{
  "abstract": "Introduction Accurate grading of dysplasia in Barrett’s oesophagus is critical for guiding surveillance and therapeutic decisions. This study assessed diagnostic concordance between peripheral hospitals and tertiary-centre review for Barrett’s oesophagus biopsies referred for expert opinion.Methods All external Barrett’s oesophagus biopsy cases referred to Addenbrooke’s Hospital for pathology review between 2021-2023 were retrospectively analysed using the Beaker Epic database. Original diagnoses from referring hospitals were compared with final tertiary-centre diagnoses. Cases were categorised as concordant or discordant, with discordant cases further classified as diagnostic upgrades or downgrades following tertiary review.Results A total of 186 referral cases were reviewed over the three-year period. Overall diagnostic concordance was 55%. 45% of cases were revised following tertiary-centre review. Among revised cases, a total of 165 biopsies were reviewed. Of those, 44.7% were upgraded, and 55.3% were downgraded compared with the original referring diagnosis.Conclusions Overall diagnostic concordance between peripheral hospitals and tertiary-centre review was good at 55%. Diagnostic revisions reflected both cautious over-calling and under-calling of dysplasia, likely influenced by the absence of dedicated gastrointestinal subspecialisation in many district hospitals. Diagnostic downgrading may reduce unnecessary surveillance, intervention, patient anxiety, and associated healthcare costs. Conversely, diagnostic upgrades highlight the risk of false-negative diagnoses with potential adverse clinical consequences. High rates of diagnostic revision in referral cases highlight the importance of specialist Gastrointestinal pathology review as well as double-reporting to support accurate diagnosis and appropriate patient management.",
  "authors": [
    {
      "affiliations": [
        "Cambridge University Hospitals NHS Foundation Trust, Soham, United Kingdom"
      ],
      "name": "Oak Kar"
    },
    {
      "affiliations": [
        "Cambridge University Hospitals NHS Foundation Trust, Soham, United Kingdom"
      ],
      "name": "James Chan"
    },
    {
      "affiliations": [
        "Cambridge University Hospitals NHS Foundation Trust, Soham, United Kingdom"
      ],
      "name": "Maria O’Donovan"
    }
  ],
  "title": "P334 Tertiary centre review of dysplastic barrett’s histology from peripheral hospitals: diagnostic concordance rates",
  "uid": "49a701c0-d580-5e06-a91d-b614f48c4167"
}