title: A multinational, internet-based assessment of observer variability in the diagnosis of serrated colorectal polyps.
abstract: This Internet-based quiz (http://kathrin.unibas.ch/polyp/) tested the diagnostic variability of 168 pathologists in the diagnosis of 20 colorectal polyps on 3 representative images, including hyperplastic polyps (HPs), traditional serrated adenomas (TSAs), sessile serrated adenomas (SSAs), and tubulovillous adenomas (TVAs). Interobserver variability for each of the 20 lesions was significant and was most pronounced for SSAs. Correct answers were independent of the participant's experience with TVAs, HPs, and TSAs. Participants with gastrointestinal subspecialty training and those who had read a reference article on serrated polyps gave a significantly higher percentage of correct answers for SSAs. The nomenclature used for serrated polyps was generally inconsistent. Our results suggest significant shortcomings in the routine H&E diagnosis of serrated colorectal polyps. A diagnostically unifying concept for lesions of the serrated neoplasia pathway, standardization of nomenclature, training of pathologists, and possibly development of ancillary techniques are of paramount importance for accurate patient management.
authors.affiliation: Departments of Pathology, University of Basel, Basel, Switzerland.
authors.forename: Katharina
authors.initials: K
authors.lastname: Glatz
authors.forename: Bobbi
authors.initials: B
authors.lastname: Pritt
authors.forename: Dieter
authors.initials: D
authors.lastname: Glatz
authors.forename: Arndt
authors.initials: A
authors.lastname: Hartmann
authors.forename: Michael J
authors.initials: MJ
authors.lastname: O'Brien
authors.forename: Hagen
authors.initials: H
authors.lastname: Blaszyk
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003106:Colon / Q000473:pathology; D003111:Colonic Polyps / Q000175:diagnosis*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007391:International Cooperation; D020407:Internet; D008297:Male; D008875:Middle Aged; D015588:Observer Variation