Effect of Tissue Processing on Assessment of Endoscopic Intestinal Biopsies in Dogs and Cats

M. D. Willard; G. E. Moore; B. D. Denton; M. J. Day; J. Mansell; T. Bilzer; B. Wilcock; M. Gualtieri; D. Olivero; P. Lecoindre; D. C. Twedt; M. G. Collett; E. J. Hall; A. E. Jergens; J. W. Simpson; R. W. Else; R. J. Washabau

doi:10.1111/j.1939-1676.2009.0432.x

Effect of Tissue Processing on Assessment of Endoscopic Intestinal Biopsies in Dogs and Cats

M. D. Willard, G. E. Moore, B. D. Denton, M. J. Day, J. Mansell, T. Bilzer, B. Wilcock, M. Gualtieri, D. Olivero, P. Lecoindre, D. C. Twedt, M. G. Collett, E. J. Hall, A. E. Jergens, J. W. Simpson, R. W. Else, R. J. Washabau

Royal (Dick) School of Veterinary Studies

Research output: Contribution to journal › Article › peer-review

Abstract

Background

Prior studies failed to detect significant association between hypoalbuminemia and small intestinal lesions.

Hypothesis

Use of pictorial templates will enhance consistency of interpathologist interpretation and identification of intestinal lesions associated with hypoalbuminemia.

Animals

Tissues from 62 dogs and 25 cats examined as clinical cases at 7 referral veterinary practices in 4 countries.

Methods

Retrospective, observational study. Histopathology slides from sequential cases undergoing endoscopic biopsy were examined by 4 pathologists by pictorial templates. Changes for 9 microscopic features were recorded as normal, mild, moderate or severe, and 2- and 4-point scales were tested for consistency of interpretation. Logistic regression models determined odds ratios (OR) of histologic lesions being associated with hypoalbuminemia while kappa statistics determined agreement between pathologists on histologic lesions.

Results

There was poor agreement (kappa = -0.013 to 0.3) between pathologists, and institution of origin of slides had effect (kappa = 1.0 for 3 of 4 lesions on slides from Institution 5) on agreement between pathologists on selected histologic features. Using 2 point as opposed to 4-point grading scale increased agreement between pathologists (maximum kappa = 0.69 using 4-point scale versus maximum kappa = 1.0 using 2-point scale). Significant association (P = .019- .04; 95% OR = 3.14-10.84) between lacteal dilation and hypoalbuminemia was found by 3 pathologists.

Conclusions and Clinical Importance

Substantial inconsistency between pathologists remains despite use of pictorial template because of differences in slide processing. Distinguishing between mild and moderate lesions might be important source of the disagreement among pathologists.

Original language	English
Pages (from-to)	84-89
Number of pages	6
Journal	Journal of Veterinary Internal Medicine
Volume	24
Issue number	1
DOIs	https://doi.org/10.1111/j.1939-1676.2009.0432.x
Publication status	Published - 2010

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Willard, M. D., Moore, G. E., Denton, B. D., Day, M. J., Mansell, J., Bilzer, T., Wilcock, B., Gualtieri, M., Olivero, D., Lecoindre, P., Twedt, D. C., Collett, M. G., Hall, E. J., Jergens, A. E., Simpson, J. W., Else, R. W., & Washabau, R. J. (2010). Effect of Tissue Processing on Assessment of Endoscopic Intestinal Biopsies in Dogs and Cats. Journal of Veterinary Internal Medicine, 24(1), 84-89. https://doi.org/10.1111/j.1939-1676.2009.0432.x

@article{a6eb72b4d63e4f339b8acd91373c76ab,

title = "Effect of Tissue Processing on Assessment of Endoscopic Intestinal Biopsies in Dogs and Cats",

abstract = "BackgroundPrior studies failed to detect significant association between hypoalbuminemia and small intestinal lesions.HypothesisUse of pictorial templates will enhance consistency of interpathologist interpretation and identification of intestinal lesions associated with hypoalbuminemia.AnimalsTissues from 62 dogs and 25 cats examined as clinical cases at 7 referral veterinary practices in 4 countries.MethodsRetrospective, observational study. Histopathology slides from sequential cases undergoing endoscopic biopsy were examined by 4 pathologists by pictorial templates. Changes for 9 microscopic features were recorded as normal, mild, moderate or severe, and 2- and 4-point scales were tested for consistency of interpretation. Logistic regression models determined odds ratios (OR) of histologic lesions being associated with hypoalbuminemia while kappa statistics determined agreement between pathologists on histologic lesions.ResultsThere was poor agreement (kappa = -0.013 to 0.3) between pathologists, and institution of origin of slides had effect (kappa = 1.0 for 3 of 4 lesions on slides from Institution 5) on agreement between pathologists on selected histologic features. Using 2 point as opposed to 4-point grading scale increased agreement between pathologists (maximum kappa = 0.69 using 4-point scale versus maximum kappa = 1.0 using 2-point scale). Significant association (P = .019- .04; 95% OR = 3.14-10.84) between lacteal dilation and hypoalbuminemia was found by 3 pathologists.Conclusions and Clinical ImportanceSubstantial inconsistency between pathologists remains despite use of pictorial template because of differences in slide processing. Distinguishing between mild and moderate lesions might be important source of the disagreement among pathologists.",

