Stability of diagnostic rate in a cohort of 38,813 colorectal polyp specimens and implications for histomorphology and statistical process control
Abstract This work sought to quantify pathologists’ diagnostic bias over time in their evaluation of colorectal polyps to assess how this may impact the utility of statistical process control (SPC). All colorectal polyp specimens(CRPS) for 2011–2017 in a region were categorized using a validated fre...
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| Format: | Article |
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Nature Portfolio
2021-08-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-021-95862-2 |
| _version_ | 1818991896421203968 |
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| author | Michael Bonert Asghar Naqvi Mozibur Rahman John K. Marshall Ted Xenodemetropoulos Paul Arora Justin Slater Pierre Major |
| author_facet | Michael Bonert Asghar Naqvi Mozibur Rahman John K. Marshall Ted Xenodemetropoulos Paul Arora Justin Slater Pierre Major |
| author_sort | Michael Bonert |
| collection | DOAJ |
| description | Abstract This work sought to quantify pathologists’ diagnostic bias over time in their evaluation of colorectal polyps to assess how this may impact the utility of statistical process control (SPC). All colorectal polyp specimens(CRPS) for 2011–2017 in a region were categorized using a validated free text string matching algorithm. Pathologist diagnostic rates (PDRs) for high grade dysplasia (HGD), tubular adenoma (TA_ad), villous morphology (TVA + VA), sessile serrated adenoma (SSA) and hyperplastic polyp (HP), were assessed (1) for each pathologist in yearly intervals with control charts (CCs), and (2) with a generalized linear model (GLM). The study included 64,115 CRPS. Fifteen pathologists each interpreted > 150 CRPS/year in all years and together diagnosed 38,813. The number of pathologists (of 15) with zero or one (p < 0.05) outlier in seven years, compared to their overall PDR, was 13, 9, 9, 5 and 9 for HGD, TVA + VA, TA_ad, HP and SSA respectively. The GLM confirmed, for the subset where pathologists/endoscopists saw > 600 CRPS each(total 52,760 CRPS), that pathologist, endoscopist, anatomical location and year were all strongly correlated (all p < 0.0001) with the diagnosis. The moderate PDR stability over time supports the hypothesis that diagnostic rates are amendable to calibration via SPC and outcome data. |
| first_indexed | 2024-12-20T20:17:33Z |
| format | Article |
| id | doaj.art-21e4bea2014a47bf971f4e75a91a9cf2 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-20T20:17:33Z |
| publishDate | 2021-08-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj.art-21e4bea2014a47bf971f4e75a91a9cf22022-12-21T19:27:40ZengNature PortfolioScientific Reports2045-23222021-08-0111111810.1038/s41598-021-95862-2Stability of diagnostic rate in a cohort of 38,813 colorectal polyp specimens and implications for histomorphology and statistical process controlMichael Bonert0Asghar Naqvi1Mozibur Rahman2John K. Marshall3Ted Xenodemetropoulos4Paul Arora5Justin Slater6Pierre Major7Department of Pathology and Molecular Medicine, McMaster UniversityDepartment of Pathology and Molecular Medicine, McMaster UniversityWestchester Medical CenterDepartment of Medicine, Farncombe Family Digestive Health Research Institute, McMaster UniversityDepartment of Medicine, Farncombe Family Digestive Health Research Institute, McMaster UniversityDivision of Epidemiology, Dalla Lana School of Public Health, University of TorontoLighthouse Outcomes Inc.Juravinski Hospital/Hamilton Health Sciences CentreAbstract This work sought to quantify pathologists’ diagnostic bias over time in their evaluation of colorectal polyps to assess how this may impact the utility of statistical process control (SPC). All colorectal polyp specimens(CRPS) for 2011–2017 in a region were categorized using a validated free text string matching algorithm. Pathologist diagnostic rates (PDRs) for high grade dysplasia (HGD), tubular adenoma (TA_ad), villous morphology (TVA + VA), sessile serrated adenoma (SSA) and hyperplastic polyp (HP), were assessed (1) for each pathologist in yearly intervals with control charts (CCs), and (2) with a generalized linear model (GLM). The study included 64,115 CRPS. Fifteen pathologists each interpreted > 150 CRPS/year in all years and together diagnosed 38,813. The number of pathologists (of 15) with zero or one (p < 0.05) outlier in seven years, compared to their overall PDR, was 13, 9, 9, 5 and 9 for HGD, TVA + VA, TA_ad, HP and SSA respectively. The GLM confirmed, for the subset where pathologists/endoscopists saw > 600 CRPS each(total 52,760 CRPS), that pathologist, endoscopist, anatomical location and year were all strongly correlated (all p < 0.0001) with the diagnosis. The moderate PDR stability over time supports the hypothesis that diagnostic rates are amendable to calibration via SPC and outcome data.https://doi.org/10.1038/s41598-021-95862-2 |
| spellingShingle | Michael Bonert Asghar Naqvi Mozibur Rahman John K. Marshall Ted Xenodemetropoulos Paul Arora Justin Slater Pierre Major Stability of diagnostic rate in a cohort of 38,813 colorectal polyp specimens and implications for histomorphology and statistical process control Scientific Reports |
| title | Stability of diagnostic rate in a cohort of 38,813 colorectal polyp specimens and implications for histomorphology and statistical process control |
| title_full | Stability of diagnostic rate in a cohort of 38,813 colorectal polyp specimens and implications for histomorphology and statistical process control |
| title_fullStr | Stability of diagnostic rate in a cohort of 38,813 colorectal polyp specimens and implications for histomorphology and statistical process control |
| title_full_unstemmed | Stability of diagnostic rate in a cohort of 38,813 colorectal polyp specimens and implications for histomorphology and statistical process control |
| title_short | Stability of diagnostic rate in a cohort of 38,813 colorectal polyp specimens and implications for histomorphology and statistical process control |
| title_sort | stability of diagnostic rate in a cohort of 38 813 colorectal polyp specimens and implications for histomorphology and statistical process control |
| url | https://doi.org/10.1038/s41598-021-95862-2 |
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