Development and reliability of the new endoscopic virtual chromoendoscopy score: the PICaSSO (Paddington International Virtual ChromoendoScopy ScOre) in ulcerative colitis
Endoscopic inflammation and healing are important therapeutic endpoints in ulcerative colitis (UC). We developed and validated a new electronic virtual chromoendoscopy (EVC) score that could reflect the full spectrum of mucosal and vascular changes including mucosal healing in UC. Eight participants...
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| Veröffentlicht in: | Gastrointestinal endoscopy 2017-12, Vol.86 (6), p.1118-1127.e5 |
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| creator | Iacucci, Marietta Daperno, Marco Lazarev, Mark Arsenascu, Razvan Tontini, Gian Eugenio Akinola, Oluseyi Gui, Xianyong Sean Villanacci, Vincenzo Goetz, Martin Lowerison, Mark Lethebe, Brendan Cord Vecchi, Maurizio Neumann, Helmut Ghosh, Subrata Bisschops, Raf Kiesslich, Ralf |
| description | Endoscopic inflammation and healing are important therapeutic endpoints in ulcerative colitis (UC). We developed and validated a new electronic virtual chromoendoscopy (EVC) score that could reflect the full spectrum of mucosal and vascular changes including mucosal healing in UC.
Eight participants reviewed a 60-minute training module outlining 3 different i-SCAN modes demonstrating the entire spectrum of inflammatory mucosal and vascular changes in UC. Performance characteristics in endoscopic scoring and predicting the histologic inflammation with EVC (i-SCAN) by using 20 video clips before (pre-test) and after (post-test) were evaluated. Exploratory univariate factor analysis was performed on Paddington International Virtual Chromoendoscopy Score (PICaSSO) covariates for mucosal and vascular score separately. Subsequently, a proportional odds logistic regression model for the prediction of histologic scores was analyzed.
The interobserver agreement for Mayo endoscopic score in the pre-test (κ = .85; 95% CI, .78-.90) and the post-test (κ = .85; 95% CI, .77-.90) evaluation were very good. This was also true for the Ulcerative Colitis Endoscopic Index of Severity in the pre-test and post-test score interobserver agreement (κ = .86; 95% CI, .77-.92; and κ = .84; 95% CI, .75-.91, respectively). The interobserver agreement of the PICaSSO endoscopic score was very good in the pre-test and post-test evaluations (κ = .92; 95% CI, .87-.96; and κ = .89; 95% CI, .84-.94, respectively). The accuracy of the overall PICaSSO in assessing histologic abnormalities and inflammation by Harpaz score was 57% (95% CI, 48%-65%), by Robarts Histological Index 72% (95% CI, 64%-79%), and by the extent, chronicity, activity, plus system (full spectrum of histologic changes) 83% (95% CI, 76%-88%).
The EVC score “PICaSSO” showed very good interobserver agreement. The new EVC score may be used to define the endoscopic findings of mucosal and vascular healing in UC and reflected the full spectrum of histologic changes. |
| doi_str_mv | 10.1016/j.gie.2017.03.012 |
| format | Article |
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Eight participants reviewed a 60-minute training module outlining 3 different i-SCAN modes demonstrating the entire spectrum of inflammatory mucosal and vascular changes in UC. Performance characteristics in endoscopic scoring and predicting the histologic inflammation with EVC (i-SCAN) by using 20 video clips before (pre-test) and after (post-test) were evaluated. Exploratory univariate factor analysis was performed on Paddington International Virtual Chromoendoscopy Score (PICaSSO) covariates for mucosal and vascular score separately. Subsequently, a proportional odds logistic regression model for the prediction of histologic scores was analyzed.
The interobserver agreement for Mayo endoscopic score in the pre-test (κ = .85; 95% CI, .78-.90) and the post-test (κ = .85; 95% CI, .77-.90) evaluation were very good. This was also true for the Ulcerative Colitis Endoscopic Index of Severity in the pre-test and post-test score interobserver agreement (κ = .86; 95% CI, .77-.92; and κ = .84; 95% CI, .75-.91, respectively). The interobserver agreement of the PICaSSO endoscopic score was very good in the pre-test and post-test evaluations (κ = .92; 95% CI, .87-.96; and κ = .89; 95% CI, .84-.94, respectively). The accuracy of the overall PICaSSO in assessing histologic abnormalities and inflammation by Harpaz score was 57% (95% CI, 48%-65%), by Robarts Histological Index 72% (95% CI, 64%-79%), and by the extent, chronicity, activity, plus system (full spectrum of histologic changes) 83% (95% CI, 76%-88%).
