Interobserver Agreement in the Diagnosis of Inflammatory Bowel Disease-Associated Neoplasia in China in Comparison to Subspecialized American Gastrointestinal Pathologists

Background. The aim of this study was to evaluate the interobserver variability in diagnosing inflammatory bowel disease (IBD)-associated neoplasia among practicing pathologists from China using telepathology, a practice of remote diagnostic consultation increasingly used nationally and internationa...

Full description

Saved in:
Bibliographic Details
Main Authors: Xian-rui Wu, Hua-shan Liu, Xue-ying Shi, Wei-xun Zhou, Zhi-nong Jiang, Yan Huang, Dipti M. Karamchandani, John R. Goldblum, Shu-yuan Xiao, Hong-fa Zhu, Michael M. Feely, Amy L. Collinsworth, Ashwini Esnakula, Hao Xie, Bo Shen, Ping Lan, Xiu-li Liu
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2018/8715263
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832568451204382720
author Xian-rui Wu
Hua-shan Liu
Xue-ying Shi
Wei-xun Zhou
Zhi-nong Jiang
Yan Huang
Dipti M. Karamchandani
John R. Goldblum
Shu-yuan Xiao
Hong-fa Zhu
Michael M. Feely
Amy L. Collinsworth
Ashwini Esnakula
Hao Xie
Bo Shen
Ping Lan
Xiu-li Liu
author_facet Xian-rui Wu
Hua-shan Liu
Xue-ying Shi
Wei-xun Zhou
Zhi-nong Jiang
Yan Huang
Dipti M. Karamchandani
John R. Goldblum
Shu-yuan Xiao
Hong-fa Zhu
Michael M. Feely
Amy L. Collinsworth
Ashwini Esnakula
Hao Xie
Bo Shen
Ping Lan
Xiu-li Liu
author_sort Xian-rui Wu
collection DOAJ
description Background. The aim of this study was to evaluate the interobserver variability in diagnosing inflammatory bowel disease (IBD)-associated neoplasia among practicing pathologists from China using telepathology, a practice of remote diagnostic consultation increasingly used nationally and internationally, and its comparison with the interpretation of subspecialized gastrointestinal (GI) pathologists from the United States (US). Methods. Eight GI pathologists from the US and 4 pathologists from China with an interest in GI pathology participated in this study. A total of 50 colonic biopsies from patients with a clinical history of IBD from 8 medical centers in China were included. All microscopic slides in each case were digitized using an Aperio system. One pathologist (XL) reviewed the digitized full-slide images, and selected areas of interest were captured at low, medium, and high magnifications at a resolution of 1712 × 1072 pixels and saved as tagged image file format (TIFF) files on read-only DVD. Each pathologist evaluated the images and selected the most appropriate diagnostic category for each case (negative, indefinite, low-grade dysplasia [LGD], high-grade dysplasia [HGD], and carcinoma). A Fleiss’ kappa coefficient (K) analysis was performed to determine interobserver agreement and the agreement of each pathologist from China with the consensus diagnosis (defined as diagnostic agreement by at least 4 participating US GI pathologists). Results. There was substantial interobserver agreement among 4 pathologists from China on the interpretation of IBD-associated neoplasia (kappa value 0.68, 95% confidence interval: 0.56–0.78). A consensus diagnosis included negative (n=22), LGD (n=22), HGD (n=3), carcinoma (n=2), and indefinite for dysplasia (n=1). Using consensus diagnoses as references, the agreement between each pathologist from China and the consensus diagnosis was substantial with kappa values ranging from 0.75 to 0.80. Conclusions. This study reveals substantial interobserver agreement for the interpretation of colonic neoplasia in IBD using digitized images among Chinese pathologists as well as between each Chinese pathologist and a consensus diagnosis generated by US GI pathologists.
