Complexities of perceived and actual performance in pathology interpretation: A comparison of cutaneous melanocytic skin and breast interpretations

Patricia (Patty) Carney, Paul D. Frederick, Lisa M. Reisch, Linda Titus, Stevan R. Knezevich, Martin A. Weinstock, Michael W. Piepkorn, Raymond L. Barnhill, David E. Elder, Donald L. Weaver, Joann G. Elmore

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Little is known about how pathologists process differences between actual and perceived interpretations. Objective: To compare perceived and actual diagnostic agreement before and after educational interventions. Methods: Pathologists interpreted test sets of skin and/or breast specimens that included benign, atypical, in situ and invasive lesions. Interventions involved self-directed learning, one skin and one breast, that showed pathologists how their interpretations compared to a reference diagnoses. Prior to the educational intervention, participants estimated how their interpretations would compare to the reference diagnoses. After the intervention, participants estimated their overall agreement with the reference diagnoses. Perceived and actual agreements were compared. Results: For pathologists interpreting skin, mean actual agreement was 52.4% and overall pre- and postinterventional mean perceived agreement was 72.9% vs 54.2%, an overestimated mean difference of 20.5% (95% confidence interval [CI] 17.2% to 24.0%) and 1.8% (95% CI −0.5% to 4.1%), respectively. For pathologists interpreting breast, mean actual agreement was 75.9% and overall pre- and postinterventional mean perceived agreement was 81.4% vs 76.9%, an overestimation of 5.5% (95% CI 3.0% to 8.0%) and 1.0% (95% CI 0.0% to 2.0%), respectively. Conclusions: Pathologists interpreting breast tissue had improved comprehension of their performance after the intervention compared to pathologists interpreting skin lesions.

Original languageEnglish (US)
Pages (from-to)478-490
Number of pages13
JournalJournal of Cutaneous Pathology
Volume45
Issue number7
DOIs
StatePublished - Jul 1 2018

Fingerprint

Breast
Pathology
Skin
Confidence Intervals
Pathologists
Skin Tests
Learning

Keywords

  • breast pathology
  • continuing medical education
  • dermatopathology

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology
  • Dermatology

Cite this

Complexities of perceived and actual performance in pathology interpretation : A comparison of cutaneous melanocytic skin and breast interpretations. / Carney, Patricia (Patty); Frederick, Paul D.; Reisch, Lisa M.; Titus, Linda; Knezevich, Stevan R.; Weinstock, Martin A.; Piepkorn, Michael W.; Barnhill, Raymond L.; Elder, David E.; Weaver, Donald L.; Elmore, Joann G.

In: Journal of Cutaneous Pathology, Vol. 45, No. 7, 01.07.2018, p. 478-490.

Research output: Contribution to journalArticle

Carney, PP, Frederick, PD, Reisch, LM, Titus, L, Knezevich, SR, Weinstock, MA, Piepkorn, MW, Barnhill, RL, Elder, DE, Weaver, DL & Elmore, JG 2018, 'Complexities of perceived and actual performance in pathology interpretation: A comparison of cutaneous melanocytic skin and breast interpretations', Journal of Cutaneous Pathology, vol. 45, no. 7, pp. 478-490. https://doi.org/10.1111/cup.13147
Carney, Patricia (Patty) ; Frederick, Paul D. ; Reisch, Lisa M. ; Titus, Linda ; Knezevich, Stevan R. ; Weinstock, Martin A. ; Piepkorn, Michael W. ; Barnhill, Raymond L. ; Elder, David E. ; Weaver, Donald L. ; Elmore, Joann G. / Complexities of perceived and actual performance in pathology interpretation : A comparison of cutaneous melanocytic skin and breast interpretations. In: Journal of Cutaneous Pathology. 2018 ; Vol. 45, No. 7. pp. 478-490.
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abstract = "Background: Little is known about how pathologists process differences between actual and perceived interpretations. Objective: To compare perceived and actual diagnostic agreement before and after educational interventions. Methods: Pathologists interpreted test sets of skin and/or breast specimens that included benign, atypical, in situ and invasive lesions. Interventions involved self-directed learning, one skin and one breast, that showed pathologists how their interpretations compared to a reference diagnoses. Prior to the educational intervention, participants estimated how their interpretations would compare to the reference diagnoses. After the intervention, participants estimated their overall agreement with the reference diagnoses. Perceived and actual agreements were compared. Results: For pathologists interpreting skin, mean actual agreement was 52.4{\%} and overall pre- and postinterventional mean perceived agreement was 72.9{\%} vs 54.2{\%}, an overestimated mean difference of 20.5{\%} (95{\%} confidence interval [CI] 17.2{\%} to 24.0{\%}) and 1.8{\%} (95{\%} CI −0.5{\%} to 4.1{\%}), respectively. For pathologists interpreting breast, mean actual agreement was 75.9{\%} and overall pre- and postinterventional mean perceived agreement was 81.4{\%} vs 76.9{\%}, an overestimation of 5.5{\%} (95{\%} CI 3.0{\%} to 8.0{\%}) and 1.0{\%} (95{\%} CI 0.0{\%} to 2.0{\%}), respectively. Conclusions: Pathologists interpreting breast tissue had improved comprehension of their performance after the intervention compared to pathologists interpreting skin lesions.",
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AU - Carney, Patricia (Patty)

