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Effect of Standardised Scoring Conventions on Inter-rater Reliability in the Endoscopic Evaluation of Crohn's Disease.
Dubcenco, Elena; Zou, Guangyong; Stitt, Larry; Baker, Jeffrey P; Jeejeebhoy, Khursheed N; Kandel, Gabor; Kim, Young-In; Grover, Samir C; McDonald, John W D; Shackelton, Lisa M; Khanna, Reena; D'Haens, Geert; Sandborn, William J; Feagan, Brian G; Levesque, Barrett G.
Afiliación
  • Dubcenco E; Robarts Clinical Trials, University of Western Ontario, London, ON, Canada.
  • Zou G; Robarts Clinical Trials, University of Western Ontario, London, ON, Canada.
  • Stitt L; Robarts Clinical Trials, University of Western Ontario, London, ON, Canada.
  • Baker JP; St Michaels Hospital, University of Toronto, Toronto, ON, Canada.
  • Jeejeebhoy KN; St Michaels Hospital, University of Toronto, Toronto, ON, Canada.
  • Kandel G; St Michaels Hospital, University of Toronto, Toronto, ON, Canada.
  • Kim YI; St Michaels Hospital, University of Toronto, Toronto, ON, Canada.
  • Grover SC; St Michaels Hospital, University of Toronto, Toronto, ON, Canada.
  • McDonald JW; Robarts Clinical Trials, University of Western Ontario, London, ON, Canada.
  • Shackelton LM; Robarts Clinical Trials, University of Western Ontario, London, ON, Canada.
  • Khanna R; Robarts Clinical Trials, University of Western Ontario, London, ON, Canada.
  • D'Haens G; Department of Gastroenterology, University Hospital, Gasthuisberg, Leuven, Belgium.
  • Sandborn WJ; Division of Gastroenterology, University of California San Diego, La Jolla, CA, USA.
  • Feagan BG; Robarts Clinical Trials, University of Western Ontario, London, ON, Canada brian.feagan@robartsinc.com brian.feagan@robartsinc.com.
  • Levesque BG; Division of Gastroenterology, University of California San Diego, La Jolla, CA, USA.
J Crohns Colitis ; 10(9): 1006-14, 2016 Sep.
Article en En | MEDLINE | ID: mdl-27385400
BACKGROUND AND AIMS: The Crohn's Disease Endoscopic Index of Severity [CDEIS] and Simplified Endoscopic Score for Crohn's Disease [SES-CD] demonstrate consistent overall intra- and inter-rater reliability. However, the reliability of some index items is relatively poor. We evaluated scoring conventions to improve the reliability of these items. METHODS: Five gastroenterologists with no previous experience scoring the CDEIS or SES-CD were trained on their use. A total of 65 video recordings of colonoscopies were scored blindly by each gastroenterologist before and after additional training on index scoring conventions. Intra-class correlation coefficients [ICCs] assessed the effect of application of these conventions on the reliability of the CDEIS, SES-CD, and a Global Evaluation of Lesion Severity [GELS] score. RESULTS: Following training on scoring conventions, inter-rater ICCs (95% confidence interval [CI]) for the total SES-CD score increased from 0.78 [0.71, 0.85] to 0.85 [0.79, 0.89]. The ICCs for the total CDEIS and GELS scores were not affected: corresponding inter-rater ICCs were 0.74 [0.65, 0.81] and 0.49, [0.38, 0.61] before and 0.73 [0.65, 0.81] and 0.53 [0.42, 0.64] following application of scoring conventions. Estimations of ulcer depth, surface area, anatomical location, and stenosis were important sources of variability. CONCLUSIONS: Use of scoring conventions previously developed by expert central readers enhanced the reliability of the SES-CD but did not similarly affect the CDEIS or GELS. As the SES-CD is more likely to be reliable than the CDEIS and can be optimised with targeted training, it is the preferred instrument for use in clinical trials.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Índice de Severidad de la Enfermedad / Enfermedad de Crohn / Colonoscopía / Toma de Decisiones Clínicas Tipo de estudio: Clinical_trials / Evaluation_studies / Prognostic_studies Límite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: J Crohns Colitis Asunto de la revista: GASTROENTEROLOGIA Año: 2016 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Índice de Severidad de la Enfermedad / Enfermedad de Crohn / Colonoscopía / Toma de Decisiones Clínicas Tipo de estudio: Clinical_trials / Evaluation_studies / Prognostic_studies Límite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: J Crohns Colitis Asunto de la revista: GASTROENTEROLOGIA Año: 2016 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Reino Unido