TY - JOUR T1 - Can reference images improve interobserver agreement in reporting liver fibrosis? JF - Journal of Clinical Pathology JO - J Clin Pathol SP - 368 LP - 371 DO - 10.1136/jclinpath-2017-204760 VL - 71 IS - 4 AU - Alyn L German AU - Kenneth Fleming AU - Philip Kaye AU - Susan Davies AU - Robert Goldin AU - Stefan G Hubscher AU - Dina Tiniakos AU - Angus McGregor AU - Judith I Wyatt Y1 - 2018/04/01 UR - http://jcp.bmj.com/content/71/4/368.abstract N2 - Staging of fibrosis in medical liver biopsies has inherent interobserver variability. There are a number of disease-specific scoring systems available. While recognising the importance of these scoring systems, there is scope to consider how concordance amongst histopathologists could be improved using a generic fibrosis staging system.Using virtual slides, we approached both specialist liver histopathologists and general histopathologists from the UK to assess the degree of fibrosis against a proposed four-tiered reporting system. Example reference images were then produced and distributed to the same responders who were asked to rate a second set of slides to assess if the use of reference images improved concordance between pathologists.The use of reference images eliminated spread across three categories (from 15% to 0%). Overall, agreement was already good; our study showed an improved agreement amongst all participants for percentage agreement (67.79% to 70.08%) and interobserver agreement improved (Fleiss’ Kappa 0.55 to 0.59). ER -