SynthesisAnnals of medicine2022
Systematic review of accuracy of reporting of Congo red-stained amyloid in 2010-2020 compared with earlier.
Synthesis in Annals of medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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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.
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Who cites it
3 citing papers in PubMed.
- Shadowless amyloid imaging with quantitative birefringence contrast.Scientific reports · 2025Article
- Article
- The evaluation of Congo red staining combined with fluorescence microscopy in the diagnosis of primary cutaneous amyloidosis.The Journal of dermatology · 2025Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlmost always, Congo red-stained amyloid between polariser and analyser is said to show "green birefringence" or "apple-green birefringence". In 2010, we found that not all published images showed green, and not all that did showed only green. This systematic review of more recent papers was to find if there had been any improvement in the accuracy of reporting. MATERIALS AND
methodsMEDLINE was searched on 15 March 2021 for papers published between 2010 and 2020 inclusive mentioning amyloid and Congo red. These were examined for descriptions of colours, which were compared with images. Papers were searched for mentions of anomalous colours, errors in physical optics, and misquotation of references about polarisation.
resultsIn 374 papers, there were 444 descriptions of colours, with 511 images in 257 papers. The commonest descriptions were apple-green, 249
conclusionsThere is widespread and increasing inaccuracy of reporting of colours seen in Congo red-stained amyloid. People persist in saying "green birefringence" or "apple-green birefringence", even when no green is seen, or there are also other colours. Few appear to appreciate that the other colours are genuine, respectable, and helpful, the physical optical principles that explain the colours are now understood, and the best expression to use is anomalous colours.KEY MESSAGE"Green birefringence" and "apple-green birefringence" are inappropriate terms to describe the findings in amyloid stained with Congo red and examined between crossed polariser and analyser, because green is not always seen, and even when it is, other colours are commonly seen as well. The proportions of colour images showing any green and green alone, and the proportion of descriptions that agreed with illustrated colours, significantly decreased in 2010-2020 compared with earlier. The most appropriate and scientific description of the findings is anomalous colours.
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