{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T03:43:30Z","timestamp":1788493410223,"version":"build-2803163510"},"reference-count":21,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T00:00:00Z","timestamp":1766707200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T00:00:00Z","timestamp":1766707200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000289","name":"Cancer Research UK","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000289","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Oral Diseases"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Histological grading of oral epithelial dysplasia (OED) is used for predicting malignant transformation risk. However, grading is associated with significant subjectivity and observer variability leading to inconsistency in prognosis prediction. Alternate histological feature\u2010specific models (\u2018six\u2010point\u2019 and \u2018two\u2010point\u2019) have been shown to have potentially better prognostic reliability than conventional grading. This study conducts a multicentre validation of these models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>102 OED cases (dating 2012\u20132017) were acquired from 4 independent centres (13 (13%) Sheffield; 40 (39%) Belfast; 30 (29%) Birmingham; 19 (19%) Piracicaba, Brazil) were independently scored using the \u2018six\u2010point\u2019 and \u2018two\u2010point\u2019 models. Feature prevalence, observer agreement and malignant transformation risk were evaluated and compared to conventional grading systems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The \u2018six\u2010point\u2019 system demonstrated superior predictive value (AUROC of 0.81) compared to the \u2018two\u2010point\u2019 system (AUROC\u2009=\u20090.73,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004), WHO grading (AUROC\u2009=\u20090.71,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03) and binary grading (AUROC\u2009=\u20090.68,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009). Transformation rate for the \u2018six\u2010point\u2019 model was 50% (95% CI 27%\u201378%) when all 6 features were present compared to 14% (95% CI 5%\u201332%) when 2\u20133 features were present.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study supports the superior performance of the \u2018six\u2010point\u2019 system for transformation prediction on a multicentric sample. Findings indicate that feature\u2010specific models may be more reliable than existing histological grading systems for prognosis prediction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/odi.70173","type":"journal-article","created":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T08:20:24Z","timestamp":1766737224000},"page":"1273-1282","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Independent Multicentre Validation of the \u2018Six\u2010Point\u2019 Model for Malignant Transformation Risk in Oral Epithelial Dysplasia"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7159-0368","authenticated-orcid":false,"given":"Hanya","family":"Mahmood","sequence":"first","affiliation":[{"name":"School of Clinical Dentistry, Faculty of Health University of Sheffield  Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike","family":"Bradburn","sequence":"additional","affiliation":[{"name":"Clinical Trials Research Unit, Sheffield Centre for Health and Related Research University of Sheffield  Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadim M.","family":"Islam","sequence":"additional","affiliation":[{"name":"Department of Oral &amp; Maxillofacial Diagnostic Sciences, College of Dentistry University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5951-8280","authenticated-orcid":false,"given":"Omar","family":"Kujan","sequence":"additional","affiliation":[{"name":"Oral Diagnostic and Surgical Sciences Division, UWA Dental School The University of Western Australia  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasir","family":"Rajpoot","sequence":"additional","affiliation":[{"name":"Department of Computer Science, Tissue Image Analytics Centre University of Warwick  Coventry UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2040-6617","authenticated-orcid":false,"given":"Alan Roger","family":"Santos\u2010Silva","sequence":"additional","affiliation":[{"name":"Oral Diagnosis Department, Piracicaba Dental School University of Campinas (UNICAMP)  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo Agustin","family":"Vargas","sequence":"additional","affiliation":[{"name":"Oral Diagnosis Department, Piracicaba Dental School University of Campinas (UNICAMP)  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"James","sequence":"additional","affiliation":[{"name":"Precision Medicine Centre, Patrick G. Johnston Centre for Cancer Research Queen's University Belfast  Belfast UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4664-6117","authenticated-orcid":false,"given":"Paul","family":"Nankivell","sequence":"additional","affiliation":[{"name":"Institute of Head and Neck Studies and Education, Department of Cancer and Genomic Sciences University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisham","family":"Mehanna","sequence":"additional","affiliation":[{"name":"Institute of Head and Neck Studies and Education, Department of Cancer and Genomic Sciences University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0378-9380","authenticated-orcid":false,"given":"Syed Ali","family":"Khurram","sequence":"additional","affiliation":[{"name":"School of Clinical Dentistry, Faculty of Health University of Sheffield  Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,26]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.014508"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.26330"},{"key":"e_1_2_12_4_1","volume-title":"WHO Classification of Head and Neck Tumors. 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J.","year":"2012"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41698-024-00624-8"},{"key":"e_1_2_12_16_1","unstructured":"Shephard A. J. H.Mahmood S. E. A.Raza et\u00a0al.2024.\u201cDevelopment and Validation of an Artificial Intelligence\u2010Based Pipeline for Predicting Oral Epithelial Dysplasia Malignant Transformation.\u201dmedRxiv 2024\u201011."},{"issue":"2","key":"e_1_2_12_17_1","first-page":"1","article-title":"A Novel AI\u2010Based Score for Assessing the Prognostic Value of Intra\u2010Epithelial Lymphocytes in Oral Epithelial Dysplasia","volume":"132","author":"Shephard A. 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