{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T22:46:40Z","timestamp":1775083600509,"version":"3.50.1"},"reference-count":33,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T00:00:00Z","timestamp":1751932800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2025,10]]},"abstract":"Aims<\/jats:title>There is a lack of published literature on the diagnostic reproducibility of oesophageal squamous dysplasia using a two\u2010tiered grading system.<\/jats:p><\/jats:sec>Methods and results<\/jats:title>We identified 75 oesophageal biopsies, which were reviewed by 10 international pathologists twice (1500 total observations) with a >\u20094\u2010week washout period. Between rounds, a consensus meeting refining diagnostic criteria was held and an atlas was created to provide illustrations. Overall agreement was fair with kappa of 0.35 and 0.32 in round 1 and 2, respectively. Agreement was moderate to fair for negative for dysplasia (ND<\/jats:styled-content>) (round 1\u2009=\u20090.41 and round 2\u2009=\u20090.34) and poor for indefinite for dysplasia (IND<\/jats:styled-content>) and low\u2010grade dysplasia (LGD<\/jats:styled-content>) (kappa <0.2). Agreement for high\u2010grade dysplasia (HGD<\/jats:styled-content>) was good in both rounds (round 1\u2009=\u20090.64; round 2\u2009=\u20090.61). In round 1, majority diagnosis (MDx<\/jats:styled-content>, \u22656 of 10 raters agreeing) was seen in 51 (68%) cases with the majority classified as ND<\/jats:styled-content> (N<\/jats:italic>\u2009=\u200927) or HGD<\/jats:styled-content> (N<\/jats:italic>\u2009=\u200918). MDx<\/jats:styled-content> was rarely achieved for LGD<\/jats:styled-content> (N<\/jats:italic>\u2009=\u20096). In round 2, MDx<\/jats:styled-content> was seen in 49 (65%) cases (20 ND<\/jats:styled-content>, 1 IND<\/jats:styled-content>, 11 LGD<\/jats:styled-content> and 17 HGD<\/jats:styled-content>). Of the 40 cases with MDx<\/jats:styled-content> for both rounds, 39 were concordant (15 HGD<\/jats:styled-content>, 6 LGD<\/jats:styled-content> and 18 ND<\/jats:styled-content>).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Overall agreement among pathologists in diagnosing squamous lesions is fair; however, HGD<\/jats:styled-content> had good agreement. This study fills an important gap in our knowledge of the inter\u2010rater variability in the diagnosis of oesophageal squamous dysplasia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/his.15509","type":"journal-article","created":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T03:48:12Z","timestamp":1751946492000},"page":"573-583","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["An international inter\u2010rater agreement study in the challenging diagnosis of squamous dysplasia of the oesophagus"],"prefix":"10.1111","volume":"87","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4666-2205","authenticated-orcid":false,"given":"Ameya","family":"Patil","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine and Pathology Mayo Clinic Arizona Scottsdale Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tracy Loh","family":"Jiezhen","sequence":"additional","affiliation":[{"name":"Department of Anatomical Pathology Singapore General Hospital Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4651-9516","authenticated-orcid":false,"given":"Heidi","family":"Kosiorek","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences Mayo Clinic Phoenix Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6329-2547","authenticated-orcid":false,"given":"Ian S.","family":"Brown","sequence":"additional","affiliation":[{"name":"Envoi Specialist Pathologists Brisbane Queensland Australia"},{"name":"Royal Brisbane and Women's Hospital Brisbane Queensland Australia"},{"name":"Faculty of Medicine, University of Queensland Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1964-1006","authenticated-orcid":false,"given":"F\u00e1tima","family":"Carneiro","sequence":"additional","affiliation":[{"name":"Ipatimup\u2014Institute of Molecular Pathology and Immunology of the University of Porto Porto Portugal"},{"name":"Department of Pathology, Faculty of Medicine University of Porto Porto Portugal"},{"name":"Centro Hospitalar Universit\u00e1rio S\u00e3o Jo\u00e3o Porto Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9447-1967","authenticated-orcid":false,"given":"Anthony J.","family":"Gill","sequence":"additional","affiliation":[{"name":"Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research Royal North Shore Hospital St Leonards New South Wales Australia"},{"name":"New South Wales Health Pathology, Department of Anatomical Pathology Royal North Shore Hospital St Leonards New South Wales Australia"},{"name":"Sydney Medical School University of Sydney Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2453-9185","authenticated-orcid":false,"given":"Priyanthi M.","family":"Kumarasinghe","sequence":"additional","affiliation":[{"name":"PathWest Perth Western Australia Australia"},{"name":"Curtin Medical School Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryoji","family":"Kushima","sequence":"additional","affiliation":[{"name":"Department of Pathology Shiga University of Medical Science Otsu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kieran","family":"Sheahan","sequence":"additional","affiliation":[{"name":"UCD School of Medicine University College Dublin Dublin Ireland"},{"name":"Department of Histopathology St. Vincent's University Hospital Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4228-6580","authenticated-orcid":false,"given":"Neil A.","family":"Shepherd","sequence":"additional","affiliation":[{"name":"Gloucestershire Cellular Pathology Laboratory Cheltenham General Hospital Cheltenham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomas","family":"Slavik","sequence":"additional","affiliation":[{"name":"Ampath Pathology Laboratories Pretoria South Africa"},{"name":"Department of Anatomical Pathology, Faculty of Health Sciences University of Pretoria Pretoria South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5165-8142","authenticated-orcid":false,"given":"Amitabh","family":"Srivastava","sequence":"additional","affiliation":[{"name":"Department of Pathology Memorial Sloan Kettering Cancer Center New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0897-5385","authenticated-orcid":false,"given":"Gregory Y.","family":"Lauwers","sequence":"additional","affiliation":[{"name":"Department of Pathology H. 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