Observer Variation in Assessment of Liver Biopsies of Alcoholic Patients
- 1 February 1988
- journal article
- Published by Wiley in Alcohol: Clinical and Experimental Research
- Vol. 12 (1), 173-178
- https://doi.org/10.1111/j.1530-0277.1988.tb00155.x
Abstract
The aim was to construct a questionnaire analyzing pathological features possibly present in alcoholic liver disease, to assess its interobserver variation and to determine the influence of technical data on this variation. A total of 764 inpatients drinking 90 g (median) of pure alcohol per day for 25 years was observed; 402 patients were excluded because of associated nonalcoholic disease, refusal or contraindication to biopsy, leaving 362 patients included. Two pathologists independently analyzed each biopsy and completed a questionnaire including 41 items. Coefficient of concordance between observers was evaluated with the kappa statistic (k). The prevalence of 14 lesions was low, equal to or under 10%, leading to a nonsignificant concordance. For the 27 remaining features, two had an almost perfect degree of concordance (k greater than 0.81): presence of hepatocellular carcinoma and cirrhosis. Three had a substantial coefficient of concordance (k greater than 0.61): fibrous septa, size of cirrhotic nodules, and liver cell regeneration. Nine had a moderate (k greater than 0.41), 11 a fair (k greater than 0.21), and two a slight (k less than 0.21) coefficient of concordance. In terms of final diagnosis of alcoholic liver disease the concordance was substantial for cirrhosis with acute alcoholic hepatitis (k = 0.77), cirrhosis without alcoholic hepatitis (k = 0.75), acute alcoholic hepatitis without cirrhosis (k = 0.65) and normal liver (k = 0.64). Concordance was moderate for steatosis (k = 0.47) and slight for fibrosis alone (k = 0.16).(ABSTRACT TRUNCATED AT 250 WORDS)Keywords
This publication has 10 references indexed in Scilit:
- SAMPLING VARIABILITY AND ITS INFLUENCE ON THE DIAGNOSTIC YIELD OF PERCUTANEOUS NEEDLE BIOPSY OF THE LIVERThe Lancet, 1986
- A simple micromethod for collagen and total protein determination in formalin-fixed paraffin-embedded sections.Journal of Histochemistry & Cytochemistry, 1985
- A Prospective Morphologic Evaluation of Hepatic Toxicity of Chenodeoxycholic Acid in Patients with Cholelithiasis: The National Cooperative Gallstone StudyHepatology, 1982
- Clinical biostatistics: LIV. The biostatistics of concordanceClinical Pharmacology & Therapeutics, 1981
- Observer variation in assessment of liver biopsies including analysis by kappa statisticsGastroenterology, 1980
- Sampling Variability on Percutaneous Liver BiopsyArchives of Internal Medicine, 1979
- The Measurement of Observer Agreement for Categorical DataBiometrics, 1977
- Observer error and sampling variability tested in evaluation of hepatitis and cirrhosis by liver biopsyDigestive Diseases and Sciences, 1971
- A Coefficient of Agreement for Nominal ScalesEducational and Psychological Measurement, 1960