Comparison of several activity indices for the evaluation of endoscopic activity in UC: Inter‐ and intraobserver consistency
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 display...
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| Veröffentlicht in: | Inflammatory bowel diseases 2010-02, Vol.16 (2), p.192-197 |
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| creator | Osada, Taro Ohkusa, Toshifumi Yokoyama, Tetsuji Shibuya, Tomoyoshi Sakamoto, Naoto Beppu, Kazuko Nagahara, Akihito Otaka, Michiro Ogihara, Tatsuo Watanabe, Sumio |
| description | 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. (Inflamm Bowel Dis 2009;) |
| doi_str_mv | 10.1002/ibd.21000 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_754548846</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>745641651</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4890-cda12573011ac6225580fa17b068d2dbe3b45f6a7055a196577d421d4b92ad053</originalsourceid><addsrcrecordid>eNqF0ctKxDAUBuAgipfRhS8g2YmLatIkbeJOx9uA4EbXJU1OMdJpxqQzMhvxEXxGn8RoB3QjchY5hO_8mx-hfUqOKSH5iavtcZ42soa2qWBFxiXn62knpcyIUnIL7cT4lGgatYm2qBKlYEJto9exn850cNF32Dc4wgKCbrE2vVu4foldZ52BiBsfcP8IGBa6neveDRw666PxM2d-X-CH8SmedD2Ej7d3rDub_vqgfR0hpHhsfBdd7KEzy1200eg2wt7qHaGHq8v78U12e3c9GZ_dZoZLRTJjNc1FyQil2hR5LoQkjaZlTQppc1sDq7loCl0SITRVhShLy3Nqea1ybYlgI3Q45M6Cf55D7KupiwbaVnfg57EqBRdcSl78L7koOC0E_V8yJhmjSiZ5NEgTfIwBmmoW3FSHZUVJ9dVglRqsvhtM9mCVOq-nYH_kqrIETgbw4lpY_p1UTc4vhshPwiumTg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>733833198</pqid></control><display><type>article</type><title>Comparison of several activity indices for the evaluation of endoscopic activity in UC: Inter‐ and intraobserver consistency</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>Oxford University Press Journals All Titles (1996-Current)</source><creator>Osada, Taro ; Ohkusa, Toshifumi ; Yokoyama, Tetsuji ; Shibuya, Tomoyoshi ; Sakamoto, Naoto ; Beppu, Kazuko ; Nagahara, Akihito ; Otaka, Michiro ; Ogihara, Tatsuo ; Watanabe, Sumio</creator><creatorcontrib>Osada, Taro ; Ohkusa, Toshifumi ; Yokoyama, Tetsuji ; Shibuya, Tomoyoshi ; Sakamoto, Naoto ; Beppu, Kazuko ; Nagahara, Akihito ; Otaka, Michiro ; Ogihara, Tatsuo ; Watanabe, Sumio</creatorcontrib><description>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. (Inflamm Bowel Dis 2009;)</description><identifier>ISSN: 1078-0998</identifier><identifier>EISSN: 1536-4844</identifier><identifier>DOI: 10.1002/ibd.21000</identifier><identifier>PMID: 19575359</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Colitis, Ulcerative - diagnosis ; Colitis, Ulcerative - pathology ; Colon - pathology ; Colonoscopy - statistics & numerical data ; Data Interpretation, Statistical ; disease activity ; endoscopic activity index ; Humans ; kappa statistics ; Observer Variation ; Reproducibility of Results ; Severity of Illness Index ; ulcerative colitis</subject><ispartof>Inflammatory bowel diseases, 2010-02, Vol.16 (2), p.192-197</ispartof><rights>Copyright © 2009 Crohn's & Colitis Foundation of America, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4890-cda12573011ac6225580fa17b068d2dbe3b45f6a7055a196577d421d4b92ad053</citedby><cites>FETCH-LOGICAL-c4890-cda12573011ac6225580fa17b068d2dbe3b45f6a7055a196577d421d4b92ad053</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fibd.21000$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fibd.21000$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19575359$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Osada, Taro</creatorcontrib><creatorcontrib>Ohkusa, Toshifumi</creatorcontrib><creatorcontrib>Yokoyama, Tetsuji</creatorcontrib><creatorcontrib>Shibuya, Tomoyoshi</creatorcontrib><creatorcontrib>Sakamoto, Naoto</creatorcontrib><creatorcontrib>Beppu, Kazuko</creatorcontrib><creatorcontrib>Nagahara, Akihito</creatorcontrib><creatorcontrib>Otaka, Michiro</creatorcontrib><creatorcontrib>Ogihara, Tatsuo</creatorcontrib><creatorcontrib>Watanabe, Sumio</creatorcontrib><title>Comparison of several activity indices for the evaluation of endoscopic activity in UC: Inter‐ and intraobserver consistency</title><title>Inflammatory bowel diseases</title><addtitle>Inflamm Bowel