H&E/mucin/IHC diagnoses than for H&E-only diagnoses. IPDA for H&E/mucin/IHC diagnoses is highest with the 2015 classification. IPDA is estimated higher after collapse of stated diagnoses into subhead or dichotomized classes. IPDA for H&E/mucin/ IHC diagnoses with the 2015 World Health Organization classification is similar for community and academic pathologists, and is higher when pathologists have pulmonary pathology expertise, have more than 6 years of practice experience, or diagnose more than 100 new lung carcinoma cases per year. Conclusions.—Higher IPDA is associated with use of mucin and IHC stains, with the 2015 NSCLC classification, and with pathologists’ pulmonary pathology expertise, ractice duration and fre uenc of lun carcinoma cases.

Original languageEnglish (US)
Pages (from-to)1537-1548
Number of pages12
JournalArchives of Pathology and Laboratory Medicine
Volume142
Issue number12
DOIs
StatePublished - Dec 1 2018

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Carcinoma
Lung
Mucins
Coloring Agents
Pathology
Mucin-4
Pathologists
Hematoxylin
Eosine Yellowish-(YS)

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Medical Laboratory Technology

Cite this

Funkhouser, W. K., Neil Hayes, D., Moore, D. T., Keith Funkhouser, W., Fine, J. P., Jo, H. J., ... Cagle, P. T. (2018). Interpathologist diagnostic agreement for non–small cell lung carcinomas using current and recent classifications. Archives of Pathology and Laboratory Medicine, 142(12), 1537-1548. https://doi.org/10.5858/arpa.2017-0481-OA

Interpathologist diagnostic agreement for non–small cell lung carcinomas using current and recent classifications. / Funkhouser, William K.; Neil Hayes, D.; Moore, Dominic T.; Keith Funkhouser, W.; Fine, Jason P.; Jo, Hee Joon; Nikolaishvilli-Feinberg, Nana; Eeva, Mervi; Grilley-Olson, Juneko E.; Banks, Peter M.; Graziano, Paolo; Boswell, Elizabeth L.; Elmberger, Goran; Raparia, Kirtee; Hart, Craig F.; Sholl, Lynette M.; Nolan, Norris J.; Fritchie, Karen J.; Pouagare, Ersie; Allen, Timothy C.; Volmar, Keith E.; Biddinger, Paul Williams; Kleven, Daniel T; Papez, Michael J.; Spencer, Deborah V.; Rekhtman, Natasha; Mino-Kenudson, Mari; Hariri, Lida; Driver, Brandon; Cagle, Philip T.

In: Archives of Pathology and Laboratory Medicine, Vol. 142, No. 12, 01.12.2018, p. 1537-1548.

Research output: Contribution to journalArticle

Funkhouser, WK, Neil Hayes, D, Moore, DT, Keith Funkhouser, W, Fine, JP, Jo, HJ, Nikolaishvilli-Feinberg, N, Eeva, M, Grilley-Olson, JE, Banks, PM, Graziano, P, Boswell, EL, Elmberger, G, Raparia, K, Hart, CF, Sholl, LM, Nolan, NJ, Fritchie, KJ, Pouagare, E, Allen, TC, Volmar, KE, Biddinger, PW, Kleven, DT, Papez, MJ, Spencer, DV, Rekhtman, N, Mino-Kenudson, M, Hariri, L, Driver, B & Cagle, PT 2018, 'Interpathologist diagnostic agreement for non–small cell lung carcinomas using current and recent classifications', Archives of Pathology and Laboratory Medicine, vol. 142, no. 12, pp. 1537-1548. https://doi.org/10.5858/arpa.2017-0481-OA
Funkhouser, William K. ; Neil Hayes, D. ; Moore, Dominic T. ; Keith Funkhouser, W. ; Fine, Jason P. ; Jo, Hee Joon ; Nikolaishvilli-Feinberg, Nana ; Eeva, Mervi ; Grilley-Olson, Juneko E. ; Banks, Peter M. ; Graziano, Paolo ; Boswell, Elizabeth L. ; Elmberger, Goran ; Raparia, Kirtee ; Hart, Craig F. ; Sholl, Lynette M. ; Nolan, Norris J. ; Fritchie, Karen J. ; Pouagare, Ersie ; Allen, Timothy C. ; Volmar, Keith E. ; Biddinger, Paul Williams ; Kleven, Daniel T ; Papez, Michael J. ; Spencer, Deborah V. ; Rekhtman, Natasha ; Mino-Kenudson, Mari ; Hariri, Lida ; Driver, Brandon ; Cagle, Philip T. / Interpathologist diagnostic agreement for non–small cell lung carcinomas using current and recent classifications. In: Archives of Pathology and Laboratory Medicine. 2018 ; Vol. 142, No. 12. pp. 1537-1548.
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abstract = "Context.—Measurement of interpathologist diagnostic agreement (IPDA) should allow pathologists to improve current diagnostic criteria and disease classifications. Objectives.—To determine how IPDA for pathologists’ diagnoses of non–small cell lung carcinoma (NSCLC) is affected by the addition of a set of mucin and immunohistochemical (IHC) stains to hematoxylin-eosin (H&E) alone, by recent NSCLC reclassifications, by simplification of these classifications, and by pathologists’ practice location, pulmonary pathology expertise, practice duration, and lung carcinoma case exposure. Design.—We used a Web-based survey to present core images of 54 NSCLC cases to 22 practicing pathologists for diagnosis, initially as H&E only, then as H&E plus mucin and 4 IHC stains. Each case was diagnosed according to published 2004, 2011, and 2015 NSCLC classifications. Cohen’s kappa was calculated for the 231 pathologist pairs as a measure of IPDA. Results.—Twenty-two pathologists diagnosed 54 NSCLC cases by using 4 published classifications. IPDA is significantly higher for H&E/mucin/IHC diagnoses than for H&E-only diagnoses. IPDA for H&E/mucin/IHC diagnoses is highest with the 2015 classification. IPDA is estimated higher after collapse of stated diagnoses into subhead or dichotomized classes. IPDA for H&E/mucin/ IHC diagnoses with the 2015 World Health Organization classification is similar for community and academic pathologists, and is higher when pathologists have pulmonary pathology expertise, have more than 6 years of practice experience, or diagnose more than 100 new lung carcinoma cases per year. Conclusions.—Higher IPDA is associated with use of mucin and IHC stains, with the 2015 NSCLC classification, and with pathologists’ pulmonary pathology expertise, ractice duration and fre uenc of lun carcinoma cases.",
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AU - Funkhouser, William K.