author = "Willard, {M. D.} and Moore, {G. E.} and Denton, {B. D.} and Day, {M. J.} and J. Mansell and T. Bilzer and B. Wilcock and M. Gualtieri and D. Olivero and P. Lecoindre and Twedt, {D. C.} and Collett, {M. G.} and Hall, {E. J.} and Jergens, {A. E.} and Simpson, {J. W.} and Else, {R. W.} and Washabau, {R. J.}",

year = "2010",

doi = "10.1111/j.1939-1676.2009.0432.x",

language = "English",

volume = "24",

pages = "84--89",

journal = "Journal of Veterinary Internal Medicine",

issn = "0891-6640",

publisher = "Wiley-Blackwell",

number = "1",

}

Willard, MD, Moore, GE, Denton, BD, Day, MJ, Mansell, J, Bilzer, T, Wilcock, B, Gualtieri, M, Olivero, D, Lecoindre, P, Twedt, DC, Collett, MG, Hall, EJ, Jergens, AE, Simpson, JW, Else, RW & Washabau, RJ 2010, 'Effect of Tissue Processing on Assessment of Endoscopic Intestinal Biopsies in Dogs and Cats', Journal of Veterinary Internal Medicine, vol. 24, no. 1, pp. 84-89. https://doi.org/10.1111/j.1939-1676.2009.0432.x

TY - JOUR

T1 - Effect of Tissue Processing on Assessment of Endoscopic Intestinal Biopsies in Dogs and Cats

AU - Willard, M. D.

AU - Moore, G. E.

AU - Denton, B. D.

AU - Day, M. J.

AU - Mansell, J.

AU - Bilzer, T.

AU - Wilcock, B.

AU - Gualtieri, M.

AU - Olivero, D.

AU - Lecoindre, P.

AU - Twedt, D. C.

AU - Collett, M. G.

AU - Hall, E. J.

AU - Jergens, A. E.

AU - Simpson, J. W.

AU - Else, R. W.

AU - Washabau, R. J.

PY - 2010

Y1 - 2010

N2 - BackgroundPrior studies failed to detect significant association between hypoalbuminemia and small intestinal lesions.HypothesisUse of pictorial templates will enhance consistency of interpathologist interpretation and identification of intestinal lesions associated with hypoalbuminemia.AnimalsTissues from 62 dogs and 25 cats examined as clinical cases at 7 referral veterinary practices in 4 countries.MethodsRetrospective, observational study. Histopathology slides from sequential cases undergoing endoscopic biopsy were examined by 4 pathologists by pictorial templates. Changes for 9 microscopic features were recorded as normal, mild, moderate or severe, and 2- and 4-point scales were tested for consistency of interpretation. Logistic regression models determined odds ratios (OR) of histologic lesions being associated with hypoalbuminemia while kappa statistics determined agreement between pathologists on histologic lesions.ResultsThere was poor agreement (kappa = -0.013 to 0.3) between pathologists, and institution of origin of slides had effect (kappa = 1.0 for 3 of 4 lesions on slides from Institution 5) on agreement between pathologists on selected histologic features. Using 2 point as opposed to 4-point grading scale increased agreement between pathologists (maximum kappa = 0.69 using 4-point scale versus maximum kappa = 1.0 using 2-point scale). Significant association (P = .019- .04; 95% OR = 3.14-10.84) between lacteal dilation and hypoalbuminemia was found by 3 pathologists.Conclusions and Clinical ImportanceSubstantial inconsistency between pathologists remains despite use of pictorial template because of differences in slide processing. Distinguishing between mild and moderate lesions might be important source of the disagreement among pathologists.

AB - BackgroundPrior studies failed to detect significant association between hypoalbuminemia and small intestinal lesions.HypothesisUse of pictorial templates will enhance consistency of interpathologist interpretation and identification of intestinal lesions associated with hypoalbuminemia.AnimalsTissues from 62 dogs and 25 cats examined as clinical cases at 7 referral veterinary practices in 4 countries.MethodsRetrospective, observational study. Histopathology slides from sequential cases undergoing endoscopic biopsy were examined by 4 pathologists by pictorial templates. Changes for 9 microscopic features were recorded as normal, mild, moderate or severe, and 2- and 4-point scales were tested for consistency of interpretation. Logistic regression models determined odds ratios (OR) of histologic lesions being associated with hypoalbuminemia while kappa statistics determined agreement between pathologists on histologic lesions.ResultsThere was poor agreement (kappa = -0.013 to 0.3) between pathologists, and institution of origin of slides had effect (kappa = 1.0 for 3 of 4 lesions on slides from Institution 5) on agreement between pathologists on selected histologic features. Using 2 point as opposed to 4-point grading scale increased agreement between pathologists (maximum kappa = 0.69 using 4-point scale versus maximum kappa = 1.0 using 2-point scale). Significant association (P = .019- .04; 95% OR = 3.14-10.84) between lacteal dilation and hypoalbuminemia was found by 3 pathologists.Conclusions and Clinical ImportanceSubstantial inconsistency between pathologists remains despite use of pictorial template because of differences in slide processing. Distinguishing between mild and moderate lesions might be important source of the disagreement among pathologists.

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U2 - 10.1111/j.1939-1676.2009.0432.x

DO - 10.1111/j.1939-1676.2009.0432.x

M3 - Article

VL - 24

SP - 84

EP - 89

JO - Journal of Veterinary Internal Medicine

JF - Journal of Veterinary Internal Medicine

SN - 0891-6640

IS - 1

ER -

Effect of Tissue Processing on Assessment of Endoscopic Intestinal Biopsies in Dogs and Cats

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