Interobserver Agreement In Grading Research Articles

Gastric foveolar dysplasia: a survey of reporting habits and diagnostic criteria

This study aimed to ascertain views, incidence of reporting and diagnostic criteria for gastric foveolar dysplasia. A questionnaire, a post-questionnaire discussion and microscopic assessment of selected cases was conducted by gastrointestinal pathologists to explore the above-stated aims. Fifty-four percent of respondents never or rarely diagnosed gastric foveolar-type dysplasia. The general consensus was that round nuclei, lack of nuclear stratification, presence of inflammation/damage and surface maturation favoured reactive change; while architectural abnormalities/complexity and nuclear enlargement mainly were used to separate low-grade from high-grade foveolar dysplasia. Immunohistochemistry was rarely used to make the diagnosis of dysplasia and was thought not to be of help in routine practice. Inter-observer agreement in grading of dysplasia versus reactive, and the type of dysplasia (foveolar versus adenomatous), was substantial/almost perfect amongst 35.7% and 21.4% of participants, respectively. This reflects low reproducibility in making these diagnoses. In conclusion, foveolar dysplasia was a rarely made diagnosis among 14 gastrointestinal pathologists, there are no uniform criteria for diagnosis and there is poor inter-observer agreement in separating low-grade foveolar dysplasia from reactive gastric mucosa and low-grade adenomatous dysplasia. Greater awareness and agreed criteria will prevent misdiagnosis of low-grade foveolar dysplasia as reactive, and vice versa.

The clinical correlation of a new practical MRI method for grading cervical neural foraminal stenosis based on oblique sagittal images.

The purpose of this study was to determine whether each grade in a new system suggested by Park et al. (Park system) to assess cervical neural foraminal stenosis validly correlates with the associated clinical findings and to evaluate the interobserver agreement in grading between two MRI readers. We evaluated 166 patients (98 men and 68 women; mean age, 46 years) at our institution who underwent oblique sagittal MRI of the cervical spine. Using the new Park grading system, two radiologists evaluated the MRI findings for the presence and grade of cervical neural foraminal stenosis at the most narrow point. A neurosurgeon assessed the associated clinical manifestations. A positive neurologic manifestation of the cervical neural foraminal stenosis was defined as more than one positive neurologic clinical manifestation combined with more than one positive neurologic sign. Interobserver agreements between the two radiologists were analyzed using kappa statistics. Correlation coefficients (R) to assess the relationship between the grade and neurologic manifestations were calculated with nonparametric correlation analysis (Spearman correlation). The relationship between the assigned grade and the clinical manifestations was analyzed several ways: vertebrae level (C4-5, C5-6, or C6-7) and by age group (< 46 years and ≥ 46 years). Among patients who were evaluated by each reader to be grade 0, only 19 (17%) and 20 patients (18%) showed positive neurologic manifestations, respectively, with most patients showing negative neurologic manifestations. Among the patients who were grade 2 and 3, one reader found all patients and the second reader found all but one patient (100% and 93%, respectively) to have positive neurologic manifestations. According to the correlation coefficients, each Park grade was moderately correlated with the associated neurologic manifestations, such that higher grades were associated with more severe clinical manifestations. If we consider grade 2 or 3 MRI findings positive for identifying positive neurologic manifestations, the sensitivities and specificities were 39.7% and 99.0% (reader 1) and 39.7% and 99.0% (reader 2), respectively. The Park system, based on oblique sagittal MRI sections, provides a reliable and reproducible assessment of the severity of cervical neural foraminal stenosis. According to the Park system, grades 2 and 3 are associated with positive neurologic manifestations, and the Park system successfully predicts positive neurologic manifestations at these grades.

Differentiation between grade 3 and grade 4 articular cartilage defects of the knee: Fat-suppressed proton density-weighted versus fat-suppressed three-dimensional gradient-echo MRI

