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Interobserver agreement for Polyomavirus nephropathy grading in renal allografts using the working proposal from the 10th Banff Conference on Allograft Pathology
Summary A classification schema for grading Polyomavirus nephropathy was proposed at the 2009 Banff allograft meeting. The schema included 3 stages of Polyomavirus nephropathy: early (stage A), florid (stage B), and late sclerosing (stage C). Grading categories for histologic viral load levels were...
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| Published in: | Human pathology 2011-12, Vol.42 (12), p.2018-2024 |
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| container_title | Human pathology |
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| creator | Sar, Aylin, MD Worawichawong, Suchin, MD Benediktsson, Hallgrimur, MD Zhang, Jianguo, MSc Yilmaz, Serdar, MD Trpkov, Kiril, MD |
| description | Summary A classification schema for grading Polyomavirus nephropathy was proposed at the 2009 Banff allograft meeting. The schema included 3 stages of Polyomavirus nephropathy: early (stage A), florid (stage B), and late sclerosing (stage C). Grading categories for histologic viral load levels were also proposed. To examine the applicability and the interobserver agreement of the proposed Polyomavirus nephropathy grading schema, we evaluated 24 renal allograft biopsies with confirmed Polyomavirus nephropathy by histology and SV40. Four renal pathologists independently scored the Polyomavirus nephropathy stage (A, B, or C), without knowledge of the clinical history. Viral load was scored as a percent of tubules exhibiting viral replication, using either a 3-tier viral load score (1: ≤1%; 2: >1%-10%; 3: >10%) or a 4-tier score (1: ≤1%; 2: >1%-≤5%; 3: >5%-15%; 4: >15%). The κ score for the Polyomavirus nephropathy stage was 0.47 (95% confidence interval, 0.35-0.60; P < .001). There was a substantial agreement using both the 3-tier and the 4-tier scoring for the viral load (Kendall concordance coefficients, 0.72 and 0.76, respectively; P < .001 for both). A better complete agreement was found using the 3-tier viral load score. In this first attempt to evaluate the interobserver reproducibility of the proposed Polyomavirus nephropathy classifying schema, we demonstrated moderate κ agreement in assessing the Polyomavirus nephropathy stage and a substantial agreement in scoring the viral load level. The proposed grading schema can be applied in routine allograft biopsy practice for grading the Polyomavirus nephropathy stage and the viral load level. |
| doi_str_mv | 10.1016/j.humpath.2011.03.008 |
| format | article |
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The schema included 3 stages of Polyomavirus nephropathy: early (stage A), florid (stage B), and late sclerosing (stage C). Grading categories for histologic viral load levels were also proposed. To examine the applicability and the interobserver agreement of the proposed Polyomavirus nephropathy grading schema, we evaluated 24 renal allograft biopsies with confirmed Polyomavirus nephropathy by histology and SV40. Four renal pathologists independently scored the Polyomavirus nephropathy stage (A, B, or C), without knowledge of the clinical history. Viral load was scored as a percent of tubules exhibiting viral replication, using either a 3-tier viral load score (1: ≤1%; 2: >1%-10%; 3: >10%) or a 4-tier score (1: ≤1%; 2: >1%-≤5%; 3: >5%-15%; 4: >15%). The κ score for the Polyomavirus nephropathy stage was 0.47 (95% confidence interval, 0.35-0.60; P < .001). There was a substantial agreement using both the 3-tier and the 4-tier scoring for the viral load (Kendall concordance coefficients, 0.72 and 0.76, respectively; P < .001 for both). A better complete agreement was found using the 3-tier viral load score. In this first attempt to evaluate the interobserver reproducibility of the proposed Polyomavirus nephropathy classifying schema, we demonstrated moderate κ agreement in assessing the Polyomavirus nephropathy stage and a substantial agreement in scoring the viral load level. The proposed grading schema can be applied in routine allograft biopsy practice for grading the Polyomavirus nephropathy stage and the viral load level.