Evaluation of dysplasia grading in colorectal adenomas according to current guidelines: a nationwide survey among pathologists in türkiye
Bibliographic record
Abstract
OBJECTIVE: Due to its effect on polypectomy surveillance, dysplasia grading is essential in colorectal adenomas. We aimed to investigate the terminologies used for high-grade dysplasia in routine practice if any, and to assess the practice patterns of dysplasia grading among Turkish pathologists with reference to current guidelines. MATERIAL AND METHODS: A survey including seven images of colorectal adenomas with low-grade and high-grade dysplasia was sent to pathologists in Türkiye. The images were selected from the Canadian National Polyp Guidelines. The pathologists were asked to grade the dysplasia as in their routine practice. RESULTS: A total of 324 pathologists (including 48 senior residents and 176 gastrointestinal pathologists) participated in the survey. Among staff pathologists, the rate of agreement of dysplasia according to the guidelines was as follows; for colorectal adenomas with low-grade dysplasia, Image 1 (with low-grade cytology)-97.1%, Image 2 (with focal cribriformity)-6.2%, Image 5 (with high-grade cytology)-26.8%, and Image 6 (with slightly high-grade cytology)-48.9%. For colorectal adenomas with high-grade dysplasia, the agreement ratio was > 91% (range 91.6-99.6%). However, intramucosal adenocarcinoma was the preferred terminology by 43.8%, 68.5%, and 50% of the participants, respectively. The results were similar for residents. CONCLUSION: Among pathologists in Türkiye, in contrast to current guidelines for colorectal adenomas, 1. Intramucosal adenocarcinoma is still a commonly used terminology, 2. High-grade cytological features are over-relied upon, 3. Small foci of architectural abnormality are overcalled. Therefore, strategies to increase the usage of established practice guidelines should be developed. A national polyp guideline seems to be necessary for an attempt to standardize the reporting of colorectal adenomas.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".