ArticleAmerican journal of clinical pathology2017
Interobserver Variability in Histologic Evaluation of Liver Fibrosis Using Categorical and Quantitative Scores.
Article in American journal of clinical pathology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
35 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Diagnostic accuracy and clinical impact of MRI-based technologies for patients with non-alcoholic fatty liver disease: systematic review and economic evaluation.Health technology assessment (Winchester, England) · 2023Pooled it
- Incidence of Complications from Percutaneous Biopsy in Chronic Liver Disease: A Systematic Review and Meta-Analysis.Digestive diseases and sciences · 2022Pooled it
- Tertiary lymphoid structures in gastrointestinal cancer: orchestrating tumour microenvironmental immune subcycles to elegantly amplify the cancer immunity cycle.Annals of medicine · 2026Review
- European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) steatotic liver disease special interest group position paper on screening, diagnosis and investigation of paediatric metabolic dysfunction-associated steatotic liver disease.Journal of pediatric gastroenterology and nutrition · 2026Article
- Artificial intelligence in small tissue biopsies: diagnostic applications, histochemical integration, and methodological challenges in surgical pathology.Histochemistry and cell biology · 2026Review
- Multi-threshold analysis of the ELF Test versus histology for prognostication of disease progression and regression in MASH.Hepatology communications · 2026Article
- The Gut-Liver Axis in Metabolic Dysfunction-Associated Steatotic Liver Disease: From Mechanistic Insights to Precision Therapeutics.FASEB journal : official publication of the Federation of American Societies for Experimental Biology · 2026Review
- Translational photoacoustic and ultrasound imaging catheter for characterizing gastrointestinal inflammation and fibrosis: a study with a pig modelBiomedical optics express · 2026Article
- The Relationship Between Non-Invasive Tests and Digital Pathology for Quantifying Liver Fibrosis in MASLD.Diagnostics (Basel, Switzerland) · 2025Article
- Serological proteomic characterization for monitoring liver fibrosis regression in chronic hepatitis B patients on treatment.Nature communications · 2025Article
- Effect of liver biopsy size on MASLD fibrosis assessment by second-harmonic generation/two-photon excitation fluorescence microscopy.JHEP reports : innovation in hepatology · 2025Article
- Digital Pathology Quantification of the Continuum of Cirrhosis Severity in Human Liver Biopsies.Liver international : official journal of the International Association for the Study of the Liver · 2025Article
- Therapeutic Strategies for MASH: An Update on Drug Candidates Under Investigation in Late-Phase Clinical Trials.International journal of translational medicine (Basel, Switzerland) · 2025Article
- Liver fibrosis classification on trichrome histology slides using weakly supervised learning in children and young adults.Journal of pathology informatics · 2025Article
- Clinical validation of an AI-based pathology tool for scoring of metabolic dysfunction-associated steatohepatitis.Nature medicine · 2025Article
- Comparison of 2D Shear Wave Elastography and Transient Elastography in Non-Invasive Evaluation of Liver Fibrosis in Hepatitis C Virus-Related Chronic Liver Disease.Journal of clinical medicine · 2024Article
- Hepatic T-cell senescence and exhaustion are implicated in the progression of fatty liver disease in patients with type 2 diabetes and mouse model with nonalcoholic steatohepatitis.Cell death & disease · 2023Article
- Clinical characteristics and management of patients with nonalcoholic steatohepatitis in a real-world setting: analysis of the Ipsos NASH therapy monitor database.BMC gastroenterology · 2023Observational
- Automated whole slide image analysis for a translational quantification of liver fibrosis.Scientific reports · 2022Article
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Authors and funding
10 authors.
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Abstract
Objectives: The aim of the study was to investigate the interobserver agreement for categorical and quantitative scores of liver fibrosis. Methods: Sixty-five consecutive biopsy specimens from patients with mixed liver disease etiologies were assessed by three pathologists using the Ishak and nonalcoholic steatohepatitis Clinical Research Network (NASH CRN) scoring systems, and the fibrosis area (collagen proportionate area [CPA]) was estimated by visual inspection (visual-CPA). A subset of 20 biopsy specimens was analyzed using digital imaging analysis (DIA) for the measurement of CPA (DIA-CPA). Results: The bivariate weighted κ between any two pathologists ranged from 0.57 to 0.67 for Ishak staging and from 0.47 to 0.57 for the NASH CRN staging. Bland-Altman analysis showed poor agreement between all possible pathologist pairings for visual-CPA but good agreement between all pathologist pairings for DIA-CPA. There was good agreement between the two pathologists who assessed biopsy specimens by visual-CPA and DIA-CPA. The intraclass correlation coefficient, which is equivalent to the κ statistic for continuous variables, was 0.78 for visual-CPA and 0.97 for DIA-CPA. Conclusions: These results suggest that DIA-CPA is the most robust method for assessing liver fibrosis followed by visual-CPA. Categorical scores perform less well than both the quantitative CPA scores assessed here.
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