Inter-Observer Agreement among Pathologists Using Wide-Area Transepithelial Sampling with Computer-Assisted Analysis in Patients with Barrett's Esophagus

Prashanth R. Vennalaganti, Vijay Naag Kanakadandi, Seth A. Gross, Sravanthi Parasa, Kenneth Ke Ning Wang, Neil Gupta, Prateek Sharma

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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.

Original languageEnglish (US)
Pages (from-to)1257-1260
Number of pages4
JournalAmerican Journal of Gastroenterology
Volume110
Issue number9
DOIs
StatePublished - Sep 10 2015

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Barrett Esophagus
Adenocarcinoma
Confidence Intervals
Pathologists
Biopsy

ASJC Scopus subject areas

  • Gastroenterology

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Inter-Observer Agreement among Pathologists Using Wide-Area Transepithelial Sampling with Computer-Assisted Analysis in Patients with Barrett's Esophagus. / Vennalaganti, Prashanth R.; Naag Kanakadandi, Vijay; Gross, Seth A.; Parasa, Sravanthi; Wang, Kenneth Ke Ning; Gupta, Neil; Sharma, Prateek.

In: American Journal of Gastroenterology, Vol. 110, No. 9, 10.09.2015, p. 1257-1260.

Research output: Contribution to journalArticle

Vennalaganti, Prashanth R. ; Naag Kanakadandi, Vijay ; Gross, Seth A. ; Parasa, Sravanthi ; Wang, Kenneth Ke Ning ; Gupta, Neil ; Sharma, Prateek. / Inter-Observer Agreement among Pathologists Using Wide-Area Transepithelial Sampling with Computer-Assisted Analysis in Patients with Barrett's Esophagus. In: American Journal of Gastroenterology. 2015 ; Vol. 110, No. 9. pp. 1257-1260.
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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.",
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AU - Vennalaganti, Prashanth R.

AU - Naag Kanakadandi, Vijay

AU - Gross, Seth A.

AU - Parasa, Sravanthi

AU - Wang, Kenneth Ke Ning

AU - Gupta, Neil

AU - Sharma, Prateek

PY - 2015/9/10

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N2 - 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.

AB - 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.

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