What is the Ask an Expert Feature and how do I use it?

We have asked 13 acclaimed experts in their respective fields to tell us which antibodies they would run to confirm a diagnosis. The result is our new Ask an Expert feature. These customized panels offer at least 500 distinct two diagnosis and three diagnosis queries. Users compare our meta-analysis with what a world- renowned expert suggests, and ultimately improve patient care with increased diagnostic effectiveness.

In general, different bodies of knowledge are consulted when determining what antibodies will be used in a diagnosis. The Ask an Expert feature provides the pathologist with the first and only source for simultaneous viewing of empirical and evidentiary support to supplement their antibody decisions. A sample expert panel is shown below. The numbered and colored boxes correspond to a similarly numbered and colored paragraph description of each column. Briefly, the appearance of a symbol in the “Expert” column (boxes 1 and 3) indicates that a particular antibody is preferred by an expert. Plus (+) and minus (-) signs signify the reactivity attributed by the expert to a particular antibody and diagnosis combination. A yellow “caution” sign (shown in box 3) indicates special staining information or caveats attributed to that antibody/diagnosis combination. Expert information is juxtaposed with data from the meta-analysis (shown in boxes 2 and 4) for comparative purposes.

NOTE: The numbers and colored boxes in the picture correspond to the following numbered descriptions of each column of data:

1. The “Expert” column indicates with a plus (+) or minus (-) the preferred antibodies Dr. Moran uses to distinguish Lung Nonsmall Cell Carcinoma from Colon Adenocarcinoma. The + sign means that Dr. Moran attributes to this antibody a percent positivity of 60% or more for this diagnosis. A – sign represents a positivity of 40% or less. An equivocal reactivity (between 40% and 60%) is indicated by a “+/-” sign. These reactivities are assigned empirically by Dr. Moran and his lifetime of experience and may differ slightly from what is reported in the meta-analysis (shown in column 2).

2. All of the meta-analysis data for Lung Nonsmall Cell Carcinoma are available here in the “Positive,” “Cases,” and “vs.2” columns. The green arrows in the “vs.2” column indicate that, according to the meta-analysis, any of the first 4 antibodies would be appropriate to use for distinguishing Lung Nonsmall Cell Carcinoma from Colon Adenocarcinoma. Compare with Dr. Moran’s antibody selections. For these two differentials, the expert opinion and meta-analysis strongly agree.

3. The “Expert” column indicates with a + or – the preferred antibodies Dr. Greenson uses to distinguish Colon Adenocarcinoma from Lung Nonsmall Cell Carcinoma. The opposing Expert symbols across the “expert” columns indicate good differentiating antibodies for Lung Nonsmall Cell Carcinoma and Colon Adenocarcinoma (for example, CDX-2 and CK 20).

4. All of the meta-analysis data for Colon Adenocarcinoma are available here in the “Positive,” “Cases,” and “vs.2” columns. Comparing the “hard” numbers of the meta-analysis with the symbols in the expert column, one can see that the expert opinion strongly agrees with the meta-analysis.

Elsevier