AU - Neil Hayes, D.

AU - Moore, Dominic T.

AU - Keith Funkhouser, W.

AU - Fine, Jason P.

AU - Jo, Hee Joon

AU - Nikolaishvilli-Feinberg, Nana

AU - Eeva, Mervi

AU - Grilley-Olson, Juneko E.

AU - Banks, Peter M.

AU - Graziano, Paolo

AU - Boswell, Elizabeth L.

AU - Elmberger, Goran

AU - Raparia, Kirtee

AU - Hart, Craig F.

AU - Sholl, Lynette M.

AU - Nolan, Norris J.

AU - Fritchie, Karen J.

AU - Pouagare, Ersie

AU - Allen, Timothy C.

AU - Volmar, Keith E.

AU - Biddinger, Paul Williams

AU - Kleven, Daniel T

AU - Papez, Michael J.

AU - Spencer, Deborah V.

AU - Rekhtman, Natasha

AU - Mino-Kenudson, Mari

AU - Hariri, Lida

AU - Driver, Brandon

AU - Cagle, Philip T.

PY - 2018/12/1

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N2 - Context.—Measurement of interpathologist diagnostic agreement (IPDA) should allow pathologists to improve current diagnostic criteria and disease classifications. Objectives.—To determine how IPDA for pathologists’ diagnoses of non–small cell lung carcinoma (NSCLC) is affected by the addition of a set of mucin and immunohistochemical (IHC) stains to hematoxylin-eosin (H&E) alone, by recent NSCLC reclassifications, by simplification of these classifications, and by pathologists’ practice location, pulmonary pathology expertise, practice duration, and lung carcinoma case exposure. Design.—We used a Web-based survey to present core images of 54 NSCLC cases to 22 practicing pathologists for diagnosis, initially as H&E only, then as H&E plus mucin and 4 IHC stains. Each case was diagnosed according to published 2004, 2011, and 2015 NSCLC classifications. Cohen’s kappa was calculated for the 231 pathologist pairs as a measure of IPDA. Results.—Twenty-two pathologists diagnosed 54 NSCLC cases by using 4 published classifications. IPDA is significantly higher for H&E/mucin/IHC diagnoses than for H&E-only diagnoses. IPDA for H&E/mucin/IHC diagnoses is highest with the 2015 classification. IPDA is estimated higher after collapse of stated diagnoses into subhead or dichotomized classes. IPDA for H&E/mucin/ IHC diagnoses with the 2015 World Health Organization classification is similar for community and academic pathologists, and is higher when pathologists have pulmonary pathology expertise, have more than 6 years of practice experience, or diagnose more than 100 new lung carcinoma cases per year. Conclusions.—Higher IPDA is associated with use of mucin and IHC stains, with the 2015 NSCLC classification, and with pathologists’ pulmonary pathology expertise, ractice duration and fre uenc of lun carcinoma cases.

AB - Context.—Measurement of interpathologist diagnostic agreement (IPDA) should allow pathologists to improve current diagnostic criteria and disease classifications. Objectives.—To determine how IPDA for pathologists’ diagnoses of non–small cell lung carcinoma (NSCLC) is affected by the addition of a set of mucin and immunohistochemical (IHC) stains to hematoxylin-eosin (H&E) alone, by recent NSCLC reclassifications, by simplification of these classifications, and by pathologists’ practice location, pulmonary pathology expertise, practice duration, and lung carcinoma case exposure. Design.—We used a Web-based survey to present core images of 54 NSCLC cases to 22 practicing pathologists for diagnosis, initially as H&E only, then as H&E plus mucin and 4 IHC stains. Each case was diagnosed according to published 2004, 2011, and 2015 NSCLC classifications. Cohen’s kappa was calculated for the 231 pathologist pairs as a measure of IPDA. Results.—Twenty-two pathologists diagnosed 54 NSCLC cases by using 4 published classifications. IPDA is significantly higher for H&E/mucin/IHC diagnoses than for H&E-only diagnoses. IPDA for H&E/mucin/IHC diagnoses is highest with the 2015 classification. IPDA is estimated higher after collapse of stated diagnoses into subhead or dichotomized classes. IPDA for H&E/mucin/ IHC diagnoses with the 2015 World Health Organization classification is similar for community and academic pathologists, and is higher when pathologists have pulmonary pathology expertise, have more than 6 years of practice experience, or diagnose more than 100 new lung carcinoma cases per year. Conclusions.—Higher IPDA is associated with use of mucin and IHC stains, with the 2015 NSCLC classification, and with pathologists’ pulmonary pathology expertise, ractice duration and fre uenc of lun carcinoma cases.

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