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Can reference images improve interobserver agreement in reporting liver fibrosis?

Lookup NU author(s): Dr Dina Tiniakos Tiniakos


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© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. Staging of fibrosis in medical liver biopsies has inherent interobserver variability. There are a number of disease-specific scoring systems available. While recognising the importance of these scoring systems, there is scope to consider how concordance amongst histopathologists could be improved using a generic fibrosis staging system.Using virtual slides, we approached both specialist liver histopathologists and general histopathologists from the UK to assess the degree of fibrosis against a proposed four-tiered reporting system. Example reference images were then produced and distributed to the same responders who were asked to rate a second set of slides to assess if the use of reference images improved concordance between pathologists.The use of reference images eliminated spread across three categories (from 15% to 0%). Overall, agreement was already good; our study showed an improved agreement amongst all participants for percentage agreement (67.79% to 70.08%) and interobserver agreement improved (Fleiss' Kappa 0.55 to 0.59).

Publication metadata

Author(s): German AL, Fleming K, Kaye P, Davies S, Goldin R, Hubscher SG, Tiniakos D, McGregor A, Wyatt JI

Publication type: Article

Publication status: Published

Journal: Journal of Clinical Pathology

Year: 2018

Volume: 71

Issue: 4

Pages: 368-371

Print publication date: 01/04/2018

Online publication date: 10/11/2017

Acceptance date: 31/10/2017

ISSN (print): 0021-9746

ISSN (electronic): 1472-4146

Publisher: BMJ Group


DOI: 10.1136/jclinpath-2017-204760

PubMed id: 29127142


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