Development of benchmark quality criteria for assessing whole-endoscopy Barrett's esophagus biopsy cases

M J van der Wel; L C Duits; E Klaver; R E Pouw; C A Seldenrijk; Gja Offerhaus; M Visser; Fjw Ten Kate; J G Tijssen; Jjghm Bergman; S L Meijer

doi:https://doi.org/10.1177/2050640618764710

Development of benchmark quality criteria for assessing whole-endoscopy Barrett's esophagus biopsy cases

M J van der Wel, L C Duits, E Klaver, R E Pouw, C A Seldenrijk, Gja Offerhaus, M Visser, Fjw Ten Kate, J G Tijssen, Jjghm Bergman, S L Meijer

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Abstract

Background: Dysplasia in Barrett's esophagus (BE) biopsies is associated with low observer agreement among general pathologists. Therefore, expert review is advised. We are developing a web-based, national expert review panel for histological review of BE biopsies.

Objective: The aim of this study was to create benchmark quality criteria for future members.

Methods: Five expert BE pathologists, with 10-30 years of BE experience, weekly handling 5-10 cases (25% dysplastic), assessed a case set of 60 digitalized cases, enriched for dysplasia. Each case contained all slides from one endoscopy (non-dysplastic BE (NDBE), n = 21; low-grade dysplasia (LGD), n = 20; high-grade dysplasia (HGD), n = 19). All cases were randomized and assessed twice followed by group discussions to create a consensus diagnosis. Outcome measures: percentage of 'indefinite for dysplasia' (IND) diagnoses, intra-observer agreement, and agreement with the consensus 'gold standard' diagnosis.

Results: Mean percentage of IND diagnoses was 8% (3-14%) and mean intra-observer agreement was 0.84 (0.66-1.02). Mean agreement with the consensus diagnosis was 90% (95% prediction interval (PI) 82-98%).

Conclusion: Expert pathology review of BE requires the scoring of a limited number of IND cases, consistency of assessment and a high agreement with a consensus gold standard diagnosis. These benchmark quality criteria will be used to assess the performance of other pathologists joining our panel.

Original language	English
Pages (from-to)	830-837
Number of pages	8
Journal	United European gastroenterology journal
Volume	6
Issue number	6
DOIs	https://doi.org/10.1177/2050640618764710
Publication status	Published - Jul 2018

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van der Wel, M. J., Duits, L. C., Klaver, E., Pouw, R. E., Seldenrijk, C. A., Offerhaus, G., Visser, M., Ten Kate, F., Tijssen, J. G., Bergman, J., & Meijer, S. L. (2018). Development of benchmark quality criteria for assessing whole-endoscopy Barrett's esophagus biopsy cases. United European gastroenterology journal, 6(6), 830-837. https://doi.org/10.1177/2050640618764710

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title = "Development of benchmark quality criteria for assessing whole-endoscopy Barrett's esophagus biopsy cases",

abstract = "Background: Dysplasia in Barrett's esophagus (BE) biopsies is associated with low observer agreement among general pathologists. Therefore, expert review is advised. We are developing a web-based, national expert review panel for histological review of BE biopsies.Objective: The aim of this study was to create benchmark quality criteria for future members.Methods: Five expert BE pathologists, with 10-30 years of BE experience, weekly handling 5-10 cases (25% dysplastic), assessed a case set of 60 digitalized cases, enriched for dysplasia. Each case contained all slides from one endoscopy (non-dysplastic BE (NDBE), n = 21; low-grade dysplasia (LGD), n = 20; high-grade dysplasia (HGD), n = 19). All cases were randomized and assessed twice followed by group discussions to create a consensus diagnosis. Outcome measures: percentage of 'indefinite for dysplasia' (IND) diagnoses, intra-observer agreement, and agreement with the consensus 'gold standard' diagnosis.Results: Mean percentage of IND diagnoses was 8% (3-14%) and mean intra-observer agreement was 0.84 (0.66-1.02). Mean agreement with the consensus diagnosis was 90% (95% prediction interval (PI) 82-98%).Conclusion: Expert pathology review of BE requires the scoring of a limited number of IND cases, consistency of assessment and a high agreement with a consensus gold standard diagnosis. These benchmark quality criteria will be used to assess the performance of other pathologists joining our panel.",

