title: Identifying factors associated with diagnostic concordance/discordance in oral lichen planus.
abstract: OBJECTIVE
  To identify factors associated with concordance and discordance between clinical and histopathologic diagnoses of oral lichen planus lesions.
  
  
  METHODS
  A retrospective analysis was conducted on all study cases derived from archival oral pathology reports generated from all cases of oral lichen planus accessioned by the Faculty of Dentistry, University of Malaya. These study cases were diagnosed from January 1980 through December 2010. Predictor variables were diagnosis year, demographics, experience of the examiner, clinical appearance and diagnosis, and final histopathologic diagnosis; these were recorded for each study case. The outcome variable was agreement between the clinical and histopathologic diagnoses, and this was classified as concordant or discordant. Descriptive statistics and multiple linear regression analyses were computed to identify associations between predictors and outcomes. Statistical significance was set at P ≤ .05.
  
  
  RESULTS
  The sample was composed of 441 study cases with 593 oral mucosal lesions that met the inclusion criteria. The mean age of the sample was 47.5 ± 13.07 years (range, 12 to 82 yr) and 64.4% were female. The mean concordance was 83.2%. Diagnosis year and demographics showed no influence on concordance or discordance. The multiple linear regression model included experience of the examiner, clinical appearance and diagnosis, and final histopathologic diagnosis (R(2) = 0.82). Except for experience of the examiner (P = .12), clinical appearance and diagnosis and final histopathologic diagnosis were the variables statistically associated with concordance (P ≤ .01).
  
  
  CONCLUSIONS
  The present results suggest that concordance is governed primarily by the clinical appearance and diagnosis of the lesion and the final histopathologic diagnosis.
authors.affiliation: Professor, Department of Oral Pathology, Oral Medicine, and Periodontology, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia. Electronic address: chsiar@gmail.com.
authors.forename: Chong Huat
authors.initials: CH
authors.lastname: Siar
authors.forename: Jimie Siew Mei
authors.initials: JS
authors.lastname: Lim
authors.forename: Sum Pei
authors.initials: SP
authors.lastname: Tang
authors.forename: Hui Shan
authors.initials: HS
authors.lastname: Chia
authors.forename: Yi Min
authors.initials: YM
authors.lastname: Loh
authors.forename: Kok Han
authors.initials: KH
authors.lastname: Ng
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002648:Child; D002983:Clinical Competence; D015331:Cohort Studies; D005260:Female; D005544:Forecasting; D006801:Humans; D017676:Lichen Planus, Oral / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D013997:Time Factors; D055815:Young Adult