Evaluation of the Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis (MPATH-Dx) classification scheme for diagnosis of cutaneous melanocytic neoplasms: Results from the International Melanoma Pathology Study Group - 20/07/16
on behalf of the
International Melanoma Pathology Study Group
Abstract |
Background |
Pathologists use diverse terminology when interpreting melanocytic neoplasms, potentially compromising quality of care.
Objective |
We sought to evaluate the Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis (MPATH-Dx) scheme, a 5-category classification system for melanocytic lesions.
Methods |
Participants (n = 16) of the 2013 International Melanoma Pathology Study Group Workshop provided independent case-level diagnoses and treatment suggestions for 48 melanocytic lesions. Individual diagnoses (including, when necessary, least and most severe diagnoses) were mapped to corresponding MPATH-Dx classes. Interrater agreement and correlation between MPATH-Dx categorization and treatment suggestions were evaluated.
Results |
Most participants were board-certified dermatopathologists (n = 15), age 50 years or older (n = 12), male (n = 9), based in the United States (n = 11), and primary academic faculty (n = 14). Overall, participants generated 634 case-level diagnoses with treatment suggestions. Mean weighted kappa coefficients for diagnostic agreement after MPATH-Dx mapping (assuming least and most severe diagnoses, when necessary) were 0.70 (95% confidence interval 0.68-0.71) and 0.72 (95% confidence interval 0.71-0.73), respectively, whereas correlation between MPATH-Dx categorization and treatment suggestions was 0.91.
Limitations |
This was a small sample size of experienced pathologists in a testing situation.
Conclusion |
Varying diagnostic nomenclature can be classified into a concise hierarchy using the MPATH-Dx scheme. Further research is needed to determine whether this classification system can facilitate diagnostic concordance in general pathology practice and improve patient care.
Le texte complet de cet article est disponible en PDF.Key words : classification, diagnosis, dysplastic nevus, melanoma, Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis, nevus, pathology, variability, variation
Abbreviations used : BI-RADS, CI, MPATH-Dx, SLN
Plan
Supported by the National Cancer Institute (R01 CA151306 and K05 CA104699). |
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Disclosure: Dr Lott is an employee of Bayer HealthCare Pharmaceuticals Inc. Dr Barnhill has received honoraria as a consultant for Myriad Genetics. Dr Elder has received honoraria as a consultant for Myriad Genetics, and royalties as a textbook editor for Lippincott Williams and Wilkins, Wolters Kluwer, and Demos Medical Publishing, and as an author of the Armed Forces Institute of Pathology's fascicles on melanocytic and nonmelanocytic tumor pathology. Dr Elenitsas has received honoraria as a consultant for Myriad Genetics and royalties as a textbook editor for Lippincott Williams and Wilkins. Dr Gerami has received honoraria as a consultant at DermTech Inc, Castle Biosciences, and Myriad Genetics. Dr Mihm has received honoraria as a textbook coauthor from Wiley and Sons Inc and advisory board member for Caliber ID, and received consulting fees as a consultant for Mela Sciences, Alnylam, and Novartis. Drs Elmore, Zhao, Knezevich, Reisch, Chu, Cook, Duncan, Landman, Lowe, Messina, van den Oord, Rabkin, Schmidt, Shea, Yun, Xu, and Piepkorn, and Mr Frederick have no conflicts of interest to declare. |
Vol 75 - N° 2
P. 356-363 - août 2016 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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