INTRAOBSERVER AND INTEROBSERVER VARIATION IN THE HISTOPATHOLOGICAL ASSESSMENT OF CHRONIC VIRAL-HEPATITIS

Background/Aims: The way in which liver biopsies showing chronic hepat itis are reported is undergoing re-evaluation, A related question is h ow the inflammatory and fibrotic changes in these liver biopsies can b e semi-quantitatively assessed so that comparisons can be made between groups of patients and the effect of treatment on disease progression studied. Methods: We have carried out a blinded trial in which 20 cas es of chronic viral hepatitis were assessed by five histopathologists, using the Knodell and Scheuer scoring systems (two of the most common ly used systems), on two separate occasions, The results were analysed using Kappa statistics, and also by seeing for how many slides the pa thologists showed no significant disagreement. Results: While both sys tems produced good inter- and intra-observer variation when fibrosis w as assessed the Scheuer system produced slightly higher Kappa values, The Scheuer system produced considerably better agreement when the sev erity of inflammation was examined, A multirater kappa analysis confir med that both systems showed better agreement for fibrosis scores than for inflammation scores. Conclusion: We conclude that, while both sys tems produced reasonable agreement, this was greater using the Scheuer system, When any new scoring system is being developed, the question of reproducibility needs active consideration.