{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T12:39:58Z","timestamp":1790858398123,"version":"4.1.0"},"reference-count":35,"publisher":"BMJ","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[2002,11]]},"abstract":"<jats:p>\n                    <jats:bold>Background and aims:<\/jats:bold>\n                    When to perform oesophagectomy for neoplastic progression in Barrett\u2019s oesophagus is controversial. Some resect for high grade dysplasia whereas others defer treatment until intramucosal adenocarcinoma is diagnosed. Interobserver agreement for a diagnosis of high grade dysplasia or intramucosal adenocarcinoma remains unknown and may have therapeutic implications.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    Histological slides from 75 oesophagectomy specimens with high grade dysplasia or T\n                    <jats:sub>1<\/jats:sub>\n                    adenocarcinoma were blindly reviewed by two gastrointestinal pathologists and one general surgical pathologist, and classified as high grade dysplasia, intramucosal adenocarcinoma, or submucosal adenocarcinoma. A subsequent re-review of all 75 cases by the same observers following establishment of uniform histological criteria was undertaken. Interobserver agreement was determined by kappa statistics. Coefficients &lt;0.21, 0.21\u20130.40, 0.41\u20130.60, 0.61\u20130.80, and &gt;0.80 were considered poor, fair, moderate, good, and very good agreement, respectively.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    Interobserver agreement among all pathologists and between gastrointestinal pathologists when comparing high grade dysplasia with intramucosal adenocarcinoma was only fair (k=0.42; 0.56, respectively) and did not substantially improve on subsequent re-evaluation following establishment of uniform histological criteria (K=0.50; 0.61, respectively).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    When evaluating resection specimens and after implementation of uniform histological criteria, even experienced gastrointestinal pathologists frequently disagree on a diagnosis of high grade dysplasia versus intramucosal adenocarcinoma. Treatment strategies based on the histological distinction of high grade dysplasia from intramucosal adenocarcinoma using limited biopsy specimens should be re-evaluated.\n                  <\/jats:p>","DOI":"10.1136\/gut.51.5.671","type":"journal-article","created":{"date-parts":[[2002,10,11]],"date-time":"2002-10-11T18:38:51Z","timestamp":1034361531000},"page":"671-676","source":"Crossref","is-referenced-by-count":168,"title":["Observer variation in the diagnosis of superficial oesophageal adenocarcinoma"],"prefix":"10.1136","volume":"51","author":[{"given":"A H","family":"Ormsby","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R E","family":"Petras","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W H","family":"Henricks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T W","family":"Rice","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L A","family":"Rybicki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J E","family":"Richter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J R","family":"Goldblum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2002,11,1]]},"reference":[{"key":"2025121305382352000_51.5.671.1","first-page":"1832","volume":"88","year":"1993","journal-title":"Am J Gastroenterol"},{"key":"2025121305382352000_51.5.671.2","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(92)91370-O"},{"key":"2025121305382352000_51.5.671.3","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(91)90367-M"},{"key":"2025121305382352000_51.5.671.4","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199605000-00014"},{"key":"2025121305382352000_51.5.671.5","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/0016-5085(93)90008-Z","volume":"105","year":"1993","journal-title":"Gastronenterology"},{"key":"2025121305382352000_51.5.671.6","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/0016-5085(88)90613-0","volume":"94","year":"1988","journal-title":"Gastroenterology"},{"key":"2025121305382352000_51.5.671.7","doi-asserted-by":"publisher","DOI":"10.1016\/S0046-8177(88)80344-7"},{"key":"2025121305382352000_51.5.671.8","doi-asserted-by":"publisher","DOI":"10.1016\/S0046-8177(83)80175-0"},{"key":"2025121305382352000_51.5.671.9","doi-asserted-by":"crossref","unstructured":"Altman DG. 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