BACKGROUND: This study evaluated inter- and intraobserver agreement in the assessment of ulcerative colitis (UC) activity using 4 established indices and a newly designed Modified 6-point Activity Index. METHOD: In all, 279 endoscopic pictures of inflammatory lesions from 93 UC patients were displayed twice to 4 expert and 4 trainee endoscopists, at an interval of 1 month. Each picture was assessed for inflammatory changes using established indices (Matts, Schroeder [a.k.a. Mayo Score], Baron, and Blackstone) and our new Modified 6-point Activity Index. Weighted kappa statistics were used to estimate intra- and interobserver variation. RESULTS: The Matts and Schroeder indices gave a "good" degree of concordance for expert endoscopists in terms of inter- and intraobserver agreements (0.74-0.78); this was not so evident with the Baron and Blackstone indices (0.61-0.73). For trainee endoscopists, all scores for inter- and intraobserver weighted kappa values using established indices (0.41-0.51) were lower than for the experts. The degree of concordance using the Modified 6-point Activity Index was rated as "good" for inter- and intraobserver agreements for expert endoscopists (0.65 and 0.79), and as "moderate" for trainee endoscopists (0.54 and 0.64). CONCLUSIONS: Accurate assessment of UC disease activity from endoscopic findings benefited from experience. For expert endoscopists, the Matts and Schroeder indices proved the most reliable of the 4 established indices. Current endoscopic technologies may be adequate for assessing UC activity, particularly if modified to permit a finer classification of disease severity based on 6 grades, as with our newly developed Modified 6-point Activity Index.
BACKGROUND: This study evaluated inter- and intraobserver agreement in the assessment of ulcerative colitis (UC) activity using 4 established indices and a newly designed Modified 6-point Activity Index. METHOD: In all, 279 endoscopic pictures of inflammatory lesions from 93 UC patients were displayed twice to 4 expert and 4 trainee endoscopists, at an interval of 1 month. Each picture was assessed for inflammatory changes using established indices (Matts, Schroeder [a.k.a. Mayo Score], Baron, and Blackstone) and our new Modified 6-point Activity Index. Weighted kappa statistics were used to estimate intra- and interobserver variation. RESULTS: The Matts and Schroeder indices gave a "good" degree of concordance for expert endoscopists in terms of inter- and intraobserver agreements (0.74-0.78); this was not so evident with the Baron and Blackstone indices (0.61-0.73). For trainee endoscopists, all scores for inter- and intraobserver weighted kappa values using established indices (0.41-0.51) were lower than for the experts. The degree of concordance using the Modified 6-point Activity Index was rated as "good" for inter- and intraobserver agreements for expert endoscopists (0.65 and 0.79), and as "moderate" for trainee endoscopists (0.54 and 0.64). CONCLUSIONS: Accurate assessment of UC disease activity from endoscopic findings benefited from experience. For expert endoscopists, the Matts and Schroeder indices proved the most reliable of the 4 established indices. Current endoscopic technologies may be adequate for assessing UC activity, particularly if modified to permit a finer classification of disease severity based on 6 grades, as with our newly developed Modified 6-point Activity Index.
Authors: Eduardo Garcia Vilela; Henrique Osvaldo da Gama Torres; Fabiana Paiva Martins; Maria de Lourdes de Abreu Ferrari; Marcella Menezes Andrade; Aloísio Sales da Cunha Journal: World J Gastroenterol Date: 2012-03-07 Impact factor: 5.742
Authors: Robert Battat; Parambir S Dulai; Christopher Ma; Vipul Jairath; Brian G Feagan; William J Sandborn; Reena Khanna Journal: Curr Treat Options Gastroenterol Date: 2020-01-04
Authors: David Chen; Clifton Fulmer; Ilyssa O Gordon; Sana Syed; Ryan W Stidham; Niels Vande Casteele; Yi Qin; Katherine Falloon; Benjamin L Cohen; Robert Wyllie; Florian Rieder Journal: J Crohns Colitis Date: 2022-03-14 Impact factor: 10.020
Authors: J E Slovak; C Wang; J A Morrison; K L Deitz; D N LeVine; C Otoni; R R King; L E Gerber; K R Hanson; A P Lundberg; A E Jergens Journal: J Vet Intern Med Date: 2014 Sep-Oct Impact factor: 3.333