Endometrial Biopsies

Abstract

Background: In histopathology, inter-observer variability is frequently encounterleading to diagnostic dilemma. Endometrial biopsies are one of them where multiple factorsincluding hormonal influences make the interpretation difficult. The aim of the article was tofind the interobserver variability level between two consultants on endometrial biopsies byapplying kappa and ICC analysis. Study Design: Prospective study. Setting: Department ofPathology Peshawar Medical College Peshawar from Health Care Centre, University Town,Peshawar. Period: March to August 2013. Methods: This study consisted of 102 endometrialbiopsies of infertile women on 22nd or 23rd day of menstrual cycle. All cases were examined bytwo consultants separately and formed their opinions independent of each other according toNoye’s criteria. Their opinions were categorized as those in agreement, with minor disagreementand with major difference in opinion. Results: Agreement of opinion was established only in 34(33.3%) cases. There was disagreement in 68 (66.7%) of cases. Out of these 68 cases, 46 (68%)belonged to the category of major conflicting opinion. In case of minor conflicting opinion,there was difference in specific day of the phase of menstrual cycle. The Kappa coefficient andICC statistics was performed which gave the overall results as fair agreement. Conclusion:The main cause of disagreement was difficulty in applying the criteria for effects of hormonalinfluences on endometrial biopsies leading to subjective interpretation.