Observer agreement in the assessment of narrowband imaging system surface patterns in Barrett’s esophagus: a multicenter study

Abstract

The clinical utility of narrow-band imaging (NBI) for Barrett's esophagus is limited by the multiplicity of classification schemes. We evaluated the interobserver agreement and accuracy of a new consensus-driven simplified binary classification of NBI surface patterns.

Electronic chromoendoscopy

“…16 There have been multiple studies looking at the reproducibility of NBI with magnification. [17][18][19][20][21] Curvers et al 17 looked at the interobserver agreement based on the mucosal and vascular morphology described previously by Kara et al 10 NBI did not improve interobserver agreement or accuracy over HD-WLE. The interobserver agreement for NBI diagnosis ranged from a k of 0.40 to 0.56 (moderate) and did not significantly differ between expert and nonexpert endoscopists.…”

“…Mean sensitivity and specificity of NBI surface patterns for predicting dysplasia were 47% and 72%, respectively 20. …”

Randomized controlled trial of self-directed versus in-classroom teaching of narrow-band imaging for diagnosis of Barrett’s esophagus–associated neoplasia

“…NBI mucosal and vascular patterns used in this study were derived from previously published criteria. 11,13 Mucosal patterns Regular. Includes circular pattern (Fig.…”

“…10 However, the optimum training method remains unknown. In a study by Singh et al, 11 a standardized in-person training session was able to generate similar interobserver agreement in the use of NBI for diagnosis of BE-associated dysplasia between NBI experts and non-experts; however, the study was not designed to evaluate differences in accuracy in diagnosing BE-associated dysplasia.…”

Quality Assurance in Endoscopy: Which Parameters?

“…Studies using HD endoscopy failed to show a significant benefit for additional chromoendoscopy (real or virtually) in the detection of dysplasia in squamous cell carcinoma and Barrett's oesophagus [26,27,28,29]. The current ESGE guideline does not classify the white light endoscopy (SD) as sufficiently exact in differentiating and diagnosing pre-neoplasm conditions and lesions ( Helicobacter pylori (HP) gastritis, atrophic gastritis, intestinal metaplasia); thus, the use of the best available endoscopy technique and the collection of sampling biopsies in the endoscopic monitoring are requested for patients with a precancerous condition ([3] chapter 4.1; [30]).…”