The EVC score “PICaSSO” showed very good interobserver agreement. The new EVC score may be used to define the endoscopic findings of mucosal and vascular healing in UC and reflected the full spectrum of histologic changes.</description><identifier>ISSN: 0016-5107</identifier><identifier>EISSN: 1097-6779</identifier><identifier>DOI: 10.1016/j.gie.2017.03.012</identifier><identifier>PMID: 28322774</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Blood Vessels - diagnostic imaging ; Colitis, Ulcerative - diagnostic imaging ; Colitis, Ulcerative - pathology ; Colonoscopy - methods ; Color ; Humans ; Intestinal Mucosa - blood supply ; Intestinal Mucosa - diagnostic imaging ; Intestinal Mucosa - pathology ; Observer Variation ; Reproducibility of Results ; Severity of Illness Index ; Wound Healing</subject><ispartof>Gastrointestinal endoscopy, 2017-12, Vol.86 (6), p.1118-1127.e5</ispartof><rights>2017 American Society for Gastrointestinal Endoscopy</rights><rights>Copyright © 2017 American Society for Gastrointestinal Endoscopy. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c462t-c03b24c3085032b4670ef6d7ff3542fde31fe7c87de20192e2e123335f9ae39e3</citedby><cites>FETCH-LOGICAL-c462t-c03b24c3085032b4670ef6d7ff3542fde31fe7c87de20192e2e123335f9ae39e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.gie.2017.03.012$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28322774$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Iacucci, Marietta</creatorcontrib><creatorcontrib>Daperno, Marco</creatorcontrib><creatorcontrib>Lazarev, Mark</creatorcontrib><creatorcontrib>Arsenascu, Razvan</creatorcontrib><creatorcontrib>Tontini, Gian Eugenio</creatorcontrib><creatorcontrib>Akinola, Oluseyi</creatorcontrib><creatorcontrib>Gui, Xianyong Sean</creatorcontrib><creatorcontrib>Villanacci, Vincenzo</creatorcontrib><creatorcontrib>Goetz, Martin</creatorcontrib><creatorcontrib>Lowerison, Mark</creatorcontrib><creatorcontrib>Lethebe, Brendan Cord</creatorcontrib><creatorcontrib>Vecchi, Maurizio</creatorcontrib><creatorcontrib>Neumann, Helmut</creatorcontrib><creatorcontrib>Ghosh, Subrata</creatorcontrib><creatorcontrib>Bisschops, Raf</creatorcontrib><creatorcontrib>Kiesslich, Ralf</creatorcontrib><title>Development and reliability of the new endoscopic virtual chromoendoscopy score: the PICaSSO (Paddington International Virtual ChromoendoScopy ScOre) in ulcerative colitis</title><title>Gastrointestinal endoscopy</title><addtitle>Gastrointest Endosc</addtitle><description>Endoscopic inflammation and healing are important therapeutic endpoints in ulcerative colitis (UC). We developed and validated a new electronic virtual chromoendoscopy (EVC) score that could reflect the full spectrum of mucosal and vascular changes including mucosal healing in UC.
Eight participants reviewed a 60-minute training module outlining 3 different i-SCAN modes demonstrating the entire spectrum of inflammatory mucosal and vascular changes in UC. Performance characteristics in endoscopic scoring and predicting the histologic inflammation with EVC (i-SCAN) by using 20 video clips before (pre-test) and after (post-test) were evaluated. Exploratory univariate factor analysis was performed on Paddington International Virtual Chromoendoscopy Score (PICaSSO) covariates for mucosal and vascular score separately. Subsequently, a proportional odds logistic regression model for the prediction of histologic scores was analyzed.
The interobserver agreement for Mayo endoscopic score in the pre-test (κ = .85; 95% CI, .78-.90) and the post-test (κ = .85; 95% CI, .77-.90) evaluation were very good. This was also true for the Ulcerative Colitis Endoscopic Index of Severity in the pre-test and post-test score interobserver agreement (κ = .86; 95% CI, .77-.92; and κ = .84; 95% CI, .75-.91, respectively). The interobserver agreement of the PICaSSO endoscopic score was very good in the pre-test and post-test evaluations (κ = .92; 95% CI, .87-.96; and κ = .89; 95% CI, .84-.94, respectively). The accuracy of the overall PICaSSO in assessing histologic abnormalities and inflammation by Harpaz score was 57% (95% CI, 48%-65%), by Robarts Histological Index 72% (95% CI, 64%-79%), and by the extent, chronicity, activity, plus system (full spectrum of histologic changes) 83% (95% CI, 76%-88%).