AU - Frederick, Paul D.

AU - Reisch, Lisa M.

AU - Titus, Linda

AU - Knezevich, Stevan R.

AU - Weinstock, Martin A.

AU - Piepkorn, Michael W.

AU - Barnhill, Raymond L.

AU - Elder, David E.

AU - Weaver, Donald L.

AU - Elmore, Joann G.

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N2 - Background: Little is known about how pathologists process differences between actual and perceived interpretations. Objective: To compare perceived and actual diagnostic agreement before and after educational interventions. Methods: Pathologists interpreted test sets of skin and/or breast specimens that included benign, atypical, in situ and invasive lesions. Interventions involved self-directed learning, one skin and one breast, that showed pathologists how their interpretations compared to a reference diagnoses. Prior to the educational intervention, participants estimated how their interpretations would compare to the reference diagnoses. After the intervention, participants estimated their overall agreement with the reference diagnoses. Perceived and actual agreements were compared. Results: For pathologists interpreting skin, mean actual agreement was 52.4% and overall pre- and postinterventional mean perceived agreement was 72.9% vs 54.2%, an overestimated mean difference of 20.5% (95% confidence interval [CI] 17.2% to 24.0%) and 1.8% (95% CI −0.5% to 4.1%), respectively. For pathologists interpreting breast, mean actual agreement was 75.9% and overall pre- and postinterventional mean perceived agreement was 81.4% vs 76.9%, an overestimation of 5.5% (95% CI 3.0% to 8.0%) and 1.0% (95% CI 0.0% to 2.0%), respectively. Conclusions: Pathologists interpreting breast tissue had improved comprehension of their performance after the intervention compared to pathologists interpreting skin lesions.

AB - Background: Little is known about how pathologists process differences between actual and perceived interpretations. Objective: To compare perceived and actual diagnostic agreement before and after educational interventions. Methods: Pathologists interpreted test sets of skin and/or breast specimens that included benign, atypical, in situ and invasive lesions. Interventions involved self-directed learning, one skin and one breast, that showed pathologists how their interpretations compared to a reference diagnoses. Prior to the educational intervention, participants estimated how their interpretations would compare to the reference diagnoses. After the intervention, participants estimated their overall agreement with the reference diagnoses. Perceived and actual agreements were compared. Results: For pathologists interpreting skin, mean actual agreement was 52.4% and overall pre- and postinterventional mean perceived agreement was 72.9% vs 54.2%, an overestimated mean difference of 20.5% (95% confidence interval [CI] 17.2% to 24.0%) and 1.8% (95% CI −0.5% to 4.1%), respectively. For pathologists interpreting breast, mean actual agreement was 75.9% and overall pre- and postinterventional mean perceived agreement was 81.4% vs 76.9%, an overestimation of 5.5% (95% CI 3.0% to 8.0%) and 1.0% (95% CI 0.0% to 2.0%), respectively. Conclusions: Pathologists interpreting breast tissue had improved comprehension of their performance after the intervention compared to pathologists interpreting skin lesions.

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