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...
Saved in:
Main Authors: | , , , , , , , , , , , , , , , , |
---|---|
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 |