Inter-observer agreement in the assessment of endoscopic findings in ulcerative colitis

Abstract

Background: Endoscopic findings are essential in evaluating the disease activity in ulcerative colitis. The aim of this study was to evaluate how endoscopists assess individual endoscopic features of mucosal inflammation in ulcerative colitis, the inter-observer agreement, and the importance of the observers' experience.

Assessment of reliability and validity of IBD phenotyping within the National Institutes of Diabetes and Digestive and Kidney Diseases (NIDDK) IBD Genetics Consortium (IBDGC)

“…This contrasts with a study of the reliability of endoscopic evaluation of UC in which experienced endoscopists had better interobserver variability as compared with less experienced endoscopists. 22 Once again, this may have been due to the development of a standard operating manual and the phenotyper training session.…”

Measurement of disease activity in ulcerative colitis

“…In addition, contrary to their findings in which granularity showed poor agreement, granularity had good IOA in our study, possibly due to improved videocolonoscopic imaging techniques allowing better accentuation of subtle signs such as mucosal unevenness. In the study by de Lange et al, 2 among 15 experienced endoscopists scoring five videoclips using a transformed VAS score (range 1-5), very good agreement was seen for friability (kappa statistic [j], 0.85) and ulcerations (j 0.80), good agreement for granularity (j, 0.68), edema (j, 0.65), erythema (j, 0.61), and moderate agreement for vascular pattern (j, 0.51). These findings are fairly similar to our study despite differences in study design and analysis.…”

“…1,2,4 In the study by Orlandi et al 4 involving four experienced endoscopists and 11 endoscopists-in-training who reviewed 49 still images preselected from endoscopic videorecordings, both groups had good or excellent agreement for mucosal lesions such as loss of vascular pattern, erythema, edema, pseudopolyp, and for grading of normal pattern and severe activity.…”

“…1 This score has not been validated using higher-resolution videocolonoscopes that are now widely used by gastroenterologists. 2 To date, there are seven different endoscopic scoring systems used in the assessment of UC patients, which are based on minor modifications of the original Baron score, 1,3 and none of them has been further validated.…”

A critical review of endoscopic indices in ulcerative colitis: inter-observer variation of the endoscopic index

“…This type of study often aims at evaluating the precision of new modalities [18,19] or new diagnostic tools [20,21] in comparison to testing existing ones or inter-observer agreement. Some investigators have compared endoscopic findings in UC patients among observers and analyzed inter-observer agreement [22,23]. Baron et al [2] analyzed inter-observer agreement with respect to spontaneous bleeding and mucosal lesions (friability, granularity, ulcers, etc.)…”