Interobserver variability in histologic evaluation of liver fibrosis using categorical and quantitative scores

Objectives: The aim of the study was to investigate the interobserver agreement for categorical and quantitative scores of liver fibrosis. Methods: Sixty-five consecutive biopsy specimens from patients with mixed liver disease etiologies were assessed by three pathologists using the Ishak and nonalc...

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Main Authors: Pavlides, M, Birks, J, Fryer, E, Delaney, D, Sarania, N, Banerjee, R, Neubauer, S, Barnes, E, Fleming, K, Wang, L
Format: Journal article
Language:English
Published: Oxford University Press 2017
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author Pavlides, M
Birks, J
Fryer, E
Delaney, D
Sarania, N
Banerjee, R
Neubauer, S
Barnes, E
Fleming, K
Wang, L
author_facet Pavlides, M
Birks, J
Fryer, E
Delaney, D
Sarania, N
Banerjee, R
Neubauer, S
Barnes, E
Fleming, K
Wang, L
author_sort Pavlides, M
collection OXFORD
description Objectives: The aim of the study was to investigate the interobserver agreement for categorical and quantitative scores of liver fibrosis. Methods: Sixty-five consecutive biopsy specimens from patients with mixed liver disease etiologies were assessed by three pathologists using the Ishak and nonalcoholic steatohepatitis Clinical Research Network (NASH CRN) scoring systems, and the fibrosis area (collagen proportionate area [CPA]) was estimated by visual inspection (visual-CPA). A subset of 20 biopsy specimens was analyzed using digital imaging analysis (DIA) for the measurement of CPA (DIA-CPA). Results: The bivariate weighted κ between any two pathologists ranged from 0.57 to 0.67 for Ishak staging and from 0.47 to 0.57 for the NASH CRN staging. Bland-Altman analysis showed poor agreement between all possible pathologist pairings for visual-CPA but good agreement between all pathologist pairings for DIA-CPA. There was good agreement between the two pathologists who assessed biopsy specimens by visual-CPA and DIA-CPA. The intraclass correlation coefficient, which is equivalent to the κ statistic for continuous variables, was 0.78 for visual-CPA and 0.97 for DIA-CPA. Conclusions: These results suggest that DIA-CPA is the most robust method for assessing liver fibrosis followed by visual-CPA. Categorical scores perform less well than both the quantitative CPA scores assessed here.
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spelling oxford-uuid:7385d230-5761-4ad6-a7a7-4952fd962c412022-03-26T19:56:57ZInterobserver variability in histologic evaluation of liver fibrosis using categorical and quantitative scoresJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:7385d230-5761-4ad6-a7a7-4952fd962c41EnglishSymplectic Elements at OxfordOxford University Press2017Pavlides, MBirks, JFryer, EDelaney, DSarania, NBanerjee, RNeubauer, SBarnes, EFleming, KWang, LObjectives: The aim of the study was to investigate the interobserver agreement for categorical and quantitative scores of liver fibrosis. Methods: Sixty-five consecutive biopsy specimens from patients with mixed liver disease etiologies were assessed by three pathologists using the Ishak and nonalcoholic steatohepatitis Clinical Research Network (NASH CRN) scoring systems, and the fibrosis area (collagen proportionate area [CPA]) was estimated by visual inspection (visual-CPA). A subset of 20 biopsy specimens was analyzed using digital imaging analysis (DIA) for the measurement of CPA (DIA-CPA). Results: The bivariate weighted κ between any two pathologists ranged from 0.57 to 0.67 for Ishak staging and from 0.47 to 0.57 for the NASH CRN staging. Bland-Altman analysis showed poor agreement between all possible pathologist pairings for visual-CPA but good agreement between all pathologist pairings for DIA-CPA. There was good agreement between the two pathologists who assessed biopsy specimens by visual-CPA and DIA-CPA. The intraclass correlation coefficient, which is equivalent to the κ statistic for continuous variables, was 0.78 for visual-CPA and 0.97 for DIA-CPA. Conclusions: These results suggest that DIA-CPA is the most robust method for assessing liver fibrosis followed by visual-CPA. Categorical scores perform less well than both the quantitative CPA scores assessed here.
spellingShingle Pavlides, M
Birks, J
Fryer, E
Delaney, D
Sarania, N
Banerjee, R
Neubauer, S
Barnes, E
Fleming, K
Wang, L
Interobserver variability in histologic evaluation of liver fibrosis using categorical and quantitative scores
title Interobserver variability in histologic evaluation of liver fibrosis using categorical and quantitative scores
title_full Interobserver variability in histologic evaluation of liver fibrosis using categorical and quantitative scores
title_fullStr Interobserver variability in histologic evaluation of liver fibrosis using categorical and quantitative scores
title_full_unstemmed Interobserver variability in histologic evaluation of liver fibrosis using categorical and quantitative scores
title_short Interobserver variability in histologic evaluation of liver fibrosis using categorical and quantitative scores
title_sort interobserver variability in histologic evaluation of liver fibrosis using categorical and quantitative scores
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