Journal Article DKFZ-2025-00168

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Discordance, accuracy and reproducibility study of pathologists' diagnosis of melanoma and melanocytic tumors.

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2025
Springer Nature [London]

Nature Communications 16(1), 789 () [10.1038/s41467-025-56160-x]
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Abstract: Accurate melanoma diagnosis is crucial for patient outcomes and reliability of AI diagnostic tools. We assess interrater variability among eight expert pathologists reviewing histopathological images and clinical metadata of 792 melanoma-suspicious lesions prospectively collected at eight German hospitals. Moreover, we provide access to the largest panel-validated dataset featuring dermoscopic and histopathological images with metadata. Complete agreement is achieved in 53.5% of cases (424/792), and a majority vote ( ≥ five pathologists) in 90.9% (720/792). Considerable discordance is observed for non-invasive melanomas (complete agreement in only 10/73 cases). The expert panel disagrees with the local pathologists' and dermatologists' diagnoses in 14.9% and 33.5% of cases, respectively. This variability highlights the diagnostic challenges of early-stage melanomas and the need to reconsider how ground truth is established in routine care and AI research. Including at least two pathologists or virtual panels may contribute to more consistent diagnostic results.

Keyword(s): Humans (MeSH) ; Melanoma: diagnosis (MeSH) ; Melanoma: pathology (MeSH) ; Melanoma: diagnostic imaging (MeSH) ; Pathologists (MeSH) ; Reproducibility of Results (MeSH) ; Skin Neoplasms: pathology (MeSH) ; Skin Neoplasms: diagnosis (MeSH) ; Observer Variation (MeSH) ; Female (MeSH) ; Male (MeSH) ; Middle Aged (MeSH) ; Adult (MeSH) ; Dermoscopy: methods (MeSH) ; Germany (MeSH) ; Aged (MeSH) ; Prospective Studies (MeSH)

Classification:

Note: #EA:C140#LA:C140#

Contributing Institute(s):
  1. Digitale Prävention, Diagnostik und Therapiesteuerung (C140)
  2. KKE Dermatoonkologie (A370)
  3. C060 Biostatistik (C060)
Research Program(s):
  1. 313 - Krebsrisikofaktoren und Prävention (POF4-313) (POF4-313)

Appears in the scientific report 2025
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Medline ; Creative Commons Attribution CC BY (No Version) ; DOAJ ; Article Processing Charges ; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Agriculture, Biology and Environmental Sciences ; Current Contents - Life Sciences ; Current Contents - Physical, Chemical and Earth Sciences ; DOAJ Seal ; Essential Science Indicators ; Fees ; IF >= 15 ; JCR ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection ; Zoological Record
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 Record created 2025-01-20, last modified 2025-01-26



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