title: Interobserver Agreement Using Histological Scoring of the Canine Liver.
abstract: BACKGROUND
  Grading schemes for the assessment of hepatic fibrosis and necroinflammatory activity in humans previously have been applied to dogs with chronic hepatitis. Interobserver agreement is a desirable characteristic for any histological scoring scheme.
  
  
  OBJECTIVE
  To assess interobserver agreement associated with pathologists using a previously published histological scoring scheme to assess hepatic fibrosis and necroinflammatory activity in dogs and to compare fibrosis scores assigned to serial sections stained with hematoxylin & eosin (H&E) and picrosirius red.
  
  
  METHODS
  Histological sections of liver from 50 dogs with variable degrees of hepatic fibrosis and necroinflammatory activity were selected from institutional tissue archives.
  
  
  METHODS
  Six board-certified veterinary anatomic pathologists assigned fibrosis and necroinflammatory activity scores to the histological sections. The multiuser kappa statistic was calculated to assess interobserver agreement. Fibrosis stage assigned to serial sections stained with picrosirius red and H&E was compared using the Wilcoxon signed-rank test.
  
  
  RESULTS
  Multiuser kappa statistics for assessment of fibrosis and necroinflammatory activity from H&E-stained sections were 0.35 and 0.16, respectively. There was no difference in median fibrosis scores assigned to serial section stained with H&E and picrosirius red (P = .248).
  
  
  CONCLUSIONS
  There was fair interobserver agreement when pathologists assessed fibrosis and poor agreement when they assessed necroinflammatory activity. This suboptimal agreement must be taken into account by clinicians making decisions based on histology reports of the liver and in the design of studies evaluating these findings. To decrease this variability, ideally >1 pathologist should evaluate each section.
authors.affiliation: Gastrointestinal Laboratory, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX.
authors.forename: J A
authors.identifier: http://orcid.org/0000-0001-5107-4577
authors.initials: JA
authors.lastname: Lidbury
authors.affiliation: Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX.
authors.forename: A
authors.initials: A
authors.lastname: Rodrigues Hoffmann
authors.affiliation: Department of Veterinary Integrative Biosciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX.
authors.forename: R
authors.initials: R
authors.lastname: Ivanek
authors.affiliation: North Carolina College of Veterinary Medicine, North Carolina State University, Raleigh, NC.
authors.forename: J M
authors.initials: JM
authors.lastname: Cullen
authors.affiliation: Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX.
authors.forename: B F
authors.initials: BF
authors.lastname: Porter
authors.affiliation: Antech Diagnostics, College Station, TX.
authors.forename: F
authors.initials: F
authors.lastname: Oliveira
authors.affiliation: Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA.
authors.forename: T J
authors.initials: TJ
authors.lastname: Van Winkle
authors.affiliation: Department of Pathobiology, Faculty of Veterinary Medicine, University of Utrecht, Utrecht, The Netherlands.
authors.forename: G C
authors.initials: GC
authors.lastname: Grinwis
authors.affiliation: Gastrointestinal Laboratory, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX.
authors.forename: J S
authors.initials: JS
authors.lastname: Sucholdolski
authors.affiliation: Gastrointestinal Laboratory, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX.
authors.forename: J M
authors.initials: JM
authors.lastname: Steiner
mesh_terms: D000818:Animals; D004283:Dog Diseases / Q000473:pathology*; D004285:Dogs; D005355:Fibrosis; D006520:Hepatitis, Animal / Q000473:pathology; D006801:Humans; D008099:Liver / Q000473:pathology*; D015588:Observer Variation; D010341:Pathology, Veterinary / Q000592:standards / Q000706:statistics & numerical data
keywords: Chronic hepatitis; Dog; Hepatic fibrosis; histological scoring