PT  - JOURNAL ARTICLE
AU  - German, Alyn L
AU  - Fleming, Kenneth
AU  - Kaye, Philip
AU  - Davies, Susan
AU  - Goldin, Robert
AU  - Hubscher, Stefan G
AU  - Tiniakos, Dina
AU  - McGregor, Angus
AU  - Wyatt, Judith I
TI  - Can reference images improve interobserver agreement in reporting liver fibrosis?
AID  - 10.1136/jclinpath-2017-204760
DP  - 2018 Apr 01
TA  - Journal of Clinical Pathology
PG  - 368--371
VI  - 71
IP  - 4
4099  - http://jcp.bmj.com/content/71/4/368.short
4100  - http://jcp.bmj.com/content/71/4/368.full
SO  - J Clin Pathol2018 Apr 01; 71
AB  - 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).