</description><identifier>ISSN: 0046-8177</identifier><identifier>EISSN: 1532-8392</identifier><identifier>DOI: 10.1016/j.humpath.2011.03.008</identifier><identifier>PMID: 21733554</identifier><identifier>CODEN: HPCQA4</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>2009 Banff ; Adolescent ; Adult ; Aged ; Agreements ; Biological and medical sciences ; Biopsy ; BK virus ; Child ; Classification ; Female ; Graft Rejection - classification ; Graft Rejection - drug therapy ; Graft Rejection - pathology ; Graft Rejection - virology ; Humans ; Infectious diseases ; Interobserver agreement ; Investigative techniques, diagnostic techniques (general aspects) ; Kidney - pathology ; Kidney - virology ; Kidney Diseases - classification ; Kidney Diseases - drug therapy ; Kidney Diseases - pathology ; Kidney Diseases - virology ; Kidney Transplantation - pathology ; Male ; Medical sciences ; Middle Aged ; Observer Variation ; Pathology ; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques ; Polyomavirus ; Polyomavirus - physiology ; Polyomavirus Infections - classification ; Polyomavirus Infections - drug therapy ; Polyomavirus Infections - pathology ; Polyomavirus nephropathy ; Reproducibility of Results ; Retrospective Studies ; Transplantation, Homologous - pathology ; Tumor Virus Infections - classification ; Tumor Virus Infections - drug therapy ; Tumor Virus Infections - pathology ; Viral diseases ; Viral Load ; Virus Replication ; κ statistic</subject><ispartof>Human pathology, 2011-12, Vol.42 (12), p.2018-2024</ispartof><rights>Elsevier Inc.</rights><rights>2011 Elsevier Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c543t-db2c041a62a8e1893fe71aa767098608474878c495643197e8ced234522570b83</citedby><cites>FETCH-LOGICAL-c543t-db2c041a62a8e1893fe71aa767098608474878c495643197e8ced234522570b83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25244531$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21733554$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sar, Aylin, MD</creatorcontrib><creatorcontrib>Worawichawong, Suchin, MD</creatorcontrib><creatorcontrib>Benediktsson, Hallgrimur, MD</creatorcontrib><creatorcontrib>Zhang, Jianguo, MSc</creatorcontrib><creatorcontrib>Yilmaz, Serdar, MD</creatorcontrib><creatorcontrib>Trpkov, Kiril, MD</creatorcontrib><title>Interobserver agreement for Polyomavirus nephropathy grading in renal allografts using the working proposal from the 10th Banff Conference on Allograft Pathology</title><title>Human pathology</title><addtitle>Hum Pathol</addtitle><description>Summary A classification schema for grading Polyomavirus nephropathy was proposed at the 2009 Banff allograft meeting. The schema included 3 stages of Polyomavirus nephropathy: early (stage A), florid (stage B), and late sclerosing (stage C). Grading categories for histologic viral load levels were also proposed. To examine the applicability and the interobserver agreement of the proposed Polyomavirus nephropathy grading schema, we evaluated 24 renal allograft biopsies with confirmed Polyomavirus nephropathy by histology and SV40. Four renal pathologists independently scored the Polyomavirus nephropathy stage (A, B, or C), without knowledge of the clinical history. Viral load was scored as a percent of tubules exhibiting viral replication, using either a 3-tier viral load score (1: ≤1%; 2: >1%-10%; 3: >10%) or a 4-tier score (1: ≤1%; 2: >1%-≤5%; 3: >5%-15%; 4: >15%). The κ score for the Polyomavirus nephropathy stage was 0.47 (95% confidence interval, 0.35-0.60; P < .001). There was a substantial agreement using both the 3-tier and the 4-tier scoring for the viral load (Kendall concordance coefficients, 0.72 and 0.76, respectively; P < .001 for both). A better complete agreement was found using the 3-tier viral load score. In this first attempt to evaluate the interobserver reproducibility of the proposed Polyomavirus nephropathy classifying schema, we demonstrated moderate κ agreement in assessing the Polyomavirus nephropathy stage and a substantial agreement in scoring the viral load level. The proposed grading schema can be applied in routine allograft biopsy practice for grading the Polyomavirus nephropathy stage and the viral load level.