Grading of dysplasia in Barrett's oesophagus: Substantial interobserver variation between general and gastrointestinal pathologists

M. Kerkhof; H. Van Dekken; E. W. Steyerberg; G. A. Meijer; A. H. Mulder; A. De Bruïne; A. Driessen; F. J. Ten Kate; J. G. Kusters; E. J. Kuipers; P. D. Siersema

doi:10.1111/j.1365-2559.2007.02706.x

Grading of dysplasia in Barrett's oesophagus: Substantial interobserver variation between general and gastrointestinal pathologists

M. Kerkhof^*, H. Van Dekken, E. W. Steyerberg, G. A. Meijer, A. H. Mulder, A. De Bruïne, A. Driessen, F. J. Ten Kate, J. G. Kusters, E. J. Kuipers, P. D. Siersema

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

224 Citations (Scopus)

Abstract

Aims: To determine interobserver variation in grading of dysplasia in Barrett's oesophagus (BO) between non-expert general pathologists and expert gastrointestinal pathologists on the one hand and between expert pathologists on the other hand. Methods and results: In this prospective multicentre study, non-expert and expert pathologists graded biopsy specimens of 920 patients with endoscopic BO, which were blindly reviewed by one member of a panel of expert pathologists (panel experts) and by a second panel expert in case of disagreement on dysplasia grade. Agreement between two of three pathologists was established as the final diagnosis. Analysis was performed by κ statistics. Due to absence of intestinal metaplasia, 127/920 (14%) patients were excluded. The interobserver agreement for dysplasia [no dysplasia (ND) versus indefinite for dysplasia/low-grade dysplasia (IND/LGD) versus high-grade dysplasia (HGD)/adenocarcinoma (AC)] between non-experts and first panel experts and between initial experts and first panel experts was fair (κ = 0.24 and κ = 0.27, respectively), and substantial for differentiation of HGD/AC from ND/IND/LGD (κ = 0.62 and κ = 0.58, respectively). Conclusions: There was considerable interobserver variability in the interpretation of ND or IND/LGD in BO between non-experts and experts, but also between expert pathologists. This suggests that less subjective markers are needed to determine the risk of developing AC in BO.

Original language	English
Pages (from-to)	920-927
Number of pages	8
Journal	Histopathology
Volume	50
Issue number	7
DOIs	https://doi.org/10.1111/j.1365-2559.2007.02706.x
Publication status	Published - Jun 2007
Externally published	Yes

ASJC Scopus Subject Areas

Pathology and Forensic Medicine
Histology

Keywords

Barrett's oesophagus
Dysplasia
Grading
Interobserver variation
Pathology

Access to Document

10.1111/j.1365-2559.2007.02706.x

Cite this

Kerkhof, M., Van Dekken, H., Steyerberg, E. W., Meijer, G. A., Mulder, A. H., De Bruïne, A., Driessen, A., Ten Kate, F. J., Kusters, J. G., Kuipers, E. J., & Siersema, P. D. (2007). Grading of dysplasia in Barrett's oesophagus: Substantial interobserver variation between general and gastrointestinal pathologists. Histopathology, 50(7), 920-927. https://doi.org/10.1111/j.1365-2559.2007.02706.x

@article{15cd494d61b94044bff31f8a57a42585,

title = "Grading of dysplasia in Barrett's oesophagus: Substantial interobserver variation between general and gastrointestinal pathologists",

abstract = "Aims: To determine interobserver variation in grading of dysplasia in Barrett's oesophagus (BO) between non-expert general pathologists and expert gastrointestinal pathologists on the one hand and between expert pathologists on the other hand. Methods and results: In this prospective multicentre study, non-expert and expert pathologists graded biopsy specimens of 920 patients with endoscopic BO, which were blindly reviewed by one member of a panel of expert pathologists (panel experts) and by a second panel expert in case of disagreement on dysplasia grade. Agreement between two of three pathologists was established as the final diagnosis. Analysis was performed by κ statistics. Due to absence of intestinal metaplasia, 127/920 (14\%) patients were excluded. The interobserver agreement for dysplasia [no dysplasia (ND) versus indefinite for dysplasia/low-grade dysplasia (IND/LGD) versus high-grade dysplasia (HGD)/adenocarcinoma (AC)] between non-experts and first panel experts and between initial experts and first panel experts was fair (κ = 0.24 and κ = 0.27, respectively), and substantial for differentiation of HGD/AC from ND/IND/LGD (κ = 0.62 and κ = 0.58, respectively). Conclusions: There was considerable interobserver variability in the interpretation of ND or IND/LGD in BO between non-experts and experts, but also between expert pathologists. This suggests that less subjective markers are needed to determine the risk of developing AC in BO.",

keywords = "Barrett's oesophagus, Dysplasia, Grading, Interobserver variation, Pathology",

author = "M. Kerkhof and \{Van Dekken\}, H. and Steyerberg, \{E. W.\} and Meijer, \{G. A.\} and Mulder, \{A. H.\} and \{De Bru{\"i}ne\}, A. and A. Driessen and \{Ten Kate\}, \{F. J.\} and Kusters, \{J. G.\} and Kuipers, \{E. J.\} and Siersema, \{P. D.\}",

