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Observer error in the assessment of nodal disease in head and neck cancer

✍ Scribed by David J. Alderson; Terry M. Jones; Sarah J. White; Nicholas J. Roland

Publisher: John Wiley and Sons
Year: 2001
Tongue: English
Weight: 154 KB
Volume: 23
Category: Article
ISSN: 1043-3074
DOI: 10.1002/hed.1105

No coin nor oath required. For personal study only.

✦ Synopsis

Background:

There is no previously published information on clinicians' abilities to accurately differentiate between different stages of node positive disease in head and neck cancer.

Methods:

Forty-two surgeons examined standardized nodes in a model neck and estimated nodal size. each recorded their confidence in their ability to perform the task using a visual analogue scale. reference nodes of known size were provided for comparison during a second examination of each node. the study was repeated after 1 month.

Results:

Accuracy was poor and was not dependent on experience or confidence. there was a tendency to underestimate the size of smaller nodes. estimates were strongly influenced by volume independent of largest diameter (p <.001). reference nodes aided accuracy (p =.031). subjects were not consistent on repeated testing (p <.001).

Conclusions:

Both trainees and specialists are poor at accurately staging nodal disease using palpation alone.

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