Reliability for Grading Acute Rejection and Airway Inflammation After Lung Transplantation
The Lung Rejection Study Group (LRSG) created a scheme for grading acute allograft rejection in 1990 and then revised it in 1996, but virtually no studies have evaluated the reliability of this formulation. This investigation assessed the reliability of the current LRSG system by determining inter-...
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| Veröffentlicht in: | The Journal of heart and lung transplantation 2005-06, Vol.24 (6), p.652-657 |
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| container_title | The Journal of heart and lung transplantation |
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| creator | Chakinala, Murali M. Ritter, Jon Gage, Brian F. Aloush, Aviva A. Hachem, Ramsey H. Lynch, John P. Patterson, G. Alexander Trulock, Elbert P. |
| description | The Lung Rejection Study Group (LRSG) created a scheme for grading acute allograft rejection in 1990 and then revised it in 1996, but virtually no studies have evaluated the reliability of this formulation. This investigation assessed the reliability of the current LRSG system by determining inter- and intrareader agreement for grading transbronchial biopsy samples from lung transplant recipients.
Biopsy samples from a cohort of 204 recipients were reviewed and classified by a single pathologist who was blinded to original interpretations. The “A” and “B” rejection grades from this contemporary review were compared with original grades by the kappa statistic.
For “A” grading, weighted kappa was 0.65 (95% confidence interval [CI] 0.60–0.70) for interreader agreement (
n = 529 specimens) and 0.65 (95% CI 0.53–0.76) for intrareader agreement (
n = 97 specimens). For “B” grading, weighted kappa was 0.26 (95% CI 0.14–0.39) for interreader agreement (
n = 164 specimens) and 0.33 (95% CI 0.15–0.51) for intrareader agreement (
n = 58 specimens).
On the basis of the analysis of the LRSG scheme, “A” grades exhibit very good reliability, but “B” grades have only fair reliability, and steps to improve this shortcoming should be taken. |
| doi_str_mv | 10.1016/j.healun.2004.04.002 |
| format | Article |
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Biopsy samples from a cohort of 204 recipients were reviewed and classified by a single pathologist who was blinded to original interpretations. The “A” and “B” rejection grades from this contemporary review were compared with original grades by the kappa statistic.
For “A” grading, weighted kappa was 0.65 (95% confidence interval [CI] 0.60–0.70) for interreader agreement (
n = 529 specimens) and 0.65 (95% CI 0.53–0.76) for intrareader agreement (
n = 97 specimens). For “B” grading, weighted kappa was 0.26 (95% CI 0.14–0.39) for interreader agreement (
n = 164 specimens) and 0.33 (95% CI 0.15–0.51) for intrareader agreement (
n = 58 specimens).
On the basis of the analysis of the LRSG scheme, “A” grades exhibit very good reliability, but “B” grades have only fair reliability, and steps to improve this shortcoming should be taken.</description><identifier>ISSN: 1053-2498</identifier><identifier>EISSN: 1557-3117</identifier><identifier>DOI: 10.1016/j.healun.2004.04.002</identifier><identifier>PMID: 15949723</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Acute Disease ; Adult ; Biological and medical sciences ; Bronchitis - etiology ; Bronchitis - pathology ; Bronchoscopy ; Cohort Studies ; Female ; Follow-Up Studies ; Graft Rejection - etiology ; Graft Rejection - pathology ; Humans ; Lung Transplantation - adverse effects ; Male ; Medical sciences ; Middle Aged ; Observer Variation ; Reproducibility of Results ; Severity of Illness Index ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the heart</subject><ispartof>The Journal of heart and lung transplantation, 2005-06, Vol.24 (6), p.652-657</ispartof><rights>2005 International Society for Heart and Lung Transplantation</rights><rights>2005 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c390t-996092d99498092216eb6cb9d5bc7e9646b7957562e125661def622e12c551bc3</citedby><cites>FETCH-LOGICAL-c390t-996092d99498092216eb6cb9d5bc7e9646b7957562e125661def622e12c551bc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.healun.2004.04.002$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16908935$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15949723$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chakinala, Murali M.</creatorcontrib><creatorcontrib>Ritter, Jon</creatorcontrib><creatorcontrib>Gage, Brian F.</creatorcontrib><creatorcontrib>Aloush, Aviva A.</creatorcontrib><creatorcontrib>Hachem, Ramsey H.</creatorcontrib><creatorcontrib>Lynch, John P.</creatorcontrib><creatorcontrib>Patterson, G. Alexander</creatorcontrib><creatorcontrib>Trulock, Elbert P.</creatorcontrib><title>Reliability for Grading Acute Rejection and Airway Inflammation After Lung Transplantation</title><title>The Journal of heart and lung transplantation</title><addtitle>J Heart Lung Transplant</addtitle><description>The Lung Rejection Study Group (LRSG) created a scheme for grading acute allograft rejection in 1990 and then revised it in 1996, but virtually no studies have evaluated the reliability of this formulation. This investigation assessed the reliability of the current LRSG system by determining inter- and intrareader agreement for grading transbronchial biopsy samples from lung transplant recipients.
