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.
Original language | English (US) |
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Pages (from-to) | 356-363 |
Number of pages | 8 |
Journal | Journal of the American Academy of Dermatology |
Volume | 75 |
Issue number | 2 |
DOIs | |
State | Published - Aug 1 2016 |
Keywords
- Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis
- classification
- diagnosis
- dysplastic nevus
- melanoma
- nevus
- pathology
- variability
- variation
ASJC Scopus subject areas
- Dermatology