Abstract：
OBJECTIVE: This study aimed to understand reasons for interobserver variability in the grading of oral epithelial dysplasia (OED) through a survey of pathologists to provide insight for improvements in the reliability and reproducibility of OED diagnoses.
METHODS: The study design included quantitative and qualitative methodology. A pre-validated 31-item questionnaire was distributed to general, head and neck, and oral and maxillofacial histopathology specialists worldwide.
RESULTS: A total of 132 pathologists participated and completed the questionnaire. Over two-thirds used the three-tier grading system for OED, while about a third used both binary and three-tier systems. Regular reporters of OED preferred the three-tier system and grading architectural features. Continuing education significantly aided recognition of architectural and cytological changes. Irregular epithelial stratification and drop-shaped rete ridges had the lowest prognostic value and recognition scores, while loss of epithelial cell cohesion had the highest. Most participants used clinical information and often sought a second opinion when grading OED.
CONCLUSIONS: Our study has found that frequency of OED reporting and attendance of CME/CPD can play an important role in grading OED. Variations in the prognostic value of individual histological features and the use of clinical information may further contribute to interobserver variability.
METHODS: The study design included quantitative and qualitative methodology. A pre-validated 31-item questionnaire was distributed to general, head and neck, and oral and maxillofacial histopathology specialists worldwide.
RESULTS: A total of 132 pathologists participated and completed the questionnaire. Over two-thirds used the three-tier grading system for OED, while about a third used both binary and three-tier systems. Regular reporters of OED preferred the three-tier system and grading architectural features. Continuing education significantly aided recognition of architectural and cytological changes. Irregular epithelial stratification and drop-shaped rete ridges had the lowest prognostic value and recognition scores, while loss of epithelial cell cohesion had the highest. Most participants used clinical information and often sought a second opinion when grading OED.
CONCLUSIONS: Our study has found that frequency of OED reporting and attendance of CME/CPD can play an important role in grading OED. Variations in the prognostic value of individual histological features and the use of clinical information may further contribute to interobserver variability.
摘要：
目的：本研究旨在通过对病理学家的调查了解口腔上皮异型增生（OED）分级中观察者间差异的原因，为改善OED诊断的可靠性和可重复性提供见解。
方法：研究设计包括定量和定性方法。一份预先验证的31项问卷分发给了一般，头部和颈部,以及世界各地的口腔和颌面部组织病理学专家。
结果：共有132名病理学家参与并完成了问卷。超过三分之二的人使用了OED的三层分级系统，而大约三分之一的人同时使用二进制和三层系统。OED的常规记者更喜欢三层系统和分级建筑功能。继续教育大大有助于认识到建筑和细胞学的变化。不规则的上皮分层和滴状网状脊具有最低的预后价值和识别评分。而上皮细胞凝聚力的损失最高。大多数参与者使用临床信息，并在对OED进行分级时经常寻求第二意见。
结论：我们的研究发现，OED报告的频率和CME/CPD的出席在OED分级中起重要作用。个体组织学特征的预后价值变化和临床信息的使用可能进一步导致观察者间的变异性。
方法：研究设计包括定量和定性方法。一份预先验证的31项问卷分发给了一般，头部和颈部,以及世界各地的口腔和颌面部组织病理学专家。
结果：共有132名病理学家参与并完成了问卷。超过三分之二的人使用了OED的三层分级系统，而大约三分之一的人同时使用二进制和三层系统。OED的常规记者更喜欢三层系统和分级建筑功能。继续教育大大有助于认识到建筑和细胞学的变化。不规则的上皮分层和滴状网状脊具有最低的预后价值和识别评分。而上皮细胞凝聚力的损失最高。大多数参与者使用临床信息，并在对OED进行分级时经常寻求第二意见。
结论：我们的研究发现，OED报告的频率和CME/CPD的出席在OED分级中起重要作用。个体组织学特征的预后价值变化和临床信息的使用可能进一步导致观察者间的变异性。
