Patricia M Harnden

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Men with clinically localized prostate cancer are faced with a wide range of treatment options, and only Gleason grading is universally used as a histopathological prognostic factor for this disease. The significance of perineural invasion in diagnostic biopsies is controversial. Opinion about whether or not it should influence treatment decisions is(More)
Clinically localized prostate cancer is associated with a wide variation in biologic behavior, and men with the less aggressive form of the disease may never develop symptoms. There has been a rise in prostate cancer incidence in countries in which the blood test for prostatic-specific antigen (PSA) is common, and concerns have been expressed that this may(More)
The Gleason system for grading prostate cancer assigns a score on the basis of the most prevalent and second most prevalent grade. Several studies have investigated the clinical significance of a tertiary grade in radical prostatectomy samples. A systematic search of the published work identified seven studies that reported the prognostic value of a(More)
AIMS To evaluate the use of virtual images as an alternative to glass slides to expand the number of participants in the External Quality Assurance Scheme for prostatic biopsies. METHODS AND RESULTS Benign and neoplastic cases, previously circulated as glass slides, were selected to include cases that had demonstrated a high level of agreement (n = 10)(More)
CONTEXT The biologic potential of prostate cancer (pCA) is variable, and the ability to identify tumours that might cause morbidity and mortality is limited. OBJECTIVE This systematic review sought to establish whether measurement of tumour extent in biopsies provides additional prognostic information on the risk of disease progression. EVIDENCE(More)
OBJECTIVE To develop a Bayesian belief network (BBN) for Gleason grading of prostate adenocarcinoma. STUDY DESIGN A shallow network was developed for Gleason grading with open-tree topology, with a root node containing 5 subjective diagnostic alternatives and 8 first-level descendant nodes for diagnostic features. Features or diagnostic clues of the(More)
BACKGROUND A Urological Pathology External Quality Assurance (EQA) Scheme in the UK has reported observer variation in the diagnosis and grading of adenocarcinoma in prostatic biopsies using basic κ statistics, which rate all disagreements equally. AIM The aim of this study is to use customised weighting schemes to report κ statistics that reflect the(More)
BACKGROUND Kappa statistics are frequently used to analyse observer agreement for panels of experts and External Quality Assurance (EQA) schemes and generally treat all disagreements as total disagreement. However, the differences between ordered categories may not be of equal importance (eg, the difference between grades 1 vs 2 compared with 1 vs 3).(More)
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