format Article
id doaj-art-a958437b885b429db422b17e46f2d6dc
institution Kabale University
issn 1687-6121
1687-630X
language English
publishDate 2018-01-01
publisher Wiley
record_format Article
series Gastroenterology Research and Practice
spelling doaj-art-a958437b885b429db422b17e46f2d6dc2025-02-03T00:59:06ZengWileyGastroenterology Research and Practice1687-61211687-630X2018-01-01201810.1155/2018/87152638715263Interobserver Agreement in the Diagnosis of Inflammatory Bowel Disease-Associated Neoplasia in China in Comparison to Subspecialized American Gastrointestinal PathologistsXian-rui Wu0Hua-shan Liu1Xue-ying Shi2Wei-xun Zhou3Zhi-nong Jiang4Yan Huang5Dipti M. Karamchandani6John R. Goldblum7Shu-yuan Xiao8Hong-fa Zhu9Michael M. Feely10Amy L. Collinsworth11Ashwini Esnakula12Hao Xie13Bo Shen14Ping Lan15Xiu-li Liu16Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaDepartment of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaDepartment of Pathology, Peking University Third Hospital, Beijing, ChinaDepartment of Pathology, Peking Union Medical College Hospital, Beijing, ChinaDepartment of Pathology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaDepartment of Pathology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaDepartment of Pathology, Penn State College of Medicine, Hershey, PA, USADepartment of Pathology, Cleveland Clinic, Cleveland, OH, USADepartment of Pathology, The University of Chicago, Chicago, IL, USADepartment of Pathology, The Mount Sinai Hospital, New York, NY, USADepartment of Pathology and Laboratory Medicine, University of Florida, Gainesville, FL, USADepartment of Pathology and Laboratory Medicine, University of Florida, Gainesville, FL, USADepartment of Pathology and Laboratory Medicine, University of Florida, Gainesville, FL, USADepartment of Internal Medicine, Yale University School of Medicine, New Haven, CT, USADepartment of Gastroenterology/Hepatology, Cleveland Clinic, Cleveland, OH, USADepartment of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaDepartment of Pathology and Laboratory Medicine, University of Florida, Gainesville, FL, USABackground. The aim of this study was to evaluate the interobserver variability in diagnosing inflammatory bowel disease (IBD)-associated neoplasia among practicing pathologists from China using telepathology, a practice of remote diagnostic consultation increasingly used nationally and internationally, and its comparison with the interpretation of subspecialized gastrointestinal (GI) pathologists from the United States (US). Methods. Eight GI pathologists from the US and 4 pathologists from China with an interest in GI pathology participated in this study. A total of 50 colonic biopsies from patients with a clinical history of IBD from 8 medical centers in China were included. All microscopic slides in each case were digitized using an Aperio system. One pathologist (XL) reviewed the digitized full-slide images, and selected areas of interest were captured at low, medium, and high magnifications at a resolution of 1712 × 1072 pixels and saved as tagged image file format (TIFF) files on read-only DVD. Each pathologist evaluated the images and selected the most appropriate diagnostic category for each case (negative, indefinite, low-grade dysplasia [LGD], high-grade dysplasia [HGD], and carcinoma). A Fleiss’ kappa coefficient (K) analysis was performed to determine interobserver agreement and the agreement of each pathologist from China with the consensus diagnosis (defined as diagnostic agreement by at least 4 participating US GI pathologists). Results. There was substantial interobserver agreement among 4 pathologists from China on the interpretation of IBD-associated neoplasia (kappa value 0.68, 95% confidence interval: 0.56–0.78). A consensus diagnosis included negative (n=22), LGD (n=22), HGD (n=3), carcinoma (n=2), and indefinite for dysplasia (n=1). Using consensus diagnoses as references, the agreement between each pathologist from China and the consensus diagnosis was substantial with kappa values ranging from 0.75 to 0.80. Conclusions. This study reveals substantial interobserver agreement for the interpretation of colonic neoplasia in IBD using digitized images among Chinese pathologists as well as between each Chinese pathologist and a consensus diagnosis generated by US GI pathologists.http://dx.doi.org/10.1155/2018/8715263
spellingShingle Xian-rui Wu
Hua-shan Liu
