Dataset Information

Sarcoma: concordance between initial diagnosis and centralized expert review in a population-based study within three European regions.

ABSTRACT:

Background

Sarcomas represent a heterogeneous group of tumors. Accurate determination of histological diagnosis and prognostic factors is critical for the delineation of treatment strategies. The contribution of second opinion (SO) to improve diagnostic accuracy has been suggested for sarcoma but has never been established in population-based studies.

Methods

Histological data of patients diagnosed with sarcoma in Rhone-Alpes (France), Veneto (Italy) and Aquitaine (France) over a 2-year period were collected. Initial diagnoses were systematically compared with SO from regional and national experts.

Results

Of 2016 selected patients, 1463 (73%) matched the inclusion criteria and were analyzed. Full concordance between primary diagnosis and SO (the first pathologist and the expert reached identical conclusions) was observed in 824 (56%) cases, partial concordance (identical diagnosis of connective tumor but different grade or histological subtype) in 518 (35%) cases and complete discordance (benign versus malignant, different histological type or invalidation of the diagnosis of sarcoma) in 121 (8%) cases. The major discrepancies were related to histological grade (n = 274, 43%), histological type (n = 144, 24%), subtype (n = 18, 3%) and grade plus subtype or grade plus histological type (n = 178, 29%).

Conclusion

More than 40% of first histological diagnoses were modified at second reading, possibly resulting in different treatment decisions.

SUBMITTER: Ray-Coquard I

PROVIDER: S-EPMC3425368 | biostudies-literature | 2012 Sep

REPOSITORIES: biostudies-literature

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Publications

Sarcoma: concordance between initial diagnosis and centralized expert review in a population-based study within three European regions.

Ray-Coquard I I Montesco M C MC Coindre J M JM Dei Tos A P AP Lurkin A A Ranchère-Vince D D Vecchiato A A Decouvelaere A V AV Mathoulin-Pélissier S S Albert S S Cousin P P Cellier D D Toffolatti L L Rossi C R CR Blay J Y JY

Annals of oncology : official journal of the European Society for Medical Oncology 20120213 9

<h4>Background</h4>Sarcomas represent a heterogeneous group of tumors. Accurate determination of histological diagnosis and prognostic factors is critical for the delineation of treatment strategies. The contribution of second opinion (SO) to improve diagnostic accuracy has been suggested for sarcoma but has never been established in population-based studies.<h4>Methods</h4>Histological data of patients diagnosed with sarcoma in Rhone-Alpes (France), Veneto (Italy) and Aquitaine (France) over a ...[more]

PMID: 22331640

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Project description:BackgroundMany physiological aspects of the neonatal transition after birth are unobservable because relevant sensors do not yet exist, compromising clinicians' understanding of a neonate's physiological status. Given that a neonate's true physiological state is currently unavailable, we explored the feasibility of using clinicians' degree of concordance as an approximation of the true physiological state.MethodsTwo phases of structured interviews were conducted. In Phase 1 (N = 8) and Phase 2 (N = 12), we presented neonatal experts with eight graphical trajectories of real newborns' heart rate and oxygen saturation values in the first 10-15 min after birth. We elicited the participants' interpretations of potential underlying physiological conditions that could explain the vital sign patterns.ResultsThe global differential diagnosis data for each phase produced the same pattern of results: (1) four trajectories produced a substantial degree of concordance among clinicians (61-80%) and (2) four trajectories produced a strong degree of concordance among clinicians (81-100%).ConclusionsIt is possible to achieve a strong degree of concordance among neonatal experts' interpretations of newborn trajectories. Thus, using the degree of concordance as an approximation of the neonate's true physiological state in resuscitation after birth may be a promising direction to explore for cognitive aid design.ImpactDifferential diagnoses with a good degree of concordance among expert neonatal clinicians could potentially substitute in part for the direct measurement of key physiological and anatomical variables of the neonatal transition, which is currently unavailable. The concordance of clinicians' judgements or inferences with regards to the true physiological state of the newborn during resuscitation after birth has never been explored. The findings provide a crucial first step toward using consensus of neonatal experts' judgements in the design of a cognitive aid to support clinicians' management of the newborns who require resuscitation after birth.

Project description:Ice ages within Europe forced many species to retreat to refugia, of which three major biogeographic basic types can be distinguished: "Mediterranean", "Continental" and "Alpine / Arctic" species. However, this classification often fails to explain the complex phylogeography of European species with a wide range of latitudinal and altitudinal distribution. Hence, we tested for the possibility that all three mentioned faunal elements are represented within one species. Our data was obtained by scoring 1,307 Euphydryas aurinia individuals (46 European locations) for 17 allozyme loci, and sequencing a subset of 492 individuals (21 sites) for a 626 base pairs COI fragment. Genetic diversity indices, F statistics, hierarchical analyses of molecular variance, individual-based clustering, and networks were used to explore the phylogeographic patterns. The COI fragment represented 18 haplotypes showing a strong geographic structure. All but one allozyme loci analysed were polymorphic with a mean FST of 0.20, supporting a pronounced among population structure. Interpretation of both genetic marker systems, using several analytical tools, calls for the recognition of twelve genetic groups. These analyses consistently distinguished different groups in Iberia (2), Italy, Provence, Alps (3), Slovenia, Carpathian Basin, the lowlands of West and Central Europe as well as Estonia, often with considerable additional substructures. The genetic data strongly support the hypothesis that E. aurinia survived the last glaciation in Mediterranean, extra-Mediterranean and perialpine refugia. It is thus a rare example of a model organism that combines attributes of faunal elements from all three of these sources. The observed differences between allozymes and mtDNA most likely result from recent introgression of mtDNA into nuclear allozyme groups. Our results indicate discrepancies with the morphologically-based subspecies models, underlining the need to revise the current taxonomy.

Dataset Information

Sarcoma: concordance between initial diagnosis and centralized expert review in a population-based study within three European regions.

Background

Methods

Results

Conclusion

Publications

Sarcoma: concordance between initial diagnosis and centralized expert review in a population-based study within three European regions.

Similar Datasets

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