Reliability of Mohs Slides Diagnoses Examined

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Slides scored as difficult to diagnose independent risk factor for interpersonal discordant diagnosis
Slides scored as difficult to diagnose independent risk factor for interpersonal discordant diagnosis

HealthDay News — There is considerable interpersonal and intrapersonal agreement on the presence of basal cell carcinoma (BCC) on Mohs slides, according to a study published online April 1 in the British Journal of Dermatology.

Charlotte Barbara van Lee, from the Erasmus University Medical Center Rotterdam in the Netherlands, and colleagues conducted a prospective study assessing the reliability of Mohs slides diagnosis on BCC presence, location on the slide, and BCC subtype. Slides were randomly selected, with difficult to diagnose slides oversampled. Six raters independently assessed 50 slides twice, with a two-month interval. A reference diagnosis was established for each slide by an expert panel.

The researchers observed considerable interpersonal and intrapersonal agreement on BCC presence (κ, 0.66 and 0.68, respectively). Moderate agreement was seen for BCC subtype (κ, 0.45 and 0.55, respectively). For the presence of BCC, slides that were difficult to diagnose were an independent risk factor for interpersonal discordant diagnosis (odds ratio, 3.54).

"Reliability of Mohs slides diagnosis was substantial on BCC presence and moderate on BCC subtype," the authors write. "For slides that are scored difficult to diagnose, a second opinion is recommended to prevent misinterpretation and thereby skin cancer recurrence."

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