Assessing Agreement between Multiple Raters with Missing Rating Information, Applied to Breast Cancer Tumour Grading 英文参考文献.docVIP
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Assessing Agreement between Multiple Raters with Missing Rating Information, Applied to Breast Cancer Tumour Grading 英文参考文献
AssessingAgreementbetweenMultipleRaterswith
MissingRatingInformation,AppliedtoBreastCancer
TumourGrading
ThomasR.Fanshawe1.*,AndrewG.Lynch2.,IanO.Ellis3,AndrewR.Green4,RudolfHanka5
1DepartmentofMedicine,LancasterUniversity,Lancaster,UnitedKingdom,2DepartmentofOncology,LiKaShingCentre,UniversityofCambridge,CambridgeResearch
Institute, Cambridge, United Kingdom, 3University of Nottingham, Nottingham, United Kingdom, 4Division of Pathology, School of Molecular Medical Sciences,
UniversityofNottingham,Nottingham,UnitedKingdom,5WolfsonCollege,UniversityofCambridge,Cambridge,UnitedKingdom
Abstract
Background:Weconsidertheproblemofassessinginter-rateragreementwhentherearemissingdataandalargenumber
ofraters.Previousstudieshaveshownonly‘moderate’agreementbetweenpathologistsingradingbreastcancertumour
specimens.Weanalysealargebutincompletedata-setconsistingof24177grades,onadiscrete1–3scale,providedby732
pathologistsfor52samples.
Methodology/PrincipalFindings:Wereviewexistingmethods foranalysinginter-rateragreement formultipleratersand
demonstrate two further methods. Firstly, we examine a simple non-chance-corrected agreement score based on the
observed proportion of agreements with the consensus for each sample, which makes no allowance for missing data.
Secondly,treatinggradesaslyingonacontinuousscalerepresentingtumourseverity,weuseaBayesianlatenttraitmethodto
modelcumulativeprobabilitiesofassigninggradevaluesasfunctionsoftheseverityandclarityofthetumourandofrater-
specificparametersrepresentingboundariesbetweengrades1–2and2–3.Wesimulatefromthefittedmodeltoestimate,for
eachrater,theprobabilityofagreementwiththemajority.Bothmethodssuggestthattherearedifferencesbetweenratersin
terms of rating behaviour, most often caused by consistent over- or under-estimation of the grade boundaries, and also
considerablevariabilityinthedistributionofgradesassignedtomanyindividualsamples.TheBayesianmodeladdressesthe
tendencyoftheagreementscoretobebiasedupwardsforraterswho,bychance,seea
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