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- W2899849069 abstract "To the Editor.—We were interested to read the paper by Brcic and colleagues1 in the Archives of Pathology & Laboratory Medicine. The authors aimed to determine the interobserver and intraobserver reproducibility in the histologic differentiation among the main types of malignant pleural mesothelioma (MPM), and in further subtyping of epithelioid MPM.1 One representative hematoxylin-eosin–stained slide was selected from the archive for each of 200 patients with MPM. The slides were reviewed independently by 3 pathologists and classified according to the current World Health Organization classification of pleural tumors. The interobserver and intraobserver agreement was interpreted using the Cohen κ statistic. Based on their results, the overall interobserver agreement for histologic subtyping of mesothelioma was fair (κ = 0.36) and the agreement was increased to substantial (κ = 0.63) in the second round; therefore, improvement was found in interobserver agreement for all types of MPM and for most epithelioid subtypes.1Knowing that there is no value of κ that is internationally a sign of good agreement is of great importance. The κ value to assess the agreement of a qualitative variable has 2 weaknesses, as follows. First, it depends on the prevalence in each category. In other words, it is possible to have different κ values with the same percentage for both concordant and discordant cells! In the Table, in both situations (a) and (b), concordant (agreement) and discordant (disagreement) cells have prevalences of 90% and 10%, respectively; however, we get different κ values (0.44, moderate, and 0.80, very good). The κ value is also dependent on the number of categories.2–6 In such a situation, especially having more than 2 observers, our suggestion is to apply weighted or Fleiss κ because the mentioned estimates provide us unbiased results.2–8Brcic et al1 concluded that the moderate to substantial agreement in histologic typing and subtyping of MPM can be achieved. Such a conclusion should be supported by the above-mentioned statistical and methodologic issues.2–8In this letter, the limitations of the κ value to assess reliability are mentioned." @default.
- W2899849069 created "2018-11-16" @default.
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- W2899849069 date "2018-11-01" @default.
- W2899849069 modified "2023-09-27" @default.
- W2899849069 title "Reproducibility of Malignant Pleural Mesothelioma Histopathologic Subtyping: Methodologic Issue" @default.
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- W2899849069 doi "https://doi.org/10.5858/arpa.2018-0154-le" @default.
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