Observer variability in the grading of oral epithelial dysplasia

ABSTRACT

Background: Various grading systems have been suggested in the literature by different authors to determine the severity of dysplastic features. Histopathological grading is subjective with low reproductivity and lacks sensitivity. Aim: To determine the inter observer and intra observer variability in diagnosing oral epithelial dysplasia using different grading systems. Materials and methods: Three oral pathologists from the Department the Oral pathology, GDC Srinagar observed the same 30 consecutive sections of oral epithelial dysplasia. Each reviewing pathologist asked to grade each case on the basis of WHO (2005) and binary grading system (2006) at different time intervals and was repeated twice. Results: The inter observer variability ranged from poor to slight in WHO system and slight to fair in binary system whereas the intra observer variability ranged from slight to fair in WHO system and fair in the binary system. Conclusion: Grading of oral epithelial dysplasia is subjective and has been shown not to be highly reproducible. The binary grading system verified to have better inter observer and intra observer agreement in the present study than the WHO grading system.