Xue-ying Shi
Wei-xun Zhou
Zhi-nong Jiang
Yan Huang
Dipti M. Karamchandani
John R. Goldblum
Shu-yuan Xiao
Hong-fa Zhu
Michael M. Feely
Amy L. Collinsworth
Ashwini Esnakula
Hao Xie
Bo Shen
Ping Lan
Xiu-li Liu
Interobserver Agreement in the Diagnosis of Inflammatory Bowel Disease-Associated Neoplasia in China in Comparison to Subspecialized American Gastrointestinal Pathologists
Gastroenterology Research and Practice
title Interobserver Agreement in the Diagnosis of Inflammatory Bowel Disease-Associated Neoplasia in China in Comparison to Subspecialized American Gastrointestinal Pathologists
title_full Interobserver Agreement in the Diagnosis of Inflammatory Bowel Disease-Associated Neoplasia in China in Comparison to Subspecialized American Gastrointestinal Pathologists
title_fullStr Interobserver Agreement in the Diagnosis of Inflammatory Bowel Disease-Associated Neoplasia in China in Comparison to Subspecialized American Gastrointestinal Pathologists
title_full_unstemmed Interobserver Agreement in the Diagnosis of Inflammatory Bowel Disease-Associated Neoplasia in China in Comparison to Subspecialized American Gastrointestinal Pathologists
title_short Interobserver Agreement in the Diagnosis of Inflammatory Bowel Disease-Associated Neoplasia in China in Comparison to Subspecialized American Gastrointestinal Pathologists
title_sort interobserver agreement in the diagnosis of inflammatory bowel disease associated neoplasia in china in comparison to subspecialized american gastrointestinal pathologists
url http://dx.doi.org/10.1155/2018/8715263
work_keys_str_mv AT xianruiwu interobserveragreementinthediagnosisofinflammatoryboweldiseaseassociatedneoplasiainchinaincomparisontosubspecializedamericangastrointestinalpathologists
AT huashanliu interobserveragreementinthediagnosisofinflammatoryboweldiseaseassociatedneoplasiainchinaincomparisontosubspecializedamericangastrointestinalpathologists
AT xueyingshi interobserveragreementinthediagnosisofinflammatoryboweldiseaseassociatedneoplasiainchinaincomparisontosubspecializedamericangastrointestinalpathologists
AT weixunzhou interobserveragreementinthediagnosisofinflammatoryboweldiseaseassociatedneoplasiainchinaincomparisontosubspecializedamericangastrointestinalpathologists
AT zhinongjiang interobserveragreementinthediagnosisofinflammatoryboweldiseaseassociatedneoplasiainchinaincomparisontosubspecializedamericangastrointestinalpathologists
AT yanhuang interobserveragreementinthediagnosisofinflammatoryboweldiseaseassociatedneoplasiainchinaincomparisontosubspecializedamericangastrointestinalpathologists
AT diptimkaramchandani interobserveragreementinthediagnosisofinflammatoryboweldiseaseassociatedneoplasiainchinaincomparisontosubspecializedamericangastrointestinalpathologists
AT johnrgoldblum interobserveragreementinthediagnosisofinflammatoryboweldiseaseassociatedneoplasiainchinaincomparisontosubspecializedamericangastrointestinalpathologists
AT shuyuanxiao interobserveragreementinthediagnosisofinflammatoryboweldiseaseassociatedneoplasiainchinaincomparisontosubspecializedamericangastrointestinalpathologists
AT hongfazhu interobserveragreementinthediagnosisofinflammatoryboweldiseaseassociatedneoplasiainchinaincomparisontosubspecializedamericangastrointestinalpathologists
AT michaelmfeely interobserveragreementinthediagnosisofinflammatoryboweldiseaseassociatedneoplasiainchinaincomparisontosubspecializedamericangastrointestinalpathologists
AT amylcollinsworth interobserveragreementinthediagnosisofinflammatoryboweldiseaseassociatedneoplasiainchinaincomparisontosubspecializedamericangastrointestinalpathologists
AT ashwiniesnakula interobserveragreementinthediagnosisofinflammatoryboweldiseaseassociatedneoplasiainchinaincomparisontosubspecializedamericangastrointestinalpathologists
AT haoxie interobserveragreementinthediagnosisofinflammatoryboweldiseaseassociatedneoplasiainchinaincomparisontosubspecializedamericangastrointestinalpathologists
AT boshen interobserveragreementinthediagnosisofinflammatoryboweldiseaseassociatedneoplasiainchinaincomparisontosubspecializedamericangastrointestinalpathologists
AT pinglan interobserveragreementinthediagnosisofinflammatoryboweldiseaseassociatedneoplasiainchinaincomparisontosubspecializedamericangastrointestinalpathologists
AT xiuliliu interobserveragreementinthediagnosisofinflammatoryboweldiseaseassociatedneoplasiainchinaincomparisontosubspecializedamericangastrointestinalpathologists