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A Clinicopathologic Study of 160 Liver Biopsy Specimens

Maartje A. M. Berends, MD; Martijn G. H. van Oijen, MSc; Josje Snoek, MSc; Peter C. M. van de Kerkhof, MD, PhD; Joost P. H. Drenth, MD, PhD; J. Han van Krieken, MD, PhD; Elke M. G. J. de Jong, MD, PhD

Arch Dermatol. 2007;143(12):1515-1519.

Objective  To determine the interobserver reliability of the Roenigk score as a classification system of liver damage and its possible consequences for clinical practice.

Design  Retrospective study.

Setting  Academic research.

Patients  One hundred sixty liver biopsy specimens from patients with psoriasis receiving methotrexate treatment were rereviewed and analyzed blindly by an experienced pathologist with an interest in liver pathologic conditions.

Main Outcome Measure  Interobserver variation was evaluated using statistics.

Results  A high concordance was present in the evaluation of the Roenigk grade of fibrosis (weighted  = 0.73; 95% confidence interval, 0.63-0.83). Agreement was good regarding the number of biopsy specimens for patients whose clinical management should be changed ( = 0.71; 95% confidence interval, 0.56-0.87).

Conclusion  The Roenigk classification in the assessment of liver fibrosis is a reliable scoring system.

Author Affiliations: Departments of Dermatology (Drs Berends, van de Kerkhof, and de Jong), Gastroenterology and Hepatology (Mr van Oijen, Ms Snoek, and Dr Drenth), and Pathology (Dr van Krieken), Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.