TY - JOUR
T1 - Gastric mucosal atrophy
T2 - Interobserver consistency using new criteria for classification and grading
AU - Rugge, M.
AU - Correa, P.
AU - Dixon, M. F.
AU - Fiocca, R.
AU - Hattori, T.
AU - Lechago, J.
AU - Leandro, G.
AU - Price, A. B.
AU - Sipponen, P.
AU - Solcia, E.
AU - Watanabe, H.
AU - Genta, R. M.
PY - 2002
Y1 - 2002
N2 - Background and aims: Considerable difficulties persist amongst pathologists in agreeing on the presence and severity of gastric atrophy. An international group of pathologists pursued the following aims: (i) to generate an acceptable definition and a simple reproducible classification of gastric atrophy; and (ii) to develop guidelines for the recognition of atrophy useful for increasing agreement among observers. Methods: After redefining atrophy as the 'loss of appropriate glands' and examining histological samples from different gastric compartments, three categories were identified: (i) negative; (ii) indefinite; (iii) atrophy, with and without intestinalization. Atrophy was graded on a three-level scale. Interobserver reproducibility of the classification was tested by κ statistics (general and weighted) in a series of 48 cases. Results: The medians of the general agreement and weighted κ values were 0.78 and 0.73, respectively. The weighted κ coefficients, obtained by cross-tabulating the evaluation of each pathologist against all others, were, with only one exception, > 0.4 (moderate to excellent agreement). Conclusions: By using the definition of atrophy as the loss of appropriate glands and distinguishing the two main morphological entities of metaplastic and non-metaplastic types, a high level of agreement was achieved by a group of gastrointestinal pathologists trained in different cultural contexts.
AB - Background and aims: Considerable difficulties persist amongst pathologists in agreeing on the presence and severity of gastric atrophy. An international group of pathologists pursued the following aims: (i) to generate an acceptable definition and a simple reproducible classification of gastric atrophy; and (ii) to develop guidelines for the recognition of atrophy useful for increasing agreement among observers. Methods: After redefining atrophy as the 'loss of appropriate glands' and examining histological samples from different gastric compartments, three categories were identified: (i) negative; (ii) indefinite; (iii) atrophy, with and without intestinalization. Atrophy was graded on a three-level scale. Interobserver reproducibility of the classification was tested by κ statistics (general and weighted) in a series of 48 cases. Results: The medians of the general agreement and weighted κ values were 0.78 and 0.73, respectively. The weighted κ coefficients, obtained by cross-tabulating the evaluation of each pathologist against all others, were, with only one exception, > 0.4 (moderate to excellent agreement). Conclusions: By using the definition of atrophy as the loss of appropriate glands and distinguishing the two main morphological entities of metaplastic and non-metaplastic types, a high level of agreement was achieved by a group of gastrointestinal pathologists trained in different cultural contexts.
UR - http://www.scopus.com/inward/record.url?scp=0036024197&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0036024197&partnerID=8YFLogxK
U2 - 10.1046/j.1365-2036.2002.01301.x
DO - 10.1046/j.1365-2036.2002.01301.x
M3 - Article
C2 - 12144574
AN - SCOPUS:0036024197
SN - 0269-2813
VL - 16
SP - 1249
EP - 1259
JO - Alimentary Pharmacology and Therapeutics
JF - Alimentary Pharmacology and Therapeutics
IS - 7
ER -