{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T04:49:20Z","timestamp":1773809360868,"version":"3.50.1"},"reference-count":45,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Gut"],"accepted":{"date-parts":[[2019,8,18]]},"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Guidelines mandate expert pathology review of Barrett\u2019s oesophagus (BO) biopsies that reveal dysplasia, but there are no evidence-based standards to corroborate expert reviewer status. We investigated BO concordance rates and pathologist features predictive of diagnostic discordance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Pathologists (n=51) from over 20 countries assessed 55 digitised BO biopsies from across the diagnostic spectrum, before and after viewing matched p53 labelling. Extensive demographic and clinical experience data were obtained via online questionnaire. Reference diagnoses were obtained from a review panel (n=4) of experienced Barrett\u2019s pathologists.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We recorded over 6000 case diagnoses with matched demographic data. Of 2805\u2009H&amp;E diagnoses, we found excellent concordance (&gt;70%) for non-dysplastic BO and high-grade dysplasia, and intermediate concordance for low-grade dysplasia (42%) and indefinite for dysplasia (23%). Major diagnostic errors were found in 248 diagnoses (8.8%), which reduced to 232 (8.3%) after viewing p53 labelled slides. Demographic variables correlating with diagnostic proficiency were analysed in multivariate analysis, which revealed that at least 5 years of professional experience was protective against major diagnostic error for H&amp;E slide review (OR 0.48, 95%\u2009CI 0.31 to 0.74). Working in a non-teaching hospital was associated with increased odds of major diagnostic error (OR 1.76, 95%\u2009CI 1.15 to 2.69); however, this was neutralised when pathologists viewed p53 labelled slides. Notably, neither case volume nor self-identifying as an expert predicted diagnostic proficiency. Extrapolating our data to real-world case prevalence suggests that 92.3% of major diagnostic errors are due to overinterpreting non-dysplastic BO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our data provide evidence-based criteria for diagnostic proficiency in Barrett\u2019s histopathology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/gutjnl-2019-318985","type":"journal-article","created":{"date-parts":[[2019,12,18]],"date-time":"2019-12-18T17:19:22Z","timestamp":1576689562000},"page":"811-822","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":54,"title":["Histopathologist features predictive of diagnostic concordance at expert level among a large international sample of pathologists diagnosing Barrett\u2019s dysplasia using digital pathology"],"prefix":"10.1136","volume":"69","author":[{"given":"Myrtle J","family":"van der Wel","sequence":"first","affiliation":[{"name":"Pathology, Amsterdam University Medical Center, Amsterdam, The Netherlands"}]},{"given":"Helen G","family":"Coleman","sequence":"additional","affiliation":[{"name":"Centre for Public Health, Queens University Belfast, Belfast, UK"}]},{"given":"Jacques J G H M","family":"Bergman","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Academic Medical Center, Amsterdam, The Netherlands"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0645-564X","authenticated-orcid":false,"given":"Marnix","family":"Jansen","sequence":"additional","affiliation":[{"name":"Pathology, UCL Cancer Institute, London, UK"}]},{"given":"Sybren L","family":"Meijer","sequence":"additional","affiliation":[{"name":"Pathology, Amsterdam University Medical Center, Amsterdam, The 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