Interobserver agreement and consensus over the esthetic evaluation of conservative treatment for breast cancer |
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| Authors: | Cardoso Maria João Cardoso Jaime Santos Ana Cristina Barros Henrique Cardoso de Oliveira Manuel |
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| Affiliation: | 1. Serviço de Cirurgia B, H.S. João, Faculdade de Medicina do Porto, Alameda do Prof. Hernâni Monteiro, 4200-319 Porto, Portugal;2. Unidade de Telecomunicações e Multimédia, INESC, Porto, Portugal;3. Serviço de Higiene e Epidemiologia, Faculdade de Medicina do Porto, Porto, Portugal;1. Ghent University Hospital, Department of Radiation Oncology and Experimental Cancer Research, Belgium;2. Ghent University, Biostatistics Unit, Department of Public Health, Faculty of Medicine and Health Sciences, Belgium;3. Ghent University Hospital, Department of Radiology, Belgium;4. Ghent University Hospital, Department of Urology, Belgium;1. Department of Plastic Surgery, The University of Texas Southwestern Medical Center, 6901 Snider Plaza, Suite 120, University Park, TX 75205, USA;2. Plastic Surgery, Weill Cornell Medical College, New York, NY, USA;3. Plastic Surgery, New York Presbyterian Hospital, 156 William Street, 12th Floor, New York, NY 10038, USA;1. Centre for Surgical Research, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom;2. Breast Care Centre, North Bristol NHS Trust, Southmead Hospital, Southmead Road, Bristol BS10 5NB, United Kingdom;3. Department of Plastic Surgery, North Bristol NHS Trust, Bristol, United Kingdom;1. Department of Plastic, Reconstructive and Hand Surgery, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands;2. Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands;3. Department for Health Evidence, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands;4. Technical Medicine, University of Twente, Enschede, The Netherlands;1. Center for Aesthetic Surgery, 2500 Route 347, Building 22A, Stony Brook, NY 11790, USA;2. Scheflan Plastic Surgery, 10 Habarzel Street, Tel Aviv 69710, Israel |
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| Abstract: | ![]()
Twenty-four experts from 13 different countries were asked to evaluate photographs taken of 60 women following conservative breast cancer treatment. The esthetic result of each case was classified as poor, fair, good or excellent. Agreement was evaluated using the kappa (k) and weighted kappa (wk) statistics, for all observers, male and female participants, those younger and older than 50 years, those seeing more than 250 cases a year, and those with previous publications in this area. Consensus was obtained by way of a modified Delphi approach, when more than 50% of participants provided the same classification. In a second round, consensual cases were disclosed and a revised opinion was asked in non-consensual ones. Agreement between all participants was fair (k=0.24, wk=0.37) and remained within the same range (k=0.20-0.31, wk=0.31-0.45) in the subgroups analyzed. First round consensus was obtained in 46 out of 60 cases (77%) and in the second round in 59 out of 60 cases (98%). Evaluation of the esthetic results of conservative treatment for breast cancer is only fairly reproducible when performed by experts working in different geographical areas. Consensus is obtainable if a relatively low threshold of agreement is considered acceptable. |
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