Inter-observer agreement on the interpretation of capsule endoscopy findings based on capsule endoscopy structured terminology: a multicenter study by the Korean Gut Image Study Group.

Jang, Byung Ik; Lee, Si Hyung; Moon, Jeong-Seop; Cheung, Dae Young; Lee, In Seok; Kim, Jin Oh; Cheon, Jae Hee; Park, Cheol Hee; Byeon, Jeong-Sik; Park, Youn Sun; Shim, Ki-Nam; Kim, Yong-Sik; Kim, Kyung-Jo; Lee, Kwang Jae; Ryu, Ji-Kon; Chang, Dong Kyung; Chun, Hoon Jai; Choi, Myung-Gyu
Scandinavian journal of gastroenterology
2010Mar ; 45 ( 3 ) :370-4.
저자 상세정보
Jang, Byung Ik -
Lee, Si Hyung -
Moon, Jeong-Seop -
Cheung, Dae Young -
Lee, In Seok -
Kim, Jin Oh -
Cheon, Jae Hee -
Park, Cheol Hee -
Byeon, Jeong-Sik -
Park, Youn Sun -
Shim, Ki-Nam -
Kim, Yong-Sik -
Kim, Kyung-Jo -
Lee, Kwang Jae -
Ryu, Ji-Kon -
Chang, Dong Kyung -
Chun, Hoon Jai -
Choi, Myung-Gyu -
OBJECTIVE: Capsule endoscopy (CE) is a novel investigation for the diagnosis of small-bowel disease but its interpretation is highly subjective. We studied the inter-observer agreement and accuracy of the interpretation of CE findings based on capsule endoscopy structured terminology (CEST). MATERIAL AND

METHODS: Fifty-six CE video clips were collected from eight university hospitals in South Korea and were independently reviewed by 13 gastroenterology experts and 10 trainees. All investigators recorded their findings based on CEST. To determine the accuracy of individual viewers, we defined the 'gold standard' as a joint review by four experts.

RESULTS: The 56 CE video clips included five normal cases, 19 cases of protruding lesions, 21 cases of depressed lesions, three cases of flat lesions, one case of abnormal mucosa, six cases with blood in the lumen, and one case of stenotic lumen. The overall mean accuracies for the experts and trainees were 74.3% +/- 22.6% and 61.7% +/- 25.4%, respectively. The overall accuracy for the trainee group was significantly lower than that for the expert group (P < 0.001), especially in normal, tumor, venous structure, and ulcer cases. The accuracies of the two groups varied with the CE findings. The accuracies were higher in cases with more prominent intraluminal changes (e.g. active small-bowel bleeding, ulcer, tumor, stenotic lumen). In contrast, subtle mucosal lesions, such as erosion, angioectasia, and diverticulum, had lower accuracies. The mean kappa values for the experts and trainees were 0.61 (range 0.39-0.97) and 0.46 (range 0.17-0.66), respectively.

CONCLUSIONS: Our results showed that there was substantial agreement between experts and moderate agreement between trainees. In order to achieve higher accuracies and better inter-observer agreement, we need not only more experience with CE but also consensus regarding CEST terminology.
Capsule endoscopy analysis, inter-observer variability, small-bowel lesions
*Capsule Endoscopy, *Clinical Competence, Female, Gastrointestinal Diseases/*diagnosis, Humans, Intestine, Small, Male, Observer Variation, Republic of Korea

주제명(Target field)
연구참여(Sample size)
질병특성(Condition Category)
연구설계(Study Design)
중재방법(Intervention Type)
중재명칭(Intervention Name)
There was substantial agreement among experts in capsule endoscopy analysis; The overall mean accuracies for the experts and trainees were 74.3% ± 22.6% and 61.7% ± 25.4%, respectively.
연구비지원(Fund Source)
근거수준평가(Evidence Hierarchy)
ICD 03