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Interobserver variation among histopathologic evaluations of intestinal tissues from dogs and cats

Michael D. Willard DVM, MS, DACVIM1, Albert E. Jergens DVM, MS, DACVIM2, Robert B. Duncan DVM, PhD, DACVP3, Michael S. Leib DVM, MS, DACVIM4, Malcolm D. McCracken DVM, PhD, DACVP5, Robert C. DeNovo DVM, DACVIM6, Rowland G. Helman DVM, PhD, DACVP7, Margaret R. Slater DVM, PhD8, and Jacque L. Harbison MS9
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  • 1 Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843-44744.
  • | 2 Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011.
  • | 3 Department of Pathology, Virginia-Maryland Regional College of Veterinary Medicine, Virginia Tech, Blacksburg, VA 24061.
  • | 4 Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Virginia Tech, Blacksburg, VA 24061.
  • | 5 Department of Pathology, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37901.
  • | 6 Department of Small Animal and Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37901.
  • | 7 Oklahoma Animal Disease Diagnostic Laboratory, Oklahoma State University, Stillwater, OK 74078.
  • | 8 Department of Anatomy and Public Health, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843-44744.
  • | 9 Department of Anatomy and Public Health, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843-44744.

Abstract

Objective—To determine whether substantial interobserver variation exists among diagnostic pathologists for descriptions of intestinal mucosal cell populations and whether histopathologic descriptions accurately predict when a patient does not have clinically evident intestinal disease.

Design—Comparative survey.

Sample Population—14 histologic slides of duodenal, ileal, or colonic tissue from 10 dogs and 3 cats.

Procedure—Each histologic slide was evaluated independently by 5 pathologists at 4 institutions. Pathologists, who had no knowledge of the tissues' origin, indicated whether slides were adequate for histologic evaluation and whether the tissue was normal or abnormal. They also identified the main infiltrating cell type in specimens that were considered abnormal, and whether infiltrates were mild, moderate, severe, or neoplastic.

Results—Quality of all slides was considered adequate or superior by at least 4 of the 5 pathologists. For intensity of mucosal cellular infiltrates, there was uniformity of opinion for 1 slide, near-uniformity for 6 slides, and nonuniformity for 7 slides. Five dogs did not have clinical evidence of intestinal disease, yet the pathologists' descriptions indicated that their intestinal tissue specimens were abnormal.

Conclusions and Clinical Relevance—Substantial interobserver variation was detected. Standardization of pathologic descriptions of intestinal tissue is necessary for meaningful comparisons with published articles. Clinicians must be cautious about correlating clinical signs and histopathologic descriptions of intestinal biopsy specimens. (J Am Vet Med Assoc 2002;220:1177–1182)

Abstract

Objective—To determine whether substantial interobserver variation exists among diagnostic pathologists for descriptions of intestinal mucosal cell populations and whether histopathologic descriptions accurately predict when a patient does not have clinically evident intestinal disease.

Design—Comparative survey.

Sample Population—14 histologic slides of duodenal, ileal, or colonic tissue from 10 dogs and 3 cats.

Procedure—Each histologic slide was evaluated independently by 5 pathologists at 4 institutions. Pathologists, who had no knowledge of the tissues' origin, indicated whether slides were adequate for histologic evaluation and whether the tissue was normal or abnormal. They also identified the main infiltrating cell type in specimens that were considered abnormal, and whether infiltrates were mild, moderate, severe, or neoplastic.

Results—Quality of all slides was considered adequate or superior by at least 4 of the 5 pathologists. For intensity of mucosal cellular infiltrates, there was uniformity of opinion for 1 slide, near-uniformity for 6 slides, and nonuniformity for 7 slides. Five dogs did not have clinical evidence of intestinal disease, yet the pathologists' descriptions indicated that their intestinal tissue specimens were abnormal.

Conclusions and Clinical Relevance—Substantial interobserver variation was detected. Standardization of pathologic descriptions of intestinal tissue is necessary for meaningful comparisons with published articles. Clinicians must be cautious about correlating clinical signs and histopathologic descriptions of intestinal biopsy specimens. (J Am Vet Med Assoc 2002;220:1177–1182)