ArticleBMJ open gastroenterology2024
CD, or not CD, that is the question: a digital interobserver agreement study in coeliac disease.
Article in BMJ open gastroenterology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- European Society for the Study of Coeliac Disease 2025 Updated Guidelines on the Diagnosis and Management of Coeliac Disease in Adults. Part 1: Diagnostic Approach.United European gastroenterology journal · 2025Guideline
- Evaluation of Novel Immunohistochemical Biomarkers for the Diagnosis of Celiac Disease Demonstrates the Utility of TCRδ Immunostaining.Diagnostics (Basel, Switzerland) · 2026Article
- Evaluating the utility of amino acid similarity-aware kmers to represent TCR repertoires for classification.PLoS computational biology · 2026Article
- Predictive Value of tTG-IgA ≥ 10×ULN for Villous Atrophy in a Romanian Adult Cohort: The Modifying Role of Smoking.Diagnostics (Basel, Switzerland) · 2026Article
- A retrospective analysis of interobserver variability in 356 cases over a period 10 years: Celiac disease.Bioinformation · 2026Article
- Article
- Duodenal Biopsy Audit: Relative Frequency of Diagnoses, Key Words on Request Forms Indicating Severe Pathology, and Potential Diagnoses for Intraepithelial Lymphocytosis, as a Foundation for Developing Artificial Intelligence Diagnostic Approaches.Diagnostics (Basel, Switzerland) · 2025Article
- Article
- Interpretable machine learning-based detection of coeliac disease.BMJ digital health & AI · 2025Article
- The Comparative Pathology Workbench: Interactive visual analytics for biomedical data.Journal of pathology informatics · 2023Article
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Authors and funding
23 authors.
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Abstract
objectiveCoeliac disease (CD) diagnosis generally depends on histological examination of duodenal biopsies. We present the first study analysing the concordance in examination of duodenal biopsies using digitised whole-slide images (WSIs). We further investigate whether the inclusion of immunoglobulin A tissue transglutaminase (IgA tTG) and haemoglobin (Hb) data improves the interobserver agreement of diagnosis.
designWe undertook a large study of the concordance in histological examination of duodenal biopsies using digitised WSIs in an entirely virtual reporting setting. Our study was organised in two phases: in phase 1, 13 pathologists independently classified 100 duodenal biopsies (40 normal; 40 CD; 20 indeterminate enteropathy) in the absence of any clinical or laboratory data. In phase 2, the same pathologists examined the (re-anonymised) WSIs with the inclusion of IgA tTG and Hb data.
resultsWe found the mean probability of two observers agreeing in the absence of additional data to be 0.73 (±0.08) with a corresponding Cohen's kappa of 0.59 (±0.11). We further showed that the inclusion of additional data increased the concordance to 0.80 (±0.06) with a Cohen's kappa coefficient of 0.67 (±0.09).
conclusionWe showed that the addition of serological data significantly improves the quality of CD diagnosis. However, the limited interobserver agreement in CD diagnosis using digitised WSIs, even after the inclusion of IgA tTG and Hb data, indicates the importance of interpreting duodenal biopsy in the appropriate clinical context. It further highlights the unmet need for an objective means of reproducible duodenal biopsy diagnosis, such as the automated analysis of WSIs using artificial intelligence.
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