Reliability of the Roenigk classification of liver damage after methotrexate treatment for psoriasis: a clinicopathologic study of 160 liver biopsy specimens.
OBJECTIVE
To determine the interobserver reliability of the Roenigk score as a classification system of liver damage and its possible consequences for clinical practice.


METHODS
Retrospective study.


METHODS
Academic research. Patients One hundred sixty liver biopsy specimens from patients with psoriasis receiving methotrexate treatment were rereviewed and analyzed blindly by an experienced pathologist with an interest in liver pathologic conditions. Main Outcome Measure Interobserver variation was evaluated using kappa statistics.


RESULTS
A high concordance was present in the evaluation of the Roenigk grade of fibrosis (weighted kappa = 0.73; 95% confidence interval, 0.63-0.83). Agreement was good regarding the number of biopsy specimens for patients whose clinical management should be changed (kappa = 0.71; 95% confidence interval, 0.56-0.87). Conclusion The Roenigk classification in the assessment of liver fibrosis is a reliable scoring system.
Berends
Maartje A M
MA
Department of Dermatology, Radboud University Nijmegen Medical Centre, PO Box 9101, 6525 GL Nijmegen, The Netherlands. m.berends@derma.umcn.nl.
van Oijen
Martijn G H
MG
Snoek
Josje
J
van de Kerkhof
Peter C M
PC
Drenth
Joost P H
JP
Han van Krieken
J
J
de Jong
Elke M G J
EM
D001706:Biopsy; D056486:Chemical and Drug Induced Liver Injury; D003879:Dermatologic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology; D008107:Liver Diseases / Q000145:classification / Q000473:pathology*; D008297:Male; D008727:Methotrexate / Q000009:adverse effects* / Q000627:therapeutic use; D011565:Psoriasis / Q000188:drug therapy*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016037:Single-Blind Method
D003879:Dermatologic Agents; D008727:Methotrexate