Interobserver and intraobserver variability in the calculation of the lipid-laden macrophage index: implications for its use in the evaluation of aspiration in children.

摘要: The lipid-laden macrophage index (LLMI) is a semiquantitative test used to evaluate aspiration in children. We assessed the reliability and reproducibility of LLMI by calculating interobserver intraobserver variability among pathologists, with without expertise cytopathology. Forty-nine bronchoalveolar washes/lavages were blindly reviewed four reviewers assigned an LLMI. Three pathologists (two cytopathologists, one pathology fellow) slides twice cytotechnologist them once. Intraclass correlation coefficient (ICC) 95% confidence interval (C.I.) was measure overall agreement. Interobserver agreement also calculated separately for each pair reviewers. ICC values did not indicate acceptable level (ICC = 0.67, C.I.: 0.56-0.77) 0.77, 0.61-0.84) included analysis. An 0.84 (95% 0.78-0.89) indicated pathologists. When reviewers, all but two less than 0.75 (the minimally value reliable clinical measurement), lower limit C.I. far below cutoff. Using Lin's coefficient, only Our study highlights lack precision subjectivity LLMI, as well significant inter bias that may occur experienced inexperienced cytotechnologists. Clinicians cytopathologists alike should be mindful this potential pitfall interpret scores caution.