Home > Publications . Search All . Browse All . Country . Browse PSC Pubs . PSC Report Series

PSC In The News

RSS Feed icon

Murphy on extending health support via a smart phone and JITAI

New analysis counters Shaefer's finding that households living on $2/day/person rose post welfare reform

Former trainee Herbert says residential squatters may be a good thing

More News

Highlights

Michigan ranked #12 on Business Insider's list of 50 best American colleges

Frey's new report explores how the changing US electorate could shape the next 5 presidential elections, 2016 to 2032

U-M's Data Science Initiative offers expanded consulting services via CSCAR

Elizabeth Bruch promoted to Associate Professor

Next Brown Bag

PSC Brown Bags
will resume fall 2016

Design and Validation of the Biliary Atresia Research Consortium Histologic Assessment System for Cholestasis in Infancy

Publication Abstract

Russo, P., J.C. Magee, J. Boitnott, K.E. Bove, Trivellore Raghunathan, M. Finegold, J. Haas, R. Jaffe, G.E. Kim, M. Magid, H. Melin-Aldana, F. White, P.F. Whitington, R.J. Sokol, and C. Biliary Atresia Res. 2011. "Design and Validation of the Biliary Atresia Research Consortium Histologic Assessment System for Cholestasis in Infancy." Clinical Gastroenterology and Hepatology, 9(4): 357-362.

BACKGROUND & AIMS: Pathologists participating in the National Institutes of Health-sponsored Biliary Atresia Research Consortium (BARC) developed and then evaluated a standardized system for histologic reporting of liver biopsies from infants with cholestasis. METHODS: A set of 97 anonymous liver biopsy samples was sent to 10 pathologists at BARC centers. A semiquantitative scoring system that had 16 histologic features was developed and then used by the pathologists, who had no knowledge of clinical history, imaging results, or laboratory data. Interobserver agreement was evaluated statistically. Agreement on scoring of each feature and on the pathologists' diagnosis, compared with the final clinical diagnosis, was evaluated by using weighted kappa statistics. RESULTS: There was moderate to substantial interobserver agreement in identification of bile plugs in ducts, giant-cell transformation, extramedullary hematopoiesis, and bile duct proliferation. The pathologists' diagnosis of obstruction in clinically proven cases of biliary atresia (BA) ranged from 79%-98%, with a positive predictive value of 90.7%. Histologic features that best predicted BA, on the basis of logistic regression, included bile duct proliferation, portal fibrosis, and absence of sinusoidal fibrosis (each P < .0001). CONCLUSIONS: The BARC histologic assessment system identified features of liver biopsies from cholestatic infants, with good interobserver agreement, that might be used in diagnosis and determination of prognosis. The system diagnosed BA with a high level of sensitivity and identified infants with biliary obstruction with reasonable interobserver agreement. However, distinguishing between BA and disorders such as total parenteral nutrition-associated liver disease and alpha(1)-antitrypsin deficiency is not possible without adequate clinical information.

DOI:10.1016/j.cgh.2011.01.003 (Full Text)

PMCID: PMC3400532. (Pub Med Central)

Browse | Search : All Pubs | Next