The EVC score “PICaSSO” showed very good interobserver agreement. The new EVC score may be used to define the endoscopic findings of mucosal and vascular healing in UC and reflected the full spectrum of histologic changes.</description><subject>Blood Vessels - diagnostic imaging</subject><subject>Colitis, Ulcerative - diagnostic imaging</subject><subject>Colitis, Ulcerative - pathology</subject><subject>Colonoscopy - methods</subject><subject>Color</subject><subject>Humans</subject><subject>Intestinal Mucosa - blood supply</subject><subject>Intestinal Mucosa - diagnostic imaging</subject><subject>Intestinal Mucosa - pathology</subject><subject>Observer Variation</subject><subject>Reproducibility of Results</subject><subject>Severity of Illness Index</subject><subject>Wound Healing</subject><issn>0016-5107</issn><issn>1097-6779</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUtu2zAURYmiQeMmXUAnBYfpQAo_kii1o8D9GQjgAG47JWjyKaEhkS5JufBuuoCuoisrEzsZZsI34LkHj7wIvaWkpIQ2l5vy1kLJCBUl4SWh7AWaUdKJohGie4lmJENFTYk4Ra9j3BBCWsbpK3TKWs6YENUM_f0EOxj8dgSXsHIGBxisWtvBpj32PU53gB38xuCMj9pvrcY7G9KkBqzvgh_948Ue5zPAh4fEzWKuVqslvrhRxlh3m7zDC5cgOJWsdzn88yiZP0lWD5KVXgZ4j63D06AhZHwH__5on_ex8Ryd9GqI8OY4z9CPL5-_z78V18uvi_nVdaGrhqVCE75mleakrQln66oRBPrGiL7ndcV6A5z2IHQrDOS_6xgwoIxzXvedAt4BP0MXB-82-F8TxCRHGzUMg3LgpyhpK7qmqWnNMkoPqA4-xgC93AY7qrCXlMj7kuRG5pLkfUmScJlLypl3R_20HsE8JR5bycDHAwD5kTsLQUZtwWkwNoBO0nj7jP4_s_-mrQ</recordid><startdate>201712</startdate><enddate>201712</enddate><creator>Iacucci, Marietta</creator><creator>Daperno, Marco</creator><creator>Lazarev, Mark</creator><creator>Arsenascu, Razvan</creator><creator>Tontini, Gian Eugenio</creator><creator>Akinola, Oluseyi</creator><creator>Gui, Xianyong Sean</creator><creator>Villanacci, Vincenzo</creator><creator>Goetz, Martin</creator><creator>Lowerison, Mark</creator><creator>Lethebe, Brendan Cord</creator><creator>Vecchi, Maurizio</creator><creator>Neumann, Helmut</creator><creator>Ghosh, Subrata</creator><creator>Bisschops, Raf</creator><creator>Kiesslich, Ralf</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201712</creationdate><title>Development and reliability of the new endoscopic virtual chromoendoscopy score: the PICaSSO (Paddington International Virtual ChromoendoScopy ScOre) in ulcerative colitis</title><author>Iacucci, Marietta ; Daperno, Marco ; Lazarev, Mark ; Arsenascu, Razvan ; Tontini, Gian Eugenio ; Akinola, Oluseyi ; Gui, Xianyong Sean ; Villanacci, Vincenzo ; Goetz, Martin ; Lowerison, Mark ; Lethebe, Brendan Cord ; Vecchi, Maurizio ; Neumann, Helmut ; Ghosh, Subrata ; Bisschops, Raf ; Kiesslich, Ralf</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c462t-c03b24c3085032b4670ef6d7ff3542fde31fe7c87de20192e2e123335f9ae39e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Blood Vessels - diagnostic imaging</topic><topic>Colitis, Ulcerative - diagnostic imaging</topic><topic>Colitis, Ulcerative - pathology</topic><topic>Colonoscopy - methods</topic><topic>Color</topic><topic>Humans</topic><topic>Intestinal Mucosa - blood supply</topic><topic>Intestinal Mucosa - diagnostic imaging</topic><topic>Intestinal Mucosa - pathology</topic><topic>Observer Variation</topic><topic>Reproducibility of Results</topic><topic>Severity of Illness Index</topic><topic>Wound Healing</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Iacucci, Marietta</creatorcontrib><creatorcontrib>Daperno, Marco</creatorcontrib><creatorcontrib>Lazarev, Mark</creatorcontrib><creatorcontrib>Arsenascu, Razvan</creatorcontrib><creatorcontrib>Tontini, Gian Eugenio</creatorcontrib><creatorcontrib>Akinola, Oluseyi</creatorcontrib><creatorcontrib>Gui, Xianyong Sean</creatorcontrib><creatorcontrib>Villanacci, Vincenzo</creatorcontrib><creatorcontrib>Goetz, Martin</creatorcontrib><creatorcontrib>Lowerison, Mark</creatorcontrib><creatorcontrib>Lethebe, Brendan