Impact of the adjunction of a short video to an original article for the recognition of newly described tumor entities in pathology: An interventional prospective study

Abstract

Context

Merkel cell carcinoma diagnosis is often based on microscopic examination by pathologists. While histopathologic diagnosis primarily hinges on conscious and analytical cognition, the pathologist's decision-making process is also influenced by a rapid “gist” or “gestalt” approach. In this study, using cases of Merkel cell carcinoma as a model, we aim to assess how pathologists' viewing short videos containing conceptual clues and visual aids, in conjunction with reading an original article as a reference, may enhance their diagnostic performance.

Method

Sixteen pathologists were included in the present work. After participants had read the original article, their ability to distinguish Merkel cell polyomavirus (MCPyV)+ and MCPyV− Merkel cell carcinoma cases was evaluated on a first preliminary series of 20 cases. Following this test, the participants watched the video and then evaluated a second “experimental” series of 20 independent cases.

Results

After reading the original article, for each case, a median number of 12 participants (75%, Q1–Q3: 10–13) classified the specimen in the correct category (92 incorrect answers in the whole series). An important interobserver variability was observed in this setting (Kappa coefficient = 0.465). By contrast, following the video, all cases were correctly classified by most of the participants, with only 12 incorrect answers on the whole series and excellent interobserver reproducibility (Kappa coefficient = 0.846).

Conclusion

Our study demonstrated that providing a short video together with an original article may enhance pathologists' performance in diagnosing Merkel cell carcinoma.