Evaluation of the Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis (MPATH-Dx) classification scheme for diagnosis of cutaneous melanocytic neoplasms: Results from the International Melanoma Pathology Study Group

Evaluation of the Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis (MPATH-Dx) classification scheme for diagnosis of cutaneous melanocytic neoplasms: Results from the International Melanoma Pathology Study Group

Author Lott, Jason P. Google Scholar
Elmore, Joann G. Google Scholar
Zhao, Ge A. Google Scholar
Knezevich, Stevan R. Google Scholar
Frederick, Paul D. Google Scholar
Reisch, Lisa M. Google Scholar
Chu, Emily Y. Google Scholar
Cook, Martin G. Google Scholar
Duncan, Lyn M. Google Scholar
Elenitsas, Rosalie Google Scholar
Gerami, Pedram Google Scholar
Landman, Gilles Autor UNIFESP Google Scholar
Lowe, Lori Google Scholar
Messina, Jane L. Google Scholar
Mihm, Martin C. Google Scholar
van den Oord, Joost J. Google Scholar
Rabkin, Michael S. Google Scholar
Schmidt, Birgitta Google Scholar
Shea, Christopher R. Google Scholar
Yun, Sook Jung Google Scholar
Xu, George X. Google Scholar
Piepkorn, Michael W. Google Scholar
Elder, David E. Google Scholar
Barnhill, Raymond L. Google Scholar
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.
Keywords classification
diagnosis
dysplastic nevus
melanoma
Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis
nevus
pathology
variability
variation
xmlui.dri2xhtml.METS-1.0.item-coverage New York
Language English
Sponsor National Cancer Institute
Grant number National Cancer Institute: R01 CA151306
National Cancer Institute: K05 CA104699
Date 2016
Published in Journal Of The American Academy Of Dermatology. New York, v. 75, n. 2, p. 356-363, 2016.
ISSN 0190-9622 (Sherpa/Romeo, impact factor)
Publisher Mosby-Elsevier
Extent 356-363
Origin http://dx.doi.org/10.1016/j.jaad.2016.04.052
Access rights Closed access
Type Article
Web of Science ID WOS:000380748300029
URI https://repositorio.unifesp.br/handle/11600/57478

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