title: Reliability, reproducibility and variability of the traditional Histologic/Histochemical Grading System vs the new OARSI Osteoarthritis Cartilage Histopathology Assessment System.
abstract: OBJECTIVE
  For many years, the Histologic/Histochemical Grading System (HHGS) for osteoarthritis monitoring has been used as a histological scoring system for the quality of cartilage. There are, however, some limitations using this grading system. The goal of the investigation presented in this paper was to examine the hypothesized advantage of the recently introduced Osteoarthritis Research Society International (OARSI) Cartilage Histopathology Assessment System (OOCHAS) as compared to the most frequently used HHGS by means of reliability, reproducibility, and variability evaluation as well as the correlation analysis between the two systems in goat knee articular cartilage.
  
  
  METHODS
  Nine hundred and thirty-six sections of Dutch Milk goat articular knee cartilage were scored using light microscopy. Three observers applied the HHGS for all sections and subsequently, the OOCHAS. The same scoring procedure was repeated after a minimum interval of 1 week. For each system the reliability, reproducibility and variability as well as the correlation between both systems were determined.
  
  
  RESULTS
  The reliability of the OOCHAS was higher as compared to the HHGS. Both the HHGS as well the OOCHAS have an excellent intra- and inter-observer reproducibility and variability and a good positive correlation between the scores.
  
  
  CONCLUSIONS
  Although the HHGS has proven to be an excellent tool for histological scoring of cartilage quality, we recommend the OOCHAS as the premium choice while stressing the importance of further research investigating the correlation of the histological results to macroscopic and biochemical parameters.
authors.affiliation: Department of Orthopaedics, University Medical Center Utrecht, The Netherlands.
authors.forename: R J H
authors.initials: RJ
authors.lastname: Custers
authors.forename: L B
authors.initials: LB
authors.lastname: Creemers
authors.forename: A J
authors.initials: AJ
authors.lastname: Verbout
authors.forename: M H P
authors.initials: MH
authors.lastname: van Rijen
authors.forename: W J A
authors.initials: WJ
authors.lastname: Dhert
authors.forename: D B F
authors.initials: DB
authors.lastname: Saris
mesh_terms: D000818:Animals; D002358:Cartilage, Articular / Q000473:pathology*; D005260:Female; D006041:Goats; D006651:Histocytochemistry; D007719:Knee Joint / Q000473:pathology*; D015588:Observer Variation; D020370:Osteoarthritis, Knee / Q000145:classification / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity