Variations in histopathological evaluation of nonneoplastic colonic mucosal abnormalities; assessment and clinical significance

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Abstract
The variation between 3 pathologists examining histological features seen in non-neoplastic colonic mucosa from 40 biopsies was analyzed. Several procedures to express to observer variation were used and compared, with emphasis on kappa statistics. Only 5 features, the presence of ulceration, villous surface, epithelioid granulomas, severe mucus depletion and crypt abscesses were sufficiently reproducibly by the 3 pairs of pathologists. Other criteria used for the classification of inflammatory bowel disease are apparently potentially unsatisfactory. When results from different studies on biopsies are being compared, influence of observer variation should be identified. Comparison of statistical techniques showed overall variation to be less useful than other statistical procedures. There was little difference between results from kappa statistics and other measures of agreement (overall agreement excluded).