Abdollahi Alireza, Sheikhbahaei Sara, Meysamie Alipasha, Bakhshandeh Mohammadreza, Hosseinzadeh Hasan
Department of Pathology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Department of Community Medicine, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Acta Med Iran. 2014;52(5):370-4.
This study was aimed at determining intra and inter-observer concordance rates in the Gleason scoring of prostatic adenocarcinoma, before and after a web-based educational course. In this self-controlled study, 150 tissue samples of prostatic adenocarcinoma are re-examined to be scored according to the Gleason scoring system. Then all pathologists attend a free web-based course. Afterwards, the same 150 samples [with different codes compared to the previous ones] are distributed differently among the pathologists to be assigned Gleason scores. After gathering the data, the concordance rate in the first and second reports of pathologists is determined. In the pre web-education, the mean kappa value of Interobserver agreement was 0.25 [fair agreement]. Post web-education significantly improved with the mean kappa value of 0.52 [moderate agreement]. Using weighted kappa values, significant improvement was observed in inter-observer agreement in higher scores of Gleason grade; Score 10 was achieved for the mean kappa value in post web-education was 0.68 [substantial agreement] compared to 0.25 (fair agreement) in pre web-education. Web-based training courses are attractive to pathologists as they do not need to spend much time and money. Therefore, such training courses are strongly recommended for significant pathological issues including the grading of the prostate adenocarcinoma. Through web-based education, pathologists can exchange views and contribute to the rise in the level of reproducibility. Such programs need to be included in post-graduation programs.
本研究旨在确定在基于网络的教育课程前后,前列腺腺癌Gleason评分中观察者内和观察者间的一致性率。在这项自我对照研究中,对150份前列腺腺癌组织样本重新进行检查,以根据Gleason评分系统进行评分。然后所有病理学家参加一个免费的网络课程。之后,将相同的150个样本(与之前的样本编码不同)以不同方式分发给病理学家,让他们给出Gleason评分。收集数据后,确定病理学家第一次和第二次报告中的一致性率。在网络教育前,观察者间一致性的平均kappa值为0.25(一致性尚可)。网络教育后显著改善,平均kappa值为0.52(中度一致)。使用加权kappa值,在Gleason分级较高的分数中,观察者间一致性有显著改善;在网络教育后,Gleason评分10分的平均kappa值为0.68(高度一致),而在网络教育前为0.25(一致性尚可)。基于网络的培训课程对病理学家很有吸引力,因为他们不需要花费太多时间和金钱。因此,强烈推荐此类培训课程用于包括前列腺腺癌分级在内的重要病理问题。通过网络教育,病理学家可以交流观点并有助于提高可重复性水平。此类课程需要纳入毕业后课程中。