Fat-suppressed (FS) proton density (PD)-weighted magnetic resonance imaging (MRI) and FS three-dimensional (3D) gradient-echo imaging such as spoiled gradient-recalled (SPGR) sequence have been established as accurate methods for detecting articular cartilage defects. To retrospectively compare the diagnostic efficacy between FS PD-weighted and FS 3D gradient-echo MRI for differentiating between grade 3 and grade 4 cartilage defects of the knee with arthroscopy as the standard of reference. Twenty-one patients who had grade 3 or 4 cartilage defects in medial femoral condyle at arthroscopy and knee MRI were included in this study: grade 3, >50% cartilage defects; grade 4, full thickness cartilage defects exposed to the bone. Sagittal FS PD-weighted MR images and FS 3D gradient-echo images with 1.5 T MR images were independently graded for the cartilage abnormalities of medial femoral condyle by two musculoskeletal radiologists. Statistical analysis was performed by Fisher's exact test. Inter-observer agreement in grading of cartilage was assessed using kappa coefficients. Arthroscopy revealed grade 3 defects in 17 patients and grade 4 defects in 4 patients in medial femoral condyles. For FS 3D gradient-echo images grade 3 defects were graded as grade 3 (n=15) and grade 4 (n=2), and all grade 4 defects (n=4) were correctly graded. However, for FS PD-weighted MR images all grade 3 defects were misinterpreted as grade 1 (n=1) and grade 4 (n=16), whereas all grade 4 defects (n=4) were correctly graded. FS 3D gradient-echo MRI could differentiate grade 3 from grade 4 defects (P=0.003), whereas FS PD-weighted imaging could not (P=1.0). Inter-observer agreement was substantial (kappa=0.70) for grading of cartilage using FS PD-weighted imaging, whereas it was moderate (kappa=0.46) using FS 3D gradient-echo imaging. FS 3D gradient-echo MRI is more helpful for differentiating between grade 3 and grade 4 cartilage defects than is FS PD-weighted imaging.

Interobserver agreement in grading of colorectal cancer – findings from a nationwide web‐based survey of histopathologists

Interobserver agreement in grading of colorectal cancer – findings from a nationwide web‐based survey of histopathologists

Interobserver agreement in grading of colorectal cancers – findings from a nationwide web‐based survey of histopathologists

HistopathologyVolume 53, Issue 4 p. 480-481 Interobserver agreement in grading of colorectal cancers – findings from a nationwide web-based survey of histopathologists I P Chandler, I P Chandler Department of Pathology, Royal Devon and Exeter Hospital, ExeterSearch for more papers by this authorR S Houlston, R S Houlston Cancer Genetics, Institute of Cancer Research, Sutton, UKSearch for more papers by this author I P Chandler, I P Chandler Department of Pathology, Royal Devon and Exeter Hospital, ExeterSearch for more papers by this authorR S Houlston, R S Houlston Cancer Genetics, Institute of Cancer Research, Sutton, UKSearch for more papers by this author First published: 24 September 2008 https://doi.org/10.1111/j.1365-2559.2008.03126.xCitations: 1Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume53, Issue4October 2008Pages 480-481 RelatedInformation

Interobserver agreement in grading of colorectal cancers—findings from a nationwide web‐based survey of histopathologists

Interobserver agreement in grading of colorectal cancers—findings from a nationwide web‐based survey of histopathologists

Interobserver agreement in grading of colorectal cancers—findings from a nationwide web‐based survey of histopathologists

Tumour grade represents a gestalt of all molecular changes in malignancy, reflecting aggressiveness and has been shown to add prognostic information independent of stage for many malignancies, including colorectal cancer. Despite the grade of colorectal cancer being reported routinely in the UK, there is paucity of data on the level of agreement between histopathologists and hence the value of this metric in clinical practice. The aim was to estimate the degree of inter-observer variation in grading by conducting a nationwide web-based survey of histopathologists. Individuals were asked to grade a series of 20 tumours. Data from 104 pathologists surveyed indicates that agreement using both two and three grade systems is at best fair. Given that for the foreseeable future the histopathological criteria of stage and grade will still provide the mainstay of prognostication and therefore clinical decision-making, efforts should be made to improve grading criteria and standardize use of the low- and high-grade categories.

Inter-observer variability in histopathological assessment of liver biopsies taken in a pediatric open label therapeutic program for chronic HBV infection treatment

To our knowledge, the inter-observer variability of the liver biopsy findings in HBV-infected children have not been studied as yet. Hence, we aimed to compare different pathologist's assessment of grading and staging in liver biopsies obtained from children prior to interferon treatment. We collected 920 biopsies from 11 medical centers. The biopsies were independently reviewed by 6 pathologists from academic centers who assessed Batts-Ludwig score for grading and staging. Satisfactory agreement among observers was defined as at least 60% of observers having the same opinion. Satisfactory dispersion between maximal and minimal score for the same biopsy specimen was defined as a maximum 1 point. Satisfactory inter-observer agreement for grading was obtained in 51.6% and for staging in 75.7% of biopsies. Satisfactory dispersion for grading scores was observed in 44.5% and for staging in 72.7% of cases. Our study demonstrates that: (1) pathologists differ in their assessment of grading and staging of liver biopsies; (2) inter-observer variability for staging is lower than that for grading; and (3) regardless of the inter-observer variability of assessments, the majority of children with chronic HBV infection have mild to moderate inflammation and mild to moderate fibrosis.

Interobserver Agreement in Grading of Open Fractures of the Tibia

Selected Abstracts Presented at the Ninth Annual Meeting of the Orthopaedic Trauma Association: PDF Only