Inter‐Observer Agreement among Pathologists Using Wide‐Area Transepithelial Sampling With Computer‐Assisted Analysis in Patients With Barrett's Esophagus. (September 2015)

• Record Type: Journal Article
• Authors: Vennalaganti, Prashanth R; Kanakadandi, Vijay Naag; Gross, Seth A; Parasa, Sravanthi; Wang, Kenneth K; Gupta, Neil; Sharma, Prateek
• Is Part Of: American journal of gastroenterology. Volume 110:Number 9(2015)
• Publication Date: 2015-09
• Subjects: Stomach -- Diseases -- Periodicals; Intestines -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Gastrointestinal Diseases -- Periodicals; Electronic journals; Periodicals; 616.33
• DOI: 10.1038/ajg.2015.116
• Languages: English
• ISSNs: 0002-9270

Abstract

Abstract : OBJECTIVES: The histopathological diagnosis of Barrett's esophagus (BE)‐associated dysplasia has poor inter‐observer agreement. The wide‐area transepithelial sampling (WATS) procedure uses a minimally invasive brush biopsy technique for acquiring wide‐area sampling of BE tissue followed by computer‐assisted analysis. In this study, our aim was to assess inter‐observer agreement among pathologists in the diagnosis of Barrett's‐associated dysplasia using the WATS computer‐assisted analysis technique. METHODS: WATS slides with varying degrees of BE dysplasia were randomly selected and distributed to four pathologists. Each pathologist graded the slides as nondysplastic, low‐grade dysplasia (LGD), or high‐grade dysplasia/esophageal adenocarcinoma (HGD/EAC) and completed a standardized case report form (CRF) for each slide. RESULTS: In all, 149 BE slides were evaluated in a blinded manner by 4 pathologists. The slides included the following: no dysplasia ( n =109), LGD, and HGD/EAC ( n =40). The overall mean kappa value for all 3 diagnoses for the 4 observers was calculated at 0.86 (95% confidence interval (CI) 0.75–0.97). The kappa values (95% CI) for HGD/EAC, IND/LGD, and no dysplasia were 0.95 (0.88–0.99), 0.74 (0.61–0.85), and 0.88 (0.81–0.94), respectively. CONCLUSIONS: The diagnosis of BE and associated dysplasia using the WATS technique has very high inter‐observer agreement. This appears to be significantly higher as compared with previously published data using standard histopathology.