ArticleHistopathology2014
Understanding diagnostic variability in breast pathology: lessons learned from an expert consensus review panel.
Article in Histopathology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 60 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
60 citing papers in PubMed.
- The BIG 2.04 MRC/EORTC SUPREMO Trial: pathology quality assurance of a large phase 3 randomised international clinical trial of postmastectomy radiotherapy in intermediate-risk breast cancer.Breast cancer research and treatment · 2017Trial
- Multi-Omics and Liquid Biopsy Integration for Precision Stratification of Breast Cancer.Cancers · 2026Review
- Distortions from Unbiased Noise in Sequential Review: Why the Research Excellence Framework Needs a Noise Audit.Quarterly journal of experimental psychology (2006) · 2026Article
- Taking a closer look: Can an app improve diagnostic accuracy in urgent care? Cluster-randomized interventional trial DASI.PLOS digital health · 2026Article
- Characterizing Interpretive and Diagnostic Competency Development in Pathology Training.Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2025Article
- Roche Digital Pathology Dx whole slide imaging system is comparable to traditional microscopy for primary diagnosis in surgical pathology.American journal of clinical pathology · 2025Article
- Variability of interobserver interpretation of selected helminth ova in the development of a training image set.International health · 2025Article
- Article
- Integration of Nuclear, Clinical, and Genetic Features for Lung Cancer Subtype Classification and Survival Prediction Based on Machine- and Deep-Learning Models.Diagnostics (Basel, Switzerland) · 2025Article
- A multi-model approach integrating whole-slide imaging and clinicopathologic features to predict breast cancer recurrence risk.NPJ breast cancer · 2024Article
- Multinational, Multicenter Evaluation of Prostate Cancer Tissue in Sub-Saharan Africa: Challenges and Opportunities.JCO global oncology · 2024Article
- A platform-independent AI tumor lineage and site (ATLAS) classifier.Communications biology · 2024Article
- Machine learning classification of diagnostic accuracy in pathologists interpreting breast biopsies.Journal of the American Medical Informatics Association : JAMIA · 2024Article
- Deep learning-based identification of esophageal cancer subtypes through analysis of high-resolution histopathology images.Frontiers in molecular biosciences · 2024Article
- Generalizations of the Jaccard index and Sørensen index for assessing agreement across multiple readers in object detection and instance segmentation in biomedical imaging.Journal of medical imaging (Bellingham, Wash.) · 2023Article
- From Image to Diagnosis: Characterizing Sources of Error in Histopathologic Interpretation.Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2023Article
- Pathologist pupil dilation reflects experience level and difficulty in diagnosing medical images.Journal of medical imaging (Bellingham, Wash.) · 2023Article
- Are Pathologists Self-Aware of Their Diagnostic Accuracy? Metacognition and the Diagnostic Process in Pathology.Medical decision making : an international journal of the Society for Medical Decision Making · 2023Article
- An interpretable decision-support model for breast cancer diagnosis using histopathology images.Journal of pathology informatics · 2023Article
- Zoom behavior during visual search modulates pupil diameter and reflects adaptive control states.PloS one · 2023Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
aimsTo gain a better understanding of the reasons for diagnostic variability, with the aim of reducing the phenomenon. METHODS AND
resultsIn preparation for a study on the interpretation of breast specimens (B-PATH), a panel of three experienced breast pathologists reviewed 336 cases to develop consensus reference diagnoses. After independent assessment, cases coded as diagnostically discordant were discussed at consensus meetings. By the use of qualitative data analysis techniques, transcripts of 16 h of consensus meetings for a subset of 201 cases were analysed. Diagnostic variability could be attributed to three overall root causes: (i) pathologist-related; (ii) diagnostic coding/study methodology-related; and (iii) specimen-related. Most pathologist-related root causes were attributable to professional differences in pathologists' opinions about whether the diagnostic criteria for a specific diagnosis were met, most frequently in cases of atypia. Diagnostic coding/study methodology-related root causes were primarily miscategorizations of descriptive text diagnoses, which led to the development of a standardized electronic diagnostic form (BPATH-Dx). Specimen-related root causes included artefacts, limited diagnostic material, and poor slide quality. After re-review and discussion, a consensus diagnosis could be assigned in all cases.
conclusionsDiagnostic variability is related to multiple factors, but consensus conferences, standardized electronic reporting formats and comments on suboptimal specimen quality can be used to reduce diagnostic variability.
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