</description><subject>2009 Banff</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Agreements</subject><subject>Biological and medical sciences</subject><subject>Biopsy</subject><subject>BK virus</subject><subject>Child</subject><subject>Classification</subject><subject>Female</subject><subject>Graft Rejection - classification</subject><subject>Graft Rejection - drug therapy</subject><subject>Graft Rejection - pathology</subject><subject>Graft Rejection - virology</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Interobserver agreement</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Kidney - pathology</subject><subject>Kidney - virology</subject><subject>Kidney Diseases - classification</subject><subject>Kidney Diseases - drug therapy</subject><subject>Kidney Diseases - pathology</subject><subject>Kidney Diseases - virology</subject><subject>Kidney Transplantation - pathology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Observer Variation</subject><subject>Pathology</subject><subject>Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques</subject><subject>Polyomavirus</subject><subject>Polyomavirus - physiology</subject><subject>Polyomavirus Infections - classification</subject><subject>Polyomavirus Infections - drug therapy</subject><subject>Polyomavirus Infections - pathology</subject><subject>Polyomavirus nephropathy</subject><subject>Reproducibility of Results</subject><subject>Retrospective Studies</subject><subject>Transplantation, Homologous - pathology</subject><subject>Tumor Virus Infections - classification</subject><subject>Tumor Virus Infections - drug therapy</subject><subject>Tumor Virus Infections - pathology</subject><subject>Viral diseases</subject><subject>Viral Load</subject><subject>Virus Replication</subject><subject>κ statistic</subject><issn>0046-8177</issn><issn>1532-8392</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><recordid>eNqFkttu1DAQhiMEokvhEUCWEOIqwcfEuQGVFYdKlagEXFteZ7LxNrG3drIoj8Ob4rBbKvWGK5---Wc8_2TZS4ILgkn5bld007DXY1dQTEiBWYGxfJStiGA0l6ymj7MVxrzMJamqs-xZjDucQMHF0-yMkooxIfgq-33pRgh-EyEcICC9DQADuBG1PqBr389-0Acbpogc7Lvgl4wz2gbdWLdF1qEATvdI971Pl-0Y0RSXl7ED9MuHm2W_T2E-JqoNfvj7QvDYoY_atS1ae9dCEjGAvEMXdzroOiXy6TA_z560uo_w4rSeZz8_f_qx_ppffftyub64yo3gbMybDTWYE11SLYHImrVQEa2rssK1LLHkFZeVNLwWJWekrkAaaCjjglJR4Y1k59nbo24q93aCOKrBRgN9rx34Kaoa89S_WtBEvn5A7vwUUhuiIphxKeuyrBMljpQJPsYArdoHO-gwJ0gtFqqdOlmoFgsVZipZmOJendSnzQDNv6g7zxLw5gToaHTfBu2MjfecoJwLRhL34chB6trBQlDR2KXRjQ1gRtV4-99S3j9QML11NiW9gRni_a9VpAqr78u8LeNGSBo1wQT7Azjr0wY</recordid><startdate>20111201</startdate><enddate>20111201</enddate><creator>Sar, Aylin, MD</creator><creator>Worawichawong, Suchin, MD</creator><creator>Benediktsson, Hallgrimur, MD</creator><creator>Zhang, Jianguo, MSc</creator><creator>Yilmaz, Serdar, MD</creator><creator>Trpkov, Kiril, MD</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20111201</creationdate><title>Interobserver agreement for Polyomavirus nephropathy grading in renal allografts using the working proposal from the 10th Banff Conference on Allograft Pathology</title><author>Sar, Aylin, MD ; Worawichawong, Suchin, MD ; Benediktsson, Hallgrimur, MD ; Zhang, Jianguo, MSc ; Yilmaz, Serdar, MD ; Trpkov, Kiril, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c543t-db2c041a62a8e1893fe71aa767098608474878c495643197e8ced234522570b83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>2009 Banff</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Agreements</topic><topic>Biological and medical sciences</topic><topic>Biopsy</topic><topic>BK virus</topic><topic>Child</topic><topic>Classification</topic><topic>Female</topic><topic>Graft Rejection - classification</topic><topic>Graft Rejection - drug therapy</topic><topic>Graft Rejection - pathology</topic><topic>Graft Rejection - virology</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Interobserver agreement</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Kidney - pathology</topic><topic>Kidney - virology</topic><topic>Kidney Diseases - classification</topic><topic>Kidney Diseases - drug therapy</topic><topic>Kidney Diseases - pathology</topic><topic>Kidney Diseases - virology</topic><topic>Kidney Transplantation - pathology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Observer Variation</topic><topic>Pathology</topic><topic>Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques</topic><topic>Polyomavirus</topic><topic>Polyomavirus - physiology</topic><topic>Polyomavirus Infections - classification</topic><topic>Polyomavirus Infections - drug therapy</topic><topic>Polyomavirus Infections - pathology</topic><topic>Polyomavirus nephropathy</topic><topic>Reproducibility of Results</topic><topic>Retrospective Studies</topic><topic>Transplantation, Homologous - pathology</topic><topic>Tumor Virus Infections - classification</topic><topic>Tumor Virus Infections - drug therapy</topic><topic>Tumor Virus Infections - pathology</topic><topic>Viral