Interobserver variability in synovial tissue biopsy markers in Rheumatoid Arthritis: Results from OMERACT special interest group on synovial tissue biopsy
Authors' conclusion
This study demonstrates that consensus-based methods can improve interobserver agreement in ST histology and IHC scoring across centres.
Study context
- Population
- Synovial tissue (ST) slides from biologic-naïve rheumatoid arthritis (RA) patients, scored by independent observers across expert centres (OMERACT special interest group)
- Participants
- 38 biologic-naïve RA patients
- Comparison
- Initial scoring vs rescoring after eDelphi consensus on a maximum-score approach
- Outcome
- Interobserver agreement (Kappa coefficients) in ST histology and immunohistochemistry (IHC) scoring
Methodological detailsmulticentre, modified eDelphi consensus, semiquantitative scoring
- Multicentre
- Modified eDelphi consensus
- Semiquantitative scoring
Recommendations
As reported in the abstract
Interobserver agreement (kappa), initial scoring
CD19/20 kappa
0.737
CD3 kappa
0.713
FVIII kappa
0.392
H&E kappa
0.316
Further findings
Agreement by observers' experience
- Lower agreement among highly experienced observers vs low and intermediate-experienced observers on specific markers
Interobserver agreement (kappa), rescoring with maximum-score approach · rescoring after eDelphi
- CD68 kappa
- 0.684
- Krenn's score kappa
- 0.545
- Improved agreement across most parameters; variability persists for certain parameters
Original publication
Interobserver variability in synovial tissue biopsy markers in Rheumatoid Arthritis: Results from OMERACT special interest group on synovial tissue biopsy. Semin Arthritis Rheum. Published 30 June 2026. doi:10.
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