背景:2020年,由13名肾脏病理学家组成的工作组发表了关于光学显微镜(LM)上发现的47个肾小球病变和电子显微镜(EM)上发现的47个肾小球病变和9个正常结构的共识定义。
方法:为了测试这些定义对识别这些病变和结构的影响,向肾脏病理学会(RPS)的所有成员分发了2项调查,每个有32个图像(19个LM,13EM)和附带的问题,有5个多项选择答案,一个是工作组的共识选择。第一次调查(调查1[S1]),由297名RPS成员回答,于2020年9月发送,在共识定义公布之前。第二个(调查2[S2]),具有相同病变和结构的图像(但不是相同的图像)以及相同的问题和不同顺序的多种选择,于2020年4月发送,也就是定义发布5个月后。
结果:181名RPS成员服用了S2;64%的人也服用了S1,61%的人报告阅读了定义文件(def。paper).在两次调查之间,与共识答案的平均一致性略有增加(65.2%与72.0%,P=0.097);当只有S2的受访者阅读DEF时,增加更大,并且显着。考虑了纸张(65.2%与74.8%,P=0.026)。此外,在S2中,阅读本文的受访者与没有阅读本文的受访者的共识答案更高(66.9%与74.8%,P<0.0001)。
结论:发表共识定义适度改善了观察者在肾小球病变识别中的共识。
BACKGROUND: In 2020, a working group of 13 renal pathologists published
consensus definitions for 47 individual glomerular lesions found on light microscopy (LM) and 47 glomerular lesions and 9 normal structures found on electron microscopy (EM).
METHODS: To test the impact of these definitions on identification of these lesions and structures, 2 surveys were circulated to all members of the Renal Pathology Society (RPS), each having 32 images (19 LM, 13 EM) and accompanying questions with 5 multiple-choice answers, one being the consensus choice of the working group. The first survey (survey 1 [S1]), answered by 297 RPS members, was sent in September 2020, before publication of the
consensus definitions. The second (survey 2 [S2]), with images of the same lesions and structures (but not the same images) and the same questions and multiple choices in different order, was sent in April 2020, 5 months after the publication of the definitions.
RESULTS: S2 was taken by 181 RPS members; 64% also took S1 and 61% reported having read the definitions paper (def. paper). Mean agreement with the
consensus answers increased modestly between the 2 surveys (65.2% vs. 72.0%, P = 0.097); the increase was greater and significant when only respondents to S2 who read the def. paper were considered (65.2% vs. 74.8%, P = 0.026). Furthermore, in S2 agreement with
consensus answers was greater among respondents who read this paper versus those who did not (66.9% vs. 74.8%, P < 0.0001).
CONCLUSIONS: Publication of the
consensus definitions modestly improved interobserver agreement in identification of glomerular lesions.