author = "{van der Wel}, {M J} and Duits, {L C} and E Klaver and Pouw, {R E} and Seldenrijk, {C A} and Gja Offerhaus and M Visser and {Ten Kate}, Fjw and Tijssen, {J G} and Jjghm Bergman and Meijer, {S L}",

year = "2018",

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doi = "https://doi.org/10.1177/2050640618764710",

language = "English",

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AU - van der Wel, M J

AU - Duits, L C

AU - Klaver, E

AU - Pouw, R E

AU - Seldenrijk, C A

AU - Offerhaus, Gja

AU - Visser, M

AU - Ten Kate, Fjw

AU - Tijssen, J G

AU - Bergman, Jjghm

AU - Meijer, S L

PY - 2018/7

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N2 - Background: Dysplasia in Barrett's esophagus (BE) biopsies is associated with low observer agreement among general pathologists. Therefore, expert review is advised. We are developing a web-based, national expert review panel for histological review of BE biopsies.Objective: The aim of this study was to create benchmark quality criteria for future members.Methods: Five expert BE pathologists, with 10-30 years of BE experience, weekly handling 5-10 cases (25% dysplastic), assessed a case set of 60 digitalized cases, enriched for dysplasia. Each case contained all slides from one endoscopy (non-dysplastic BE (NDBE), n = 21; low-grade dysplasia (LGD), n = 20; high-grade dysplasia (HGD), n = 19). All cases were randomized and assessed twice followed by group discussions to create a consensus diagnosis. Outcome measures: percentage of 'indefinite for dysplasia' (IND) diagnoses, intra-observer agreement, and agreement with the consensus 'gold standard' diagnosis.Results: Mean percentage of IND diagnoses was 8% (3-14%) and mean intra-observer agreement was 0.84 (0.66-1.02). Mean agreement with the consensus diagnosis was 90% (95% prediction interval (PI) 82-98%).Conclusion: Expert pathology review of BE requires the scoring of a limited number of IND cases, consistency of assessment and a high agreement with a consensus gold standard diagnosis. These benchmark quality criteria will be used to assess the performance of other pathologists joining our panel.

AB - Background: Dysplasia in Barrett's esophagus (BE) biopsies is associated with low observer agreement among general pathologists. Therefore, expert review is advised. We are developing a web-based, national expert review panel for histological review of BE biopsies.Objective: The aim of this study was to create benchmark quality criteria for future members.Methods: Five expert BE pathologists, with 10-30 years of BE experience, weekly handling 5-10 cases (25% dysplastic), assessed a case set of 60 digitalized cases, enriched for dysplasia. Each case contained all slides from one endoscopy (non-dysplastic BE (NDBE), n = 21; low-grade dysplasia (LGD), n = 20; high-grade dysplasia (HGD), n = 19). All cases were randomized and assessed twice followed by group discussions to create a consensus diagnosis. Outcome measures: percentage of 'indefinite for dysplasia' (IND) diagnoses, intra-observer agreement, and agreement with the consensus 'gold standard' diagnosis.Results: Mean percentage of IND diagnoses was 8% (3-14%) and mean intra-observer agreement was 0.84 (0.66-1.02). Mean agreement with the consensus diagnosis was 90% (95% prediction interval (PI) 82-98%).Conclusion: Expert pathology review of BE requires the scoring of a limited number of IND cases, consistency of assessment and a high agreement with a consensus gold standard diagnosis. These benchmark quality criteria will be used to assess the performance of other pathologists joining our panel.

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Development of benchmark quality criteria for assessing whole-endoscopy Barrett's esophagus biopsy cases

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