Cord</creatorcontrib><creatorcontrib>Vecchi, Maurizio</creatorcontrib><creatorcontrib>Neumann, Helmut</creatorcontrib><creatorcontrib>Ghosh, Subrata</creatorcontrib><creatorcontrib>Bisschops, Raf</creatorcontrib><creatorcontrib>Kiesslich, Ralf</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Gastrointestinal endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Iacucci, Marietta</au><au>Daperno, Marco</au><au>Lazarev, Mark</au><au>Arsenascu, Razvan</au><au>Tontini, Gian Eugenio</au><au>Akinola, Oluseyi</au><au>Gui, Xianyong Sean</au><au>Villanacci, Vincenzo</au><au>Goetz, Martin</au><au>Lowerison, Mark</au><au>Lethebe, Brendan Cord</au><au>Vecchi, Maurizio</au><au>Neumann, Helmut</au><au>Ghosh, Subrata</au><au>Bisschops, Raf</au><au>Kiesslich, Ralf</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Development and reliability of the new endoscopic virtual chromoendoscopy score: the PICaSSO (Paddington International Virtual ChromoendoScopy ScOre) in ulcerative colitis</atitle><jtitle>Gastrointestinal endoscopy</jtitle><addtitle>Gastrointest Endosc</addtitle><date>2017-12</date><risdate>2017</risdate><volume>86</volume><issue>6</issue><spage>1118</spage><epage>1127.e5</epage><pages>1118-1127.e5</pages><issn>0016-5107</issn><eissn>1097-6779</eissn><abstract>Endoscopic inflammation and healing are important therapeutic endpoints in ulcerative colitis (UC). We developed and validated a new electronic virtual chromoendoscopy (EVC) score that could reflect the full spectrum of mucosal and vascular changes including mucosal healing in UC.
Eight participants reviewed a 60-minute training module outlining 3 different i-SCAN modes demonstrating the entire spectrum of inflammatory mucosal and vascular changes in UC. Performance characteristics in endoscopic scoring and predicting the histologic inflammation with EVC (i-SCAN) by using 20 video clips before (pre-test) and after (post-test) were evaluated. Exploratory univariate factor analysis was performed on Paddington International Virtual Chromoendoscopy Score (PICaSSO) covariates for mucosal and vascular score separately. Subsequently, a proportional odds logistic regression model for the prediction of histologic scores was analyzed.
The interobserver agreement for Mayo endoscopic score in the pre-test (κ = .85; 95% CI, .78-.90) and the post-test (κ = .85; 95% CI, .77-.90) evaluation were very good. This was also true for the Ulcerative Colitis Endoscopic Index of Severity in the pre-test and post-test score interobserver agreement (κ = .86; 95% CI, .77-.92; and κ = .84; 95% CI, .75-.91, respectively). The interobserver agreement of the PICaSSO endoscopic score was very good in the pre-test and post-test evaluations (κ = .92; 95% CI, .87-.96; and κ = .89; 95% CI, .84-.94, respectively). The accuracy of the overall PICaSSO in assessing histologic abnormalities and inflammation by Harpaz score was 57% (95% CI, 48%-65%), by Robarts Histological Index 72% (95% CI, 64%-79%), and by the extent, chronicity, activity, plus system (full spectrum of histologic changes) 83% (95% CI, 76%-88%).
The EVC score “PICaSSO” showed very good interobserver agreement. The new EVC score may be used to define the endoscopic findings of mucosal and vascular healing in UC and reflected the full spectrum of histologic changes.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28322774</pmid><doi>10.1016/j.gie.2017.03.012</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Blood Vessels - diagnostic imaging Colitis, Ulcerative - diagnostic imaging Colitis, Ulcerative - pathology Colonoscopy - methods Color Humans Intestinal Mucosa - blood supply Intestinal Mucosa - diagnostic imaging Intestinal Mucosa - pathology Observer Variation Reproducibility of Results Severity of Illness Index Wound Healing |
| title | Development and reliability of the new endoscopic virtual chromoendoscopy score: the PICaSSO (Paddington International Virtual ChromoendoScopy ScOre) in ulcerative colitis |
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