This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Dermatologic Disorders  • Neoplasms  • Diagnosis  • Alert me on articles by topic  Social Bookmarking   What's this?

An Internet-Based Study of the Reproducibility of Terminology

Giovanni Pellacani, MD; Marco Vinceti, MD; Sara Bassoli, MD; Ralph Braun, MD; Salvador Gonzalez, MD; Pascale Guitera, MD; Caterina Longo, MD; Ashfaq A. Marghoob, MD; Scott W. Menzies, MD; Susana Puig, MD; Alon Scope, MD; Stefania Seidenari, MD; Josep Malvehy, MD

Arch Dermatol. 2009;145(10):1137-1143.

Objective  To test the interobserver and intraobserver reproducibility of the standard terminology for description and diagnosis of melanocytic lesions in in vivo confocal microscopy.

Design  A dedicated Web platform was developed to train the participants and to allow independent distant evaluations of confocal images via the Internet.

Setting  Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.

Participants  The study population was composed of 15 melanomas, 30 nevi, and 5 Spitz/Reed nevi. Six expert centers were invited to participate at the study.

Intervention  Evaluation of 36 features in 345 confocal microscopic images from melanocytic lesions.

Main Outcome Measure  Interobserved and intraobserved agreement, by calculating the Cohen statistics measure for each descriptor.

Results  High overall levels of reproducibility were shown for most of the evaluated features. In both the training and test sets there was a parallel trend of decreasing values as deeper anatomic skin levels were evaluated. All of the features, except 1, used for melanoma diagnosis, including roundish pagetoid cells, nonedged papillae, atypical cells in basal layer, cerebriform clusters, and nucleated cells infiltrating dermal papillae, showed high overall levels of reproducibility. However, less-than-ideal reproducibility was obtained for some descriptors, such as grainy appearance of the epidermis, junctional thickening, mild atypia in basal layer, plump bright cells, small bright cells, and reticulated fibers in the dermis.

Conclusion  The standard consensus confocal terminology useful for the evaluation of melanocytic lesions was reproducibly recognized by independent observers.

Author Affiliations: Departments of Dermatology (Drs Pellacani, Bassoli, Longo, and Seidenari) and Hygiene and Public Health (Dr Vinceti), University of Modena and Reggio Emilia, Modena, Italy; Department of Dermatology, University of Zurich, Zurich, Switzerland (Dr Braun); Dermatology Service, Ramon y Cajal Hospital, Alcala University, Madrid, Spain (Dr Gonzales); Department of Dermatology, Memorial Sloan Kettering Cancer Center, New York, New York (Drs Gonzales, Marghoob, and Scope); Sydney Melanoma Diagnostic Centre, Sydney Cancer Centre and Department of Dermatology, Royal Prince Alfred Hospital, Faculty of Medicine, University of Sydney, Sydney, Australia (Drs Guitera and Menzies); Department of Dermatology, Melanoma Unit, Hospital Clínic, Institute de Investigacions Biomèdiques August Pi-Sunyer, Barcelona, Spain (Drs Puig and Malvehy); and Centro de Investigacion Biomedica en Red Enfermedades Raras, Barcelona (Drs Puig and Malvehy).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?