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Reproducibility of histological assessments of disease activity in UC.
Mosli, Mahmoud H; Feagan, Brian G; Zou, Guangyong; Sandborn, William J; D'Haens, Geert; Khanna, Reena; Behling, Cynthia; Kaplan, Keith; Driman, David K; Shackelton, Lisa M; Baker, Kenneth A; MacDonald, John K; Vandervoort, Margaret K; Samaan, Mark A; Geboes, Karel; Valasek, Mark A; Pai, Rish; Langner, Cord; Riddell, Robert; Harpaz, Noam; Sewitch, Maida; Peterson, Michael; Stitt, Larry W; Levesque, Barrett G.
Afiliação
  • Mosli MH; Robarts Clinical Trials, Robarts Research Institute, Western University, London, Ontario, Canada Department of Medicine, Western University, London, Ontario, Canada Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia Department of Epidemiology, Biostatistics and Occupational Medi
  • Feagan BG; Robarts Clinical Trials, Robarts Research Institute, Western University, London, Ontario, Canada Department of Medicine, Western University, London, Ontario, Canada Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada.
  • Zou G; Robarts Clinical Trials, Robarts Research Institute, Western University, London, Ontario, Canada Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada.
  • Sandborn WJ; Robarts Clinical Trials, Robarts Research Institute, Western University, London, Ontario, Canada Division of Gastroenterology, University of California San Diego, La Jolla, California, USA.
  • D'Haens G; Robarts Clinical Trials, Robarts Research Institute, Western University, London, Ontario, Canada Department of Gastroenterology, Academic Medical Center, Amsterdam, The Netherlands.
  • Khanna R; Robarts Clinical Trials, Robarts Research Institute, Western University, London, Ontario, Canada Department of Medicine, Western University, London, Ontario, Canada.
  • Behling C; Pacific Rim Pathology Medical Corporation, San Diego, California, USA.
  • Kaplan K; Carolinas Medical Center, Charlotte, North Carolina, USA.
  • Driman DK; Department of Pathology, Western University, London, Ontario, Canada.
  • Shackelton LM; Robarts Clinical Trials, Robarts Research Institute, Western University, London, Ontario, Canada.
  • Baker KA; Robarts Clinical Trials, Robarts Research Institute, Western University, London, Ontario, Canada.
  • MacDonald JK; Robarts Clinical Trials, Robarts Research Institute, Western University, London, Ontario, Canada.
  • Vandervoort MK; Robarts Clinical Trials, Robarts Research Institute, Western University, London, Ontario, Canada.
  • Samaan MA; Robarts Clinical Trials, Robarts Research Institute, Western University, London, Ontario, Canada.
  • Geboes K; Department of Pathology, University Hospital of KU Leuven and UZ Gent, Leuven, Belgium.
  • Valasek MA; Department of Pathology, University of California, San Diego, California, USA.
  • Pai R; Department of Anatomic Pathology, Cleveland Clinic, Cleveland, Ohio, USA.
  • Langner C; Department of Pathology, Medical University of Graz, Graz, Austria.
  • Riddell R; Department of Pathology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
  • Harpaz N; Department of Pathology, Mount Sinai Hospital, New York, New York, USA.
  • Sewitch M; Department of Medicine, McGill University, Montreal, Quebec, Canada.
  • Peterson M; Department of Pathology, Western Washington Pathology and Multicare Health System, Tacoma, Washington, USA.
  • Stitt LW; Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada.
  • Levesque BG; Robarts Clinical Trials, Robarts Research Institute, Western University, London, Ontario, Canada Division of Gastroenterology, University of California San Diego, La Jolla, California, USA.
Gut ; 64(11): 1765-73, 2015 Nov.
Article em En | MEDLINE | ID: mdl-25360036
ABSTRACT

OBJECTIVE:

Histopathology is potentially an important outcome measure in UC. Multiple histological disease activity (HA) indices, including the Geboes score (GS) and modified Riley score (MRS), have been developed; however, the operating properties of these instruments are not clearly defined. We assessed the reproducibility of existing measures of HA.

DESIGN:

Five experienced pathologists with GI pathology fellowship training and expertise in IBD evaluated, on three separate occasions at least two weeks apart, 49 UC colon biopsies and scored the GS, MRS and a global rating of histological severity using a 100 mm visual analogue scale (VAS). The reproducibility of each grading system and for individual instrument items was quantified by estimates of intraclass correlation coefficients (ICCs) based on two-way random effects models. Uncertainty of estimates was quantified by 95% two-sided CIs obtained using the non-parametric cluster bootstrap method. Biopsies responsible for the greatest disagreement based on the ICC estimates were identified. A consensus process was used to determine the most common sources of measurement disagreement. Recommendations for minimising disagreement were subsequently generated.

RESULTS:

Intrarater ICCs (95% CIs) for the total GS, MRS and VAS scores were 0.82 (0.73 to 0.88), 0.71 (0.63 to 0.80) and 0.79 (0.72 to 0.85), respectively. Corresponding inter-rater ICCs were substantially lower 0.56 (0.39 to 0.67), 0.48 (0.35 to 0.66) and 0.61 (0.47 to 0.72). Correlation between the GS and VAS was 0.62 and between the MRS and VAS was 0.61.

CONCLUSIONS:

Although 'substantial' to 'almost perfect' ICCs for intrarater agreement were found in the assessment of HA in UC, ICCs for inter-rater agreement were considerably lower. According to the consensus process results, standardisation of item definitions and modification of the existing indices is required to create an optimal UC histological instrument.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Colite Ulcerativa Tipo de estudo: Prognostic_studies Limite: Adult / Female / Humans / Male Idioma: En Ano de publicação: 2015 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Colite Ulcerativa Tipo de estudo: Prognostic_studies Limite: Adult / Female / Humans / Male Idioma: En Ano de publicação: 2015 Tipo de documento: Article