Weinstock M A, Barnhill R L, Rhodes A R, Brodsky G L
Dermatology Section, Department of Veterans Affairs Medical Center Providence, RI, USA.
Arch Dermatol. 1997 Aug;133(8):953-8.
To determine the reliability of the histopathologic diagnosis of melanocytic dysplasia among diverse dermatopathologists who had no joint training, agreed to abide by predetermined criteria, and who were provided reference photomicrographs illustrative of the criteria.
DESIGN, SETTING, AND PARTICIPANTS: A stratified random sample of 112 melanocytic tumors were chosen from the files of the pathology department of a large staff-model health maintenance organization. The original diagnoses included typical and dysplastic melanocytic nevi and melanoma. A single representative slide for each case was interpreted independently by each of the 5 panel dermatopathologists and 2 melanoma specialists. They had no prior knowledge of the original diagnosis or the diagnoses of the other panel members.
None.
Interrater reliability was measured by intraclass and Pearson correlation coefficients. Each case was graded on a 5-point scale from no dysplasia to melanoma.
The intraclass correlation among the panel members was 0.67 (95% confidence interval, 0.59-0.73). The Pearson correlations of each of the 5 panel dermatopathologists with the mean of the 2 melanoma specialists ranged from 0.67 to 0.84, and the correlations of the mean of the panel with the 2 melanoma specialists were 0.79 and 0.82; the mean reading of the melanoma specialists correlated 0.89 with the mean panel reading. Apparent protocol violations occurred in 6.5% of the readings.
Agreement was substantial to excellent for the histopathologic diagnosis of 112 melanocytic tumors by dermatopathologists. Using predetermined criteria, melanocytic dysplasia can be reproducibly graded among diverse general dermatopathologists.
确定不同的皮肤科病理医生对黑素细胞发育异常进行组织病理学诊断的可靠性，这些医生没有共同培训经历，但同意遵循预定标准，并被提供了说明该标准的参考显微照片。
设计、地点和参与者：从一家大型员工模式健康维护组织的病理科档案中选取了112例黑素细胞肿瘤的分层随机样本。原始诊断包括典型和发育异常的黑素细胞痣以及黑色素瘤。5名皮肤科病理专家小组和2名黑色素瘤专家分别独立解读每个病例的一张代表性玻片。他们事先不知道原始诊断或其他专家小组成员的诊断结果。
无。
通过组内相关系数和皮尔逊相关系数测量评分者间的可靠性。每个病例根据从无发育异常到黑色素瘤的5分制进行分级。
专家小组成员之间的组内相关系数为0.67（95%置信区间，0.59 - 0.73）。5名皮肤科病理专家小组中的每一位与2名黑色素瘤专家的平均值之间的皮尔逊相关系数范围为0.67至0.84，专家小组的平均值与2名黑色素瘤专家之间的相关系数分别为0.79和0.82；黑色素瘤专家的平均读数与专家小组的平均读数之间的相关系数为0.89。在6.5%的读数中出现了明显违反方案的情况。
皮肤科病理医生对112例黑素细胞肿瘤的组织病理学诊断一致性为实质性到优秀。使用预定标准，不同的普通皮肤科病理医生能够对黑素细胞发育异常进行可重复的分级。