Biopsy samples from a cohort of 204 recipients were reviewed and classified by a single pathologist who was blinded to original interpretations. The “A” and “B” rejection grades from this contemporary review were compared with original grades by the kappa statistic.
For “A” grading, weighted kappa was 0.65 (95% confidence interval [CI] 0.60–0.70) for interreader agreement (
n = 529 specimens) and 0.65 (95% CI 0.53–0.76) for intrareader agreement (
n = 97 specimens). For “B” grading, weighted kappa was 0.26 (95% CI 0.14–0.39) for interreader agreement (
n = 164 specimens) and 0.33 (95% CI 0.15–0.51) for intrareader agreement (
n = 58 specimens).
On the basis of the analysis of the LRSG scheme, “A” grades exhibit very good reliability, but “B” grades have only fair reliability, and steps to improve this shortcoming should be taken.</description><subject>Acute Disease</subject><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Bronchitis - etiology</subject><subject>Bronchitis - pathology</subject><subject>Bronchoscopy</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Graft Rejection - etiology</subject><subject>Graft Rejection - pathology</subject><subject>Humans</subject><subject>Lung Transplantation - adverse effects</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Observer Variation</subject><subject>Reproducibility of Results</subject><subject>Severity of Illness Index</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. 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Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the heart</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chakinala, Murali M.</creatorcontrib><creatorcontrib>Ritter, Jon</creatorcontrib><creatorcontrib>Gage, Brian F.</creatorcontrib><creatorcontrib>Aloush, Aviva A.</creatorcontrib><creatorcontrib>Hachem, Ramsey H.</creatorcontrib><creatorcontrib>Lynch, John P.</creatorcontrib><creatorcontrib>Patterson, G. 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Alexander</au><au>Trulock, Elbert P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Reliability for Grading Acute Rejection and Airway Inflammation After Lung Transplantation</atitle><jtitle>The Journal of heart and lung transplantation</jtitle><addtitle>J Heart Lung Transplant</addtitle><date>2005-06-01</date><risdate>2005</risdate><volume>24</volume><issue>6</issue><spage>652</spage><epage>657</epage><pages>652-657</pages><issn>1053-2498</issn><eissn>1557-3117</eissn><abstract>The Lung Rejection Study Group (LRSG) created a scheme for grading acute allograft rejection in 1990 and then revised it in 1996, but virtually no studies have evaluated the reliability of this formulation. This investigation assessed the reliability of the current LRSG system by determining inter- and intrareader agreement for grading transbronchial biopsy samples from lung transplant recipients.
Biopsy samples from a cohort of 204 recipients were reviewed and classified by a single pathologist who was blinded to original interpretations. The “A” and “B” rejection grades from this contemporary review were compared with original grades by the kappa statistic.
For “A” grading, weighted kappa was 0.65 (95% confidence interval [CI] 0.60–0.70) for interreader agreement (
n = 529 specimens) and 0.65 (95% CI 0.53–0.76) for intrareader agreement (
n = 97 specimens). For “B” grading, weighted kappa was 0.26 (95% CI 0.14–0.39) for interreader agreement (
n = 164 specimens) and 0.33 (95% CI 0.15–0.51) for intrareader agreement (
n = 58 specimens).
On the basis of the analysis of the LRSG scheme, “A” grades exhibit very good reliability, but “B” grades have only fair reliability, and steps to improve this shortcoming should be taken.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>15949723</pmid><doi>10.1016/j.healun.2004.04.002</doi><tpages>6</tpages></addata></record> |
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| subjects | Acute Disease Adult Biological and medical sciences Bronchitis - etiology Bronchitis - pathology Bronchoscopy Cohort Studies Female Follow-Up Studies Graft Rejection - etiology Graft Rejection - pathology Humans Lung Transplantation - adverse effects Male Medical sciences Middle Aged Observer Variation Reproducibility of Results Severity of Illness Index Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the heart |
| title | Reliability for Grading Acute Rejection and Airway Inflammation After Lung Transplantation |
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