diseases</topic><topic>Viral Load</topic><topic>Virus Replication</topic><topic>κ statistic</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sar, Aylin, MD</creatorcontrib><creatorcontrib>Worawichawong, Suchin, MD</creatorcontrib><creatorcontrib>Benediktsson, Hallgrimur, MD</creatorcontrib><creatorcontrib>Zhang, Jianguo, MSc</creatorcontrib><creatorcontrib>Yilmaz, Serdar, MD</creatorcontrib><creatorcontrib>Trpkov, Kiril, MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Human pathology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sar, Aylin, MD</au><au>Worawichawong, Suchin, MD</au><au>Benediktsson, Hallgrimur, MD</au><au>Zhang, Jianguo, MSc</au><au>Yilmaz, Serdar, MD</au><au>Trpkov, Kiril, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Interobserver agreement for Polyomavirus nephropathy grading in renal allografts using the working proposal from the 10th Banff Conference on Allograft Pathology</atitle><jtitle>Human pathology</jtitle><addtitle>Hum Pathol</addtitle><date>2011-12-01</date><risdate>2011</risdate><volume>42</volume><issue>12</issue><spage>2018</spage><epage>2024</epage><pages>2018-2024</pages><issn>0046-8177</issn><eissn>1532-8392</eissn><coden>HPCQA4</coden><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>Summary A classification schema for grading Polyomavirus nephropathy was proposed at the 2009 Banff allograft meeting. The schema included 3 stages of Polyomavirus nephropathy: early (stage A), florid (stage B), and late sclerosing (stage C). Grading categories for histologic viral load levels were also proposed. To examine the applicability and the interobserver agreement of the proposed Polyomavirus nephropathy grading schema, we evaluated 24 renal allograft biopsies with confirmed Polyomavirus nephropathy by histology and SV40. Four renal pathologists independently scored the Polyomavirus nephropathy stage (A, B, or C), without knowledge of the clinical history. Viral load was scored as a percent of tubules exhibiting viral replication, using either a 3-tier viral load score (1: ≤1%; 2: >1%-10%; 3: >10%) or a 4-tier score (1: ≤1%; 2: >1%-≤5%; 3: >5%-15%; 4: >15%). The κ score for the Polyomavirus nephropathy stage was 0.47 (95% confidence interval, 0.35-0.60; P < .001). There was a substantial agreement using both the 3-tier and the 4-tier scoring for the viral load (Kendall concordance coefficients, 0.72 and 0.76, respectively; P < .001 for both). A better complete agreement was found using the 3-tier viral load score. In this first attempt to evaluate the interobserver reproducibility of the proposed Polyomavirus nephropathy classifying schema, we demonstrated moderate κ agreement in assessing the Polyomavirus nephropathy stage and a substantial agreement in scoring the viral load level. The proposed grading schema can be applied in routine allograft biopsy practice for grading the Polyomavirus nephropathy stage and the viral load level.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>21733554</pmid><doi>10.1016/j.humpath.2011.03.008</doi><tpages>7</tpages></addata></record> |
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| subjects | 2009 Banff Adolescent Adult Aged Agreements Biological and medical sciences Biopsy BK virus Child Classification Female Graft Rejection - classification Graft Rejection - drug therapy Graft Rejection - pathology Graft Rejection - virology Humans Infectious diseases Interobserver agreement Investigative techniques, diagnostic techniques (general aspects) Kidney - pathology Kidney - virology Kidney Diseases - classification Kidney Diseases - drug therapy Kidney Diseases - pathology Kidney Diseases - virology Kidney Transplantation - pathology Male Medical sciences Middle Aged Observer Variation Pathology Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques Polyomavirus Polyomavirus - physiology Polyomavirus Infections - classification Polyomavirus Infections - drug therapy Polyomavirus Infections - pathology Polyomavirus nephropathy Reproducibility of Results Retrospective Studies Transplantation, Homologous - pathology Tumor Virus Infections - classification Tumor Virus Infections - drug therapy Tumor Virus Infections - pathology Viral diseases Viral Load Virus Replication κ statistic |
| title | Interobserver agreement for Polyomavirus nephropathy grading in renal allografts using the working proposal from the 10th Banff Conference on Allograft Pathology |
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