Derek Coleman

Publications (4)7.01 Total impact

• Article: Evaluation of the use of digital images for a national prostate core external quality assurance scheme.

  Patricia Harnden, Derek Coleman, Sue Moss, Sandhya Kodikara, Nick R Griffin, Jane Melia
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  ABSTRACT: 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. Benign and neoplastic cases, previously circulated as glass slides, were selected to include cases that had demonstrated a high level of agreement (n = 10) and a lesser degree of agreement (n = 10). Whole slide virtual images were circulated to 68 pathologists; 51 responses were returned. The levels of agreement for the primary diagnosis and for Gleason grading of cancers were analysed using kappa statistics. Responses for glass slides versus images were compared for the 24 pathologists for whom data were available. Levels of agreement for diagnostic categories using virtual slides were moderate to substantial, comparable to those found using glass slides. The level of agreement for Gleason grades 8-10 was substantial, but for lower grades was fair or moderate, poorer than for the glass slide circulation. Circulation of virtual images of biopsy material is a suitable alternative to glass slide-based schemes for the evaluation of diagnostic consistency. The majority of participants agreed that the ability to evaluate limited diagnostic material outweighed the disadvantages of a virtual system.
  Histopathology 10/2011; 59(4):703-9. · 3.08 Impact Factor
• Article: Measuring interobserver variation in a pathology EQA scheme using weighted κ for multiple readers.

  Karen C Wright, Jane Melia, Sue Moss, Dan M Berney, Derek Coleman, Patricia Harnden
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  ABSTRACT: 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. The aim of this study is to use customised weighting schemes to report κ statistics that reflect the closeness of interobserver agreement in the prostate EQA scheme. A total of 83, 114 and 116 pathologists took part, respectively, in three web-based circulations and were classified as either expert or other readers. For analyses of diagnosis, there were 10, 8 and 8 cases in the three circulations, respectively. For analyses of Gleason Sum Score, only invasive cases were included, leaving 5, 5 and 6 cases, respectively. Analyses were conducted using customised weighting schemes with 'pairwise-weighted' κ for multiple readers. Analysis of diagnosis for all circulations and all readers gave a composite κ value of 0.86 and pairwise-weighted κ (κ(p-w)) value of 0.91, both regarded as 'almost perfect' agreement. This was due to the high proportion of responses that showed partial agreement. Analysis of Gleason Sum Score gave κ=0.38 and κ(p-w)=0.58 over all circulations and all readers, indicating that discrepancies occur at the boundary between adjacent grades and may not be as clinically significant as suggested by composite κ. Weighted κ show higher levels of agreement than previously reported as they have the advantage of applying weighting, which reflects the relative importance of different types of discordance in diagnosis or grading. Agreement on grading remained low.
  Journal of clinical pathology 08/2011; 64(12):1128-31. · 2.43 Impact Factor
• Article: Effects of a prostate awareness pilot on GP consultations and PSA requests.

  Jane Melia, Penny Coulson, Sue Moss, Derek Coleman
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  ABSTRACT: A Department of Health prostate awareness initiative, piloted in Coventry in 2006, promoted reporting of symptoms of benign prostatic hyperplasia, prostatitis and prostate cancer to GPs without causing sudden increases in workload. Qualitative evaluation showed a wide distribution of materials. Evaluation of effects of the pilot on rates of GP urological consultations, prescriptions and prostate-specific antigen (PSA) requests in general practice in Coventry and three control areas. Data on GP consultations provided by the General Practice Research Database for three to five practices per area covered the periods 1 October 2005 to 31 March 2006 and 1 October 2006 to 31 March 2007. Pathology laboratory data on PSA requests covered 18 months from 1 December 2005 in consenting practices: 44/55 (80%) in Coventry and 102/159 (64%) in control areas. The rates of GP consultations for urological symptoms and of prescriptions issued for urological conditions per 100 person-years in men with no prior diagnosis of benign or malignant prostate disease and rates of PSA tests per 100 men were analysed. There was no significant change in consultation rates for urological symptoms over time in Coventry. The rate of prescriptions and of PSA testing increased in Coventry before the pilot began (P < 0.001) but there was no sudden increase after the pilot launch with similar trends in the control areas. There was no increase in GP workload following the start of the pilot. Routine data can be used in evaluation but should be linked to surveys of awareness, health-seeking behaviour and delivery of campaign materials.
  Family Practice 11/2009; 27(1):69-76. · 1.50 Impact Factor
• Source

  Available from: cancerscreening.nhs.uk

  Article: Evaluation of the effects of the DH prostate awareness pilot on consultation rates in primary and secondary care, and PSA testing

  Jane Melia, Penny Coulson, Sue Moss, Derek Coleman