Interobserver Variation in Grading and Staging of Chronic Hepatitis Using Knodell Ishak (Modified HAI) or Batts-Ludwig Scoring Systems

Reliable assessment of liver histopathology in patients with chronic hepatitis is important for assessing the severity of the disease. This study aimed to survey the interobserver variability of liver biopsy assessment performed via two of the most commonly used systems. 54 liver biopsies from patients with chronic hepatitis were scored by three independent observers using Knodell Ishak [modified histology activity index (HAI)] and Batts-Ludwig systems. The best agreement was seen for Knodell Ishak’s staging (Kendall’s correlation coefficient (r) = 90%، P < 0. 001). The worst agreement was seen for Batts-Ludwig grading. (r = 63%، P < 0. 001). We conclude that both systems showed better agreement for staging than for grading; while both systems produced reasonable agreement between the observers، Knodell Ishak system showed greater results.