year = "2007",

month = jun,

doi = "10.1111/j.1365-2559.2007.02706.x",

language = "English",

volume = "50",

pages = "920--927",

journal = "Histopathology",

issn = "0309-0167",

publisher = "Wiley-Blackwell",

number = "7",

}

Kerkhof, M, Van Dekken, H, Steyerberg, EW, Meijer, GA, Mulder, AH, De Bruïne, A, Driessen, A, Ten Kate, FJ, Kusters, JG, Kuipers, EJ & Siersema, PD 2007, 'Grading of dysplasia in Barrett's oesophagus: Substantial interobserver variation between general and gastrointestinal pathologists', Histopathology, vol. 50, no. 7, pp. 920-927. https://doi.org/10.1111/j.1365-2559.2007.02706.x

TY - JOUR

T1 - Grading of dysplasia in Barrett's oesophagus

T2 - Substantial interobserver variation between general and gastrointestinal pathologists

AU - Kerkhof, M.

AU - Van Dekken, H.

AU - Steyerberg, E. W.

AU - Meijer, G. A.

AU - Mulder, A. H.

AU - De Bruïne, A.

AU - Driessen, A.

AU - Ten Kate, F. J.

AU - Kusters, J. G.

AU - Kuipers, E. J.

AU - Siersema, P. D.

PY - 2007/6

Y1 - 2007/6

N2 - Aims: To determine interobserver variation in grading of dysplasia in Barrett's oesophagus (BO) between non-expert general pathologists and expert gastrointestinal pathologists on the one hand and between expert pathologists on the other hand. Methods and results: In this prospective multicentre study, non-expert and expert pathologists graded biopsy specimens of 920 patients with endoscopic BO, which were blindly reviewed by one member of a panel of expert pathologists (panel experts) and by a second panel expert in case of disagreement on dysplasia grade. Agreement between two of three pathologists was established as the final diagnosis. Analysis was performed by κ statistics. Due to absence of intestinal metaplasia, 127/920 (14%) patients were excluded. The interobserver agreement for dysplasia [no dysplasia (ND) versus indefinite for dysplasia/low-grade dysplasia (IND/LGD) versus high-grade dysplasia (HGD)/adenocarcinoma (AC)] between non-experts and first panel experts and between initial experts and first panel experts was fair (κ = 0.24 and κ = 0.27, respectively), and substantial for differentiation of HGD/AC from ND/IND/LGD (κ = 0.62 and κ = 0.58, respectively). Conclusions: There was considerable interobserver variability in the interpretation of ND or IND/LGD in BO between non-experts and experts, but also between expert pathologists. This suggests that less subjective markers are needed to determine the risk of developing AC in BO.

AB - Aims: To determine interobserver variation in grading of dysplasia in Barrett's oesophagus (BO) between non-expert general pathologists and expert gastrointestinal pathologists on the one hand and between expert pathologists on the other hand. Methods and results: In this prospective multicentre study, non-expert and expert pathologists graded biopsy specimens of 920 patients with endoscopic BO, which were blindly reviewed by one member of a panel of expert pathologists (panel experts) and by a second panel expert in case of disagreement on dysplasia grade. Agreement between two of three pathologists was established as the final diagnosis. Analysis was performed by κ statistics. Due to absence of intestinal metaplasia, 127/920 (14%) patients were excluded. The interobserver agreement for dysplasia [no dysplasia (ND) versus indefinite for dysplasia/low-grade dysplasia (IND/LGD) versus high-grade dysplasia (HGD)/adenocarcinoma (AC)] between non-experts and first panel experts and between initial experts and first panel experts was fair (κ = 0.24 and κ = 0.27, respectively), and substantial for differentiation of HGD/AC from ND/IND/LGD (κ = 0.62 and κ = 0.58, respectively). Conclusions: There was considerable interobserver variability in the interpretation of ND or IND/LGD in BO between non-experts and experts, but also between expert pathologists. This suggests that less subjective markers are needed to determine the risk of developing AC in BO.

KW - Barrett's oesophagus

KW - Dysplasia

KW - Grading

KW - Interobserver variation

KW - Pathology

UR - http://www.scopus.com/inward/record.url?scp=34249815173&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34249815173&partnerID=8YFLogxK

U2 - 10.1111/j.1365-2559.2007.02706.x

DO - 10.1111/j.1365-2559.2007.02706.x

M3 - Article

C2 - 17543082

AN - SCOPUS:34249815173

SN - 0309-0167

VL - 50

SP - 920

EP - 927

JO - Histopathology

JF - Histopathology

IS - 7

ER -

Grading of dysplasia in Barrett's oesophagus: Substantial interobserver variation between general and gastrointestinal pathologists

Abstract

ASJC Scopus Subject Areas

Keywords

Access to Document

Other files and links

Fingerprint

Cite this