دورية أكاديمية
أعرض في EDS

CD, or not CD, that is the question: a digital interobserver agreement study in coeliac disease.

التفاصيل البيبلوغرافية
العنوان: CD, or not CD, that is the question: a digital interobserver agreement study in coeliac disease.
المؤلفون: Denholm J; Department of Pathology, University of Cambridge, Cambridge, UK.; Department of Applied Mathematics and Theoretical Physics, University of Cambridge, Cambridge, UK.; Lyzeum Ltd, Cambridge, UK., Schreiber BA; Department of Pathology, University of Cambridge, Cambridge, UK.; Department of Applied Mathematics and Theoretical Physics, University of Cambridge, Cambridge, UK., Jaeckle F; Department of Pathology, University of Cambridge, Cambridge, UK florian.jaeckle@gmail.com.; Lyzeum Ltd, Cambridge, UK., Wicks MN; Department of Pathology, The University of Edinburgh College of Medicine and Veterinary Medicine, Edinburgh, UK., Benbow EW; Division of Medical Education, The University of Manchester, Manchester, UK.; Department of Histopathology, Manchester University NHS Foundation Trust, Manchester, UK., Bracey TS; Department of Diagnostic and Molecular Pathology, Royal Cornwall Hospitals NHS Trust, Truro, UK.; University Hospitals Plymouth NHS Trust, Plymouth, UK., Chan JYH; Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK., Farkas L; Department of Pathology, Akershus University Hospital, Nordbyhagen, Norway.; Institute of Clinical Medicine, University of Oslo, Nordbyhagen, Norway., Fryer E; Department of Cellular Pathology, Oxford University Hospitals NHS foundation Trust, Oxford, UK., Gopalakrishnan K; Department of Histopathology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK., Hughes CA; Department of Cellular Pathology, Oxford University Hospitals NHS foundation Trust, Oxford, UK., Kirkwood KJ; Department of Pathology, Western General Hospital, Edinburgh, UK., Langman G; Department of Cellular Pathology, Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK., Mahler-Araujo B; Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.; MRC Institute of Metabolic Science, Wellcome Trust, Cambridge, UK., McMahon RFT; Division of Medical Education, The University of Manchester, Manchester, UK.; Department of Histopathology, Manchester University NHS Foundation Trust, Manchester, UK., Myint KW; Department of Pathology, Queen Elizabeth University Hospital, Glasgow, UK., Natu S; University Hospital of North Tees, North Tees and Hartlepool NHS Foundation Trust, Stockton on Tees, UK., Robinson A; Department of Histopathology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK., Sanduka A; Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK., Sheppard KA; Department of Cellular Pathology, Oxford University Hospitals NHS foundation Trust, Oxford, UK., Tsang YW; Department of Histopathology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK., Arends MJ; Division of Pathology, University of Edinburgh, Edinburgh, UK., Soilleux EJ; Department of Pathology, University of Cambridge, Cambridge, UK.; Lyzeum Ltd, Cambridge, UK.
المصدر: BMJ open gastroenterology [BMJ Open Gastroenterol] 2024 Feb 01; Vol. 11 (1). Date of Electronic Publication: 2024 Feb 01.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BMJ Publishing Group Ltd & British Society of Gastroenterology Country of Publication: England NLM ID: 101660690 Publication Model: Electronic Cited Medium: Print ISSN: 2054-4774 (Print) Linking ISSN: 20544774 NLM ISO Abbreviation: BMJ Open Gastroenterol Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [London] : BMJ Publishing Group Ltd & British Society of Gastroenterology, [2014]-
مواضيع طبية MeSH: Celiac Disease*/diagnosis, Humans ; Transglutaminases ; Artificial Intelligence ; Observer Variation ; Immunoglobulin A
مستخلص: Objective: Coeliac disease (CD) diagnosis generally depends on histological examination of duodenal biopsies. We present the first study analysing the concordance in examination of duodenal biopsies using digitised whole-slide images (WSIs). We further investigate whether the inclusion of immunoglobulin A tissue transglutaminase (IgA tTG) and haemoglobin (Hb) data improves the interobserver agreement of diagnosis.
Design: We undertook a large study of the concordance in histological examination of duodenal biopsies using digitised WSIs in an entirely virtual reporting setting. Our study was organised in two phases: in phase 1, 13 pathologists independently classified 100 duodenal biopsies (40 normal; 40 CD; 20 indeterminate enteropathy) in the absence of any clinical or laboratory data. In phase 2, the same pathologists examined the (re-anonymised) WSIs with the inclusion of IgA tTG and Hb data.
Results: We found the mean probability of two observers agreeing in the absence of additional data to be 0.73 (±0.08) with a corresponding Cohen's kappa of 0.59 (±0.11). We further showed that the inclusion of additional data increased the concordance to 0.80 (±0.06) with a Cohen's kappa coefficient of 0.67 (±0.09).
Conclusion: We showed that the addition of serological data significantly improves the quality of CD diagnosis. However, the limited interobserver agreement in CD diagnosis using digitised WSIs, even after the inclusion of IgA tTG and Hb data, indicates the importance of interpreting duodenal biopsy in the appropriate clinical context. It further highlights the unmet need for an objective means of reproducible duodenal biopsy diagnosis, such as the automated analysis of WSIs using artificial intelligence.
Competing Interests: Competing interests: ES and MS are shareholders in Lyzeum Ltd, by whom JD was employed at the time of this work.
(© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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فهرسة مساهمة: Keywords: COELIAC DISEASE; GLUTEN SENSITIVE ENTEROPATHY; HISTOPATHOLOGY; MEDICAL STATISTICS; SMALL INTESTINAL BIOPSY
المشرفين على المادة: EC 2.3.2.13 (Transglutaminases)
0 (Immunoglobulin A)
تواريخ الأحداث: Date Created: 20240201 Date Completed: 20240205 Latest Revision: 20240218
رمز التحديث: 20240218
مُعرف محوري في PubMed: PMC10870791
DOI: 10.1136/bmjgast-2023-001252
PMID: 38302475
قاعدة البيانات: MEDLINE
الوصف
تدمد:2054-4774
DOI:10.1136/bmjgast-2023-001252