Observer variability in the histopathologic diagnosis of microscopic colitis and subgroups
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Observer variability in the histopathologic diagnosis of microscopic colitis and subgroups. / Fiehn, Anne-Marie Kanstrup; Bjørnbak, Camilla; Warnecke, Mads; Engel, Peter Johan Heiberg; Munck, Lars Kristian.
In: Human Pathology, Vol. 44, No. 11, 11.2013, p. 2461-6.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Observer variability in the histopathologic diagnosis of microscopic colitis and subgroups
AU - Fiehn, Anne-Marie Kanstrup
AU - Bjørnbak, Camilla
AU - Warnecke, Mads
AU - Engel, Peter Johan Heiberg
AU - Munck, Lars Kristian
N1 - © 2013.
PY - 2013/11
Y1 - 2013/11
N2 - The diagnosis of microscopic colitis (MC) is based on histologic findings and includes collagenous colitis (CC) and lymphocytic colitis (LC). Incomplete MC (MCi) denotes patients with chronic diarrhea and a normal endoscopy and morphological changes that do not completely meet the histologic criteria of LC or CC. The aim of this study was to investigate the intraobserver and interobserver agreement on the MC subtypes of CC, LC, and MCi and the ability to discriminate MCi from normal and inflammatory bowel disease/nonspecific reactive changes. A single hematoxylin and eosin-stained specimen from biopsies of the following 5 groups were randomly selected and blinded: CC, LC, MCi, inflammatory bowel disease, and normal. Three pathologists independently reviewed the specimens. The specimens were relabeled and reinterpreted 4 months later. Intraobserver and interobserver agreement was evaluated by κ statistics. κ values for intraobserver agreement were good for 5 diagnostic groups varying from 0.70 to 0.83 and very good when simplifying to only 3 diagnostic groups varying from 0.88 to 0.96, separating MC/MCi from non-MC. κ values for interobserver agreement varied from 0.60 to 0.75 for 5 diagnostic groups and 0.81 to 0.89 for 3 diagnostic groups. The study shows that the intraobserver and interobserver agreement is high for discriminating between MC/MCi and non-MC, whereas the ability to discriminate MCi from CC and LC is lower. A revision and consensus on the histologic criteria of the MC subtypes seem warranted.
AB - The diagnosis of microscopic colitis (MC) is based on histologic findings and includes collagenous colitis (CC) and lymphocytic colitis (LC). Incomplete MC (MCi) denotes patients with chronic diarrhea and a normal endoscopy and morphological changes that do not completely meet the histologic criteria of LC or CC. The aim of this study was to investigate the intraobserver and interobserver agreement on the MC subtypes of CC, LC, and MCi and the ability to discriminate MCi from normal and inflammatory bowel disease/nonspecific reactive changes. A single hematoxylin and eosin-stained specimen from biopsies of the following 5 groups were randomly selected and blinded: CC, LC, MCi, inflammatory bowel disease, and normal. Three pathologists independently reviewed the specimens. The specimens were relabeled and reinterpreted 4 months later. Intraobserver and interobserver agreement was evaluated by κ statistics. κ values for intraobserver agreement were good for 5 diagnostic groups varying from 0.70 to 0.83 and very good when simplifying to only 3 diagnostic groups varying from 0.88 to 0.96, separating MC/MCi from non-MC. κ values for interobserver agreement varied from 0.60 to 0.75 for 5 diagnostic groups and 0.81 to 0.89 for 3 diagnostic groups. The study shows that the intraobserver and interobserver agreement is high for discriminating between MC/MCi and non-MC, whereas the ability to discriminate MCi from CC and LC is lower. A revision and consensus on the histologic criteria of the MC subtypes seem warranted.
KW - Adult
KW - Aged
KW - Biopsy
KW - Colitis, Collagenous
KW - Colitis, Lymphocytic
KW - Colitis, Microscopic
KW - Colonoscopy
KW - Diagnosis, Differential
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Observer Variation
KW - Reproducibility of Results
U2 - 10.1016/j.humpath.2013.06.004
DO - 10.1016/j.humpath.2013.06.004
M3 - Journal article
C2 - 24029708
VL - 44
SP - 2461
EP - 2466
JO - Human Pathology
JF - Human Pathology
SN - 0046-8177
IS - 11
ER -
ID: 135497140