Pitfalls in assessing stromal tumor infiltrating lymphocytes (sTILs) in breast cancer

Stromal tumor-infiltrating lymphocytes (sTILs) are important prognostic and predictive biomarkers in triple-negative (TNBC) and HER2-positive breast cancer. Incorporating sTILs into clinical practice necessitates reproducible assessment. Previously developed standardized scoring guidelines have been widely embraced by the clinical and research communities. We evaluated sources of variability in sTIL assessment by pathologists in three previous sTIL ring studies. We identify common challenges and evaluate impact of discrepancies on outcome estimates in early TNBC using a newly-developed prognostic tool. Discordant sTIL assessment is driven by heterogeneity in lymphocyte distribution. Additional factors include: technical slide-related issues; scoring outside the tumor boundary; tumors with minimal assessable stroma; including lymphocytes associated with other structures; and including other inflammatory cells. Small variations in sTIL assessment modestly alter risk estimation in early TNBC but have the potential to affect treatment selection if cutpoints are employed. Scoring and averaging multiple areas, as well as use of reference images, improve consistency of sTIL evaluation. Moreover, to assist in avoiding the pitfalls identified in this analysis, we developed an educational resource available at www.tilsinbreastcancer.org/pitfalls.Stromal tumor-infiltrating lymphocytes (sTILs) are important prognostic and predictive biomarkers in triple-negative (TNBC) and HER2-positive breast cancer. Incorporating sTILs into clinical practice necessitates reproducible assessment. Previously developed standardized scoring guidelines have been widely embraced by the clinical and research communities. We evaluated sources of variability in sTIL assessment by pathologists in three previous sTIL ring studies. We identify common challenges and evaluate impact of discrepancies on outcome estimates in early TNBC using a newly-developed prognostic tool. Discordant sTIL assessment is driven by heterogeneity in lymphocyte distribution. Additional factors include: technical slide-related issues; scoring outside the tumor boundary; tumors with minimal assessable stroma; including lymphocytes associated with other structures; and including other inflammatory cells. Small variations in sTIL assessment modestly alter risk estimation in early TNBC but have the potential to affect treatment selection if cutpoints are employed. Scoring and averaging multiple areas, as well as use of reference images, improve consistency of sTIL evaluation. Moreover, to assist in avoiding the pitfalls identified in this analysis, we developed an educational resource available at www.tilsinbreastcancer.org/pitfalls.Peer reviewe

Towards better measures: evaluation of estimated resource description quality for distributed IR

An open problem for Distributed Information Retrieval systems (DIR) is how to represent large document repositories, also known as resources, both accurately and efficiently. Obtaining resource description estimates is an important phase in DIR, especially in non-cooperative environments. Measuring the quality of an estimated resource description is a contentious issue as current measures do not provide an adequate indication of quality. In this paper, we provide an overview of these currently applied measures of resource description quality, before proposing the Kullback-Leibler (KL) divergence as an alternative. Through experimentation we illustrate the shortcomings of these past measures, whilst providing evidence that KL is a more appropriate measure of quality. When applying KL to compare different QBS algorithms, our experiments provide strong evidence in favour of a previously unsupported hypothesis originally posited in the initial Query-Based Sampling work

Personnel/Human Resources Management: A Political Influence Perspective

It was suggested over ten years ago that new and different perspectives needed to be applied to the Personnel/Human Resources Management field in an effort to (P /HRM) promote theory and research and expand our understanding of the dynamics underlying P/HRM processes. Both theory and research are emerging which characterize important P/HRM decisions and activities substantially influenced by opportunistic behavior of both subordinates and supervisors. The purpose of the present review is to systematically examine the P/HRM field from a political influence perspective, reviewing existing theory and research and discussing future directions

Reactions to Skill Assessment: The Forgotten Factor in Explaining Motivation to Learn

This study examined the effects of trainees’ reactions to skill assessment on their motivation to learn. A model was developed that suggests that two dimensions of trainees’ assessment reactions – distributive justice and utility – influence training motivation and overall training effectiveness. The model was tested using a sample of individuals (N = 113) enrolled in a truck driving training program. Results revealed that trainees’ who perceived higher levels of distributive justice and utility had higher motivation to learn. Training motivation was found to significantly predict several measures of training effectiveness. Trainees’ performance on the pre-training assessment and trait goal orientation exhibited direct and interactive effects on their reactions to the skill assessment. Implications of these findings for future research on reactions to skill assessments are identified along with the practical implications for the design and conduct of training needs assessment

Measurement Error in Performance Studies of Health Information Technology: Lessons from the Management Literature

Just as researchers and clinicians struggle to pin down the benefits attendant to health information technology (IT), management scholars have long labored to identify the performance effects arising from new technologies and from other organizational innovations, namely the reorganization of work and the devolution of decision-making authority. This paper applies lessons from that literature to theorize the likely sources of measurement error that yield the weak statistical relationship between measures of health IT and various performance outcomes. In so doing, it complements the evaluation literature’s more conceptual examination of health IT’s limited performance impact. The paper focuses on seven issues, in particular, that likely bias downward the estimated performance effects of health IT. They are 1.) negative self-selection, 2.) omitted or unobserved variables, 3.) mis-measured contextual variables, 4.) mismeasured health IT variables, 5.) lack of attention to the specific stage of the adoption-to-use continuum being examined, 6.) too short of a time horizon, and 7.) inappropriate units-of-analysis. The authors offer ways to counter these challenges. Looking forward more broadly, they suggest that researchers take an organizationally-grounded approach that privileges internal validity over generalizability. This focus on statistical and empirical issues in health IT-performance studies should be complemented by a focus on theoretical issues, in particular, the ways that health IT creates value and apportions it to various stakeholders