Evidence map›Paper›PMID 34487353›Full record

ArticleJournal of cutaneous pathology2022

Characterization of multiple diagnostic terms in melanocytic skin lesion pathology reports.

Oliver H Chang, David E Elder, Raymond L Barnhill, Michael W Piepkorn, Megan M Eguchi, Stevan R Knezevich, Annie C Lee, Raul J Moreno, Kathleen F Kerr, Joann G Elmore

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of cutaneous pathology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Oliver H ChangDepartment of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, Washington, USA.
David E ElderDepartment of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Raymond L BarnhillDepartments of Pathology and Translational Research, Institut Curie, Paris Sciences and Lettres Research University, and Faculty of Medicine University of Paris Descartes, Paris, France.
Michael W PiepkornDivision of Dermatology, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA.
Megan M EguchiDepartment of Medicine, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, California, USA.
Stevan R KnezevichPathology Associates, Clovis, California, USA.
Annie C LeeDepartment of Medicine, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, California, USA.
Raul J MorenoDepartment of Medicine, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, California, USA.
Kathleen F KerrDepartment of Biostatistics, University of Washington, Seattle, Washington, USA.
Joann G ElmoreDepartment of Medicine, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, California, USA.ORCID https://orcid.org/0000-0002-7311-6835

Funding

Accuracy in the Diagnosis of Melanoma & the Impact of Double ReadingR01CA151306 · NCI · UNIVERSITY OF WASHINGTON · PI ELMORE, JOANN G · 2011 to 2015
$4.1M
Reducing Errors in the Diagnosis of Melanoma and Melanocytic LesionsR01CA201376 · NCI · UNIVERSITY OF WASHINGTON · PI ELMORE, JOANN G, KERR, KATHLEEN F. · 2016 to 2020
$3.2M
Improving Melanoma Pathology Accuracy through Computer Vision Techniques - the IMPACT StudyR01CA200690 · NCI · UNIVERSITY OF WASHINGTON · PI ELMORE, JOANN G, SHAPIRO, LINDA · 2016 to 2020
$1.9M
NCI NIH HHS R01 CA151306NCI NIH HHS R01 CA200690NCI NIH HHS R01 CA201376
6 · The paper itself

Abstract

backgroundHistopathologically ambiguous melanocytic lesions lead some pathologists to list multiple diagnostic considerations in the pathology report. The frequency and circumstance of multiple diagnostic considerations remain poorly characterized.

methodsTwo hundred and forty skin biopsy samples were interpreted by 187 pathologists (8976 independent diagnoses) and classified according to a diagnostic/treatment stratification (MPATH-Dx).

resultsMultiple diagnoses in different MPATH-Dx classes were used in n = 1320 (14.7%) interpretations, with 97% of pathologists and 91% of cases having at least one such interpretation. Multiple diagnoses were more common for intermediate risk lesions and are associated with greater subjective difficulty and lower confidence. We estimate that 6% of pathology reports for melanocytic lesions in the United States contain two diagnoses of different MPATH-Dx prognostic classes, and 2% of cases are given two diagnoses with significant treatment implications.

conclusionsDifficult melanocytic diagnoses in skin may necessitate multiple diagnostic considerations; however, as patients increasingly access their health records and retrieve pathology reports (as mandated by US law), uncertainty should be expressed unambiguously.

Indexed as

PathologistsAdultAgedBiopsyFemaleHumansMaleMelanocytesMiddle AgedSkinSkin NeoplasmsTerminology as Topicborderline diagnosisdermatopathologistsdermatopathologydiagnostic dilemmamelanomaMELTUMP

Identifiers

PMID34487353
PMCPMC10367580

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.