Related Experiment Video
Updated: Jan 5, 2026
Software-Assisted Quantitative Measurement of Osteoarthritic Subchondral Bone Thickness
Published on: March 18, 2022
Reproducibility of Grading in Chronic Intervillositis of Unknown Etiology
Deidre Ongaro1, Jefferson Terry1
1Department of Pathology and Laboratory Medicine, BC Children's Hospital, Vancouver, British Columbia, Canada.
Insights
Chronic intervillositis of unknown etiology (CIUE) grading showed high diagnostic accuracy but moderate reproducibility. Simplifying the grading scheme may enhance consistency in diagnosing this rare placental condition.
Area of Science:
- Perinatal Pathology
- Reproductive Medicine
- Histopathology
Background:
- Chronic intervillositis of unknown etiology (CIUE) is a rare placental inflammatory condition.
- CIUE is linked to adverse pregnancy outcomes, including pregnancy loss and recurrence.
- Standardized diagnostic criteria and reproducible grading are crucial for managing CIUE.
Purpose of the Study:
- To evaluate the diagnostic accuracy and reproducibility of CIUE grading.
- To assess interobserver variability among perinatal pathologists using the Rota scheme.
- To identify potential improvements for CIUE diagnostic consistency.
Main Methods:
- A quality assurance study involving 7 perinatal pathologists reviewing 31 H&E-stained slides from 20 CIUE cases.
- Two sequential review rounds using existing diagnostic criteria and the Rota grading scheme.
- Statistical analysis of diagnostic accuracy, average percent agreement, and Fleiss' kappa for interobserver variability.
Main Results:
- Round 1: 94% diagnostic accuracy, 79% average agreement on Rota grade (kappa=0.54).
- Round 2 (after group review and criteria refinement): 83% accuracy, 70% agreement (kappa=0.36).
- Overall high diagnostic accuracy but only moderate agreement on Rota grade, with no improvement after group review.
Conclusions:
- Current CIUE grading demonstrates high diagnostic accuracy but moderate interobserver agreement.
- Group review did not significantly enhance diagnostic accuracy or grading reproducibility.
- A simplified low-grade/high-grade classification (<50% or ≥50%) may improve grading reproducibility for CIUE.
Abstract:
Chronic intervillositis of unknown etiology (CIUE) is a rare placental inflammatory process associated with pregnancy loss and recurrence. We conducted a quality assurance study to assess the diagnostic accuracy and reproducibility of CIUE grading at our institution. Hematoxylin and eosin-stained slides from 20 CIUE cases (31 slides) were reviewed by 7 perinatal pathologists in 2 sequential rounds. Reviewers were instructed to use the diagnostic criteria they were presently following for CIUE and to grade each slide according to the Rota scheme. In the first round, 20 slides were assessed. The diagnostic accuracy was 94%, the average percent agreement of Rota grade was 79%, and the Fleiss' kappa value for interobserver variability was 0.54. The results were reviewed by all pathologists with diagnostic and grading criteria agreed upon prior to the second round. In round 2, the remaining 11 slides were assessed. Diagnostic accuracy was 83%, the average percent agreement on Rota grade was 70%, and the Fleiss' kappa value for interobserver variability was 0.36. Overall, diagnostic accuracy was high and agreement on Rota grade was moderate. Group review did not appear to improve accuracy. Simplifying CIUE grading to a low-grade/high-grade scheme (<50% or ≥50%) might improve grading reproducibility.
Related Concept Videos
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:17Chronic Bowel Disorders: Introduction
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
01:27Myocarditis II: Clinical Features and Diagnostic Tests