Evidence map›Paper›PMID 33097074›Full record

ArticleDiagnostic pathology2020

Interobserver study on histologic features of idiopathic non-cirrhotic portal hypertension.

Michel Kmeid, Chunlai Zuo, Stephen M Lagana, Won-Tak Choi, Jingmei Lin, Zhaohai Yang, Xiuli Liu, Maria Westerhoff, M Isabel Fiel, Kajsa Affolter and 2 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Diagnostic pathology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.0field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 15 citations in OpenAlex.

  1. Article
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  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 9 institutions in 1 country.

Michel KmeidDepartment of Pathology, Albany Medical Center, 47 New Scotland Ave., MC81, Albany, NY, 12208, USA.
Chunlai ZuoDepartment of Pathology, Albany Medical Center, 47 New Scotland Ave., MC81, Albany, NY, 12208, USA.
Stephen M LaganaDepartment of Pathology, Columbia University, New York, NY, 10032, USA.
Won-Tak ChoiDepartment of Pathology, University of California San Francisco, San Francisco, CA, 94143, USA.
Jingmei LinDepartment of Pathology, Indiana University, Indianapolis, IN, 46202, USA.
Zhaohai YangDepartment of Pathology, University of Pennsylvania, Philadelphia, PA, 19104, USA.
Xiuli LiuDepartment of Pathology, University of Florida at Gainesville, Gainesville, FL, 32608, USA.
Maria WesterhoffDepartment of Pathology, University of Michigan, Ann Arbor, MI, 48109, USA.
M Isabel FielDepartment of Pathology, Mount Sinai Medical Center, New York, NY, 10029, USA.
Kajsa AffolterDepartment of Pathology, University of Utah, Salt Lake City, UT, 84132, USA.
Eun-Young K ChoiDepartment of Pathology, University of Michigan, Ann Arbor, MI, 48109, USA.
Hwajeong LeeDepartment of Pathology, Albany Medical Center, 47 New Scotland Ave., MC81, Albany, NY, 12208, USA. LeeH5@amc.edu.ORCID https://orcid.org/0000-0001-7005-6278
Albany Medical Center Hospital · USUniversity of Michigan · USColumbia University · USIndiana University – Purdue University Indianapolis · USMount Sinai Medical Center · USUniversity of California, San Francisco · USUniversity of Florida · USUniversity of Pennsylvania · USUniversity of Utah · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHistologic features of idiopathic non-cirrhotic portal hypertension (INCPH) may overlap with those without INCPH. Recently, these features have been recognized as part of the larger spectrum of porto-sinusoidal vascular disease (PSVD). We assessed interobserver agreement on histologic features that are commonly associated with INCPH and studied whether a provision of relevant clinical history improves interobserver agreement.

methodsThe examined histologic features include lobular (such as anisocytosis, nodular regeneration, sinusoidal dilatation, increased parenchymal draining veins, and incomplete fibrous septa) and portal tract changes (such as paraportal shunting vessel(s), portal tract remnant, increased number of portal vessels, and obliterative portal venopathy). Thirty-four archived liver samples from patients with (group A) and without (group B) INCPH were retrieved. A total of 90 representative images of lobules (L) and portal tracts (P) were distributed among 9 liver pathologists blinded to true clinical history. Each pathologist answered multiple choice questions based on the absence (Q1) or presence (Q2) of clinical history of portal hypertension. Fleiss' kappa coefficient analysis (unweighted) was performed to assess interobserver agreement on normal versus abnormal diagnosis, in L and P, based on Q1 and Q2.

resultsThe kappa values regarding normal versus abnormal diagnosis were 0.24, 0.24, 0.18 and 0.18 for L-Q1, L-Q2, P-Q1, and P-Q2, respectively. With true clinical history provided, the kappa values were L- 0.32, P-0.17 for group A and L-0.12, P-0.14 for group B. Four pathologists changed their assessments based on the provided history. Interobserver agreement on the interpretation of L and P as normal versus abnormal was slight to fair regardless of provision of clinical history.

conclusionsOur findings indicate that the histologic features of INCPH/PSVD are not limited to patients with portal hypertension and are subject to significant interobserver variation.

Indexed as

AdolescentAdultAgedFemaleHumansHypertension, PortalLiver CirrhosisMaleMiddle AgedObserver VariationPathologistsYoung AdultInterobserverPortal hypertensionPorto-sinusoidal vascular disease

Identifiers

PMID33097074
PMCPMC7583235
OpenAlexW3094124760

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.