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CD, or not CD, that is the question: a digital interobserver agreement study in coeliac disease.
Denholm, James; Schreiber, Benjamin A; Jaeckle, Florian; Wicks, Mike N; Benbow, Emyr W; Bracey, Tim S; Chan, James Y H; Farkas, Lorant; Fryer, Eve; Gopalakrishnan, Kishore; Hughes, Caroline A; Kirkwood, Kathryn J; Langman, Gerald; Mahler-Araujo, Betania; McMahon, Raymond F T; Myint, Khun La Win; Natu, Sonali; Robinson, Andrew; Sanduka, Ashraf; Sheppard, Katharine A; Tsang, Yee Wah; Arends, Mark J; Soilleux, Elizabeth J.
Afiliación
  • Denholm J; Department of Pathology, University of Cambridge, Cambridge, UK.
  • Schreiber BA; Department of Applied Mathematics and Theoretical Physics, University of Cambridge, Cambridge, UK.
  • Jaeckle F; Lyzeum Ltd, Cambridge, UK.
  • Wicks MN; Department of Pathology, University of Cambridge, Cambridge, UK.
  • Benbow EW; Department of Applied Mathematics and Theoretical Physics, University of Cambridge, Cambridge, UK.
  • Bracey TS; Department of Pathology, University of Cambridge, Cambridge, UK florian.jaeckle@gmail.com.
  • Chan JYH; Lyzeum Ltd, Cambridge, UK.
  • Farkas L; Department of Pathology, The University of Edinburgh College of Medicine and Veterinary Medicine, Edinburgh, UK.
  • Fryer E; Division of Medical Education, The University of Manchester, Manchester, UK.
  • Gopalakrishnan K; Department of Histopathology, Manchester University NHS Foundation Trust, Manchester, UK.
  • Hughes CA; Department of Diagnostic and Molecular Pathology, Royal Cornwall Hospitals NHS Trust, Truro, UK.
  • Kirkwood KJ; University Hospitals Plymouth NHS Trust, Plymouth, UK.
  • Langman G; Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
  • Mahler-Araujo B; Department of Pathology, Akershus University Hospital, Nordbyhagen, Norway.
  • McMahon RFT; Institute of Clinical Medicine, University of Oslo, Nordbyhagen, Norway.
  • Myint KW; Department of Cellular Pathology, Oxford University Hospitals NHS foundation Trust, Oxford, UK.
  • Natu S; Department of Histopathology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
  • Robinson A; Department of Cellular Pathology, Oxford University Hospitals NHS foundation Trust, Oxford, UK.
  • Sanduka A; Department of Pathology, Western General Hospital, Edinburgh, UK.
  • Sheppard KA; Department of Cellular Pathology, Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
  • Tsang YW; Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
  • Arends MJ; MRC Institute of Metabolic Science, Wellcome Trust, Cambridge, UK.
  • Soilleux EJ; Division of Medical Education, The University of Manchester, Manchester, UK.
BMJ Open Gastroenterol ; 11(1)2024 Feb 01.
Article en En | MEDLINE | ID: mdl-38302475
ABSTRACT

OBJECTIVE:

Coeliac disease (CD) diagnosis generally depends on histological examination of duodenal biopsies. We present the first study analysing the concordance in examination of duodenal biopsies using digitised whole-slide images (WSIs). We further investigate whether the inclusion of immunoglobulin A tissue transglutaminase (IgA tTG) and haemoglobin (Hb) data improves the interobserver agreement of diagnosis.

DESIGN:

We undertook a large study of the concordance in histological examination of duodenal biopsies using digitised WSIs in an entirely virtual reporting setting. Our study was organised in two phases in phase 1, 13 pathologists independently classified 100 duodenal biopsies (40 normal; 40 CD; 20 indeterminate enteropathy) in the absence of any clinical or laboratory data. In phase 2, the same pathologists examined the (re-anonymised) WSIs with the inclusion of IgA tTG and Hb data.

RESULTS:

We found the mean probability of two observers agreeing in the absence of additional data to be 0.73 (±0.08) with a corresponding Cohen's kappa of 0.59 (±0.11). We further showed that the inclusion of additional data increased the concordance to 0.80 (±0.06) with a Cohen's kappa coefficient of 0.67 (±0.09).

CONCLUSION:

We showed that the addition of serological data significantly improves the quality of CD diagnosis. However, the limited interobserver agreement in CD diagnosis using digitised WSIs, even after the inclusion of IgA tTG and Hb data, indicates the importance of interpreting duodenal biopsy in the appropriate clinical context. It further highlights the unmet need for an objective means of reproducible duodenal biopsy diagnosis, such as the automated analysis of WSIs using artificial intelligence.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad Celíaca Tipo de estudio: Diagnostic_studies Límite: Humans Idioma: En Revista: BMJ Open Gastroenterol Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad Celíaca Tipo de estudio: Diagnostic_studies Límite: Humans Idioma: En Revista: BMJ Open Gastroenterol Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Reino Unido