Inter-observer reproducibility before and after web-based education in the Gleason grading of the prostate adenocarcinoma among the Iranian pathologists.

This study was aimed at determining intra and inter-observer concordance rates in the Gleason scoring of prostatic adenocarcinoma, before and after a web-based educational course. In this self-controlled study, 150 tissue samples of prostatic adenocarcinoma are re-examined to be scored according to the Gleason scoring system. Then all pathologists attend a free web-based course. Afterwards, the same 150 samples [with different codes compared to the previous ones] are distributed differently among the pathologists to be assigned Gleason scores. After gathering the data, the concordance rate in the first and second reports of pathologists is determined. In the pre web-education, the mean kappa value of Interobserver agreement was 0.25 [fair agreement]. Post web-education significantly improved with the mean kappa value of 0.52 [moderate agreement]. Using weighted kappa values, significant improvement was observed in inter-observer agreement in higher scores of Gleason grade; Score 10 was achieved for the mean kappa value in post web-education was 0.68 [substantial agreement] compared to 0.25 (fair agreement) in pre web-education. Web-based training courses are attractive to pathologists as they do not need to spend much time and money. Therefore, such training courses are strongly recommended for significant pathological issues including the grading of the prostate adenocarcinoma. Through web-based education, pathologists can exchange views and contribute to the rise in the level of reproducibility. Such programs need to be included in post-graduation programs.

Inter/intra-observer reproducibility of Gleason scoring in prostate adenocarcinoma in Iranian pathologists.

PURPOSE: To measure the level of inter/intra-observer reproducibility among pathologists as far as Gleason scoring of adenocarcinoma of the prostate is concerned. MATERIALS AND METHODS: A total of 101 prostate biopsy slides, diagnosed with adenocarcinoma of the prostate by five pathologists from different education centers, were exposed to Gleason scoring. Two months later, the slides were re-examined by three of the same pathologists. Thereafter, the kappa was calculated for the data provided in the first and second reports of each pathologist and compared between pathologists. RESULTS: Inter-observer reproducibility was inappropriate, but intra-observer diagnostic reproducibility was almost perfect with a corresponding percentage of agreement of 85.2%. CONCLUSION: The inter-observer reproducibility was poor.