Dis</addtitle><description>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. (Inflamm Bowel Dis 2009;)</description><subject>Colitis, Ulcerative - diagnosis</subject><subject>Colitis, Ulcerative - pathology</subject><subject>Colon - pathology</subject><subject>Colonoscopy - statistics & numerical data</subject><subject>Data Interpretation, Statistical</subject><subject>disease activity</subject><subject>endoscopic activity index</subject><subject>Humans</subject><subject>kappa statistics</subject><subject>Observer Variation</subject><subject>Reproducibility of Results</subject><subject>Severity of Illness Index</subject><subject>ulcerative colitis</subject><issn>1078-0998</issn><issn>1536-4844</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqF0ctKxDAUBuAgipfRhS8g2YmLatIkbeJOx9uA4EbXJU1OMdJpxqQzMhvxEXxGn8RoB3QjchY5hO_8mx-hfUqOKSH5iavtcZ42soa2qWBFxiXn62knpcyIUnIL7cT4lGgatYm2qBKlYEJto9exn850cNF32Dc4wgKCbrE2vVu4foldZ52BiBsfcP8IGBa6neveDRw666PxM2d-X-CH8SmedD2Ej7d3rDub_vqgfR0hpHhsfBdd7KEzy1200eg2wt7qHaGHq8v78U12e3c9GZ_dZoZLRTJjNc1FyQil2hR5LoQkjaZlTQppc1sDq7loCl0SITRVhShLy3Nqea1ybYlgI3Q45M6Cf55D7KupiwbaVnfg57EqBRdcSl78L7koOC0E_V8yJhmjSiZ5NEgTfIwBmmoW3FSHZUVJ9dVglRqsvhtM9mCVOq-nYH_kqrIETgbw4lpY_p1UTc4vhshPwiumTg</recordid><startdate>201002</startdate><enddate>201002</enddate><creator>Osada, Taro</creator><creator>Ohkusa, Toshifumi</creator><creator>Yokoyama, Tetsuji</creator><creator>Shibuya, Tomoyoshi</creator><creator>Sakamoto, Naoto</creator><creator>Beppu, Kazuko</creator><creator>Nagahara, Akihito</creator><creator>Otaka, Michiro</creator><creator>Ogihara, Tatsuo</creator><creator>Watanabe, Sumio</creator><general>Wiley Subscription Services, Inc., A Wiley Company</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><scope>7T5</scope><scope>H94</scope></search><sort><creationdate>201002</creationdate><title>Comparison of several activity indices for the evaluation of endoscopic activity in UC: Inter‐ and intraobserver consistency</title><author>Osada, Taro ; Ohkusa, Toshifumi ; Yokoyama, Tetsuji ; Shibuya, Tomoyoshi ; Sakamoto, Naoto ; Beppu, Kazuko ; Nagahara, Akihito ; Otaka, Michiro ; Ogihara, Tatsuo ; Watanabe, Sumio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4890-cda12573011ac6225580fa17b068d2dbe3b45f6a7055a196577d421d4b92ad053</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Colitis, Ulcerative - diagnosis</topic><topic>Colitis, Ulcerative - pathology</topic><topic>Colon - pathology</topic><topic>Colonoscopy - statistics & numerical data</topic><topic>Data Interpretation, Statistical</topic><topic>disease activity</topic><topic>endoscopic activity index</topic><topic>Humans</topic><topic>kappa statistics</topic><topic>Observer Variation</topic><topic>Reproducibility of Results</topic><topic>Severity of Illness Index</topic><topic>ulcerative colitis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Osada, Taro</creatorcontrib><creatorcontrib>Ohkusa, Toshifumi</creatorcontrib><creatorcontrib>Yokoyama, Tetsuji</creatorcontrib><creatorcontrib>Shibuya, Tomoyoshi</creatorcontrib><creatorcontrib>Sakamoto, Naoto</creatorcontrib><creatorcontrib>Beppu, Kazuko</creatorcontrib><creatorcontrib>Nagahara, Akihito</creatorcontrib><creatorcontrib>Otaka, Michiro</creatorcontrib><creatorcontrib>Ogihara, Tatsuo</creatorcontrib><creatorcontrib>Watanabe, Sumio</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><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>Inflammatory bowel diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Osada, Taro</au><au>Ohkusa, Toshifumi</au><au>Yokoyama, Tetsuji</au><au>Shibuya, Tomoyoshi</au><au>Sakamoto, Naoto</au><au>Beppu, Kazuko</au><au>Nagahara, Akihito</au><au>Otaka, Michiro</au><au>Ogihara, Tatsuo</au><au>Watanabe, Sumio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of several activity indices for the evaluation of endoscopic activity in UC: Inter‐ and intraobserver consistency</atitle><jtitle>Inflammatory bowel diseases</jtitle><addtitle>Inflamm Bowel Dis</addtitle><date>2010-02</date><risdate>2010</risdate><volume>16</volume><issue>2</issue><spage>192</spage><epage>197</epage><pages>192-197</pages><issn>1078-0998</issn><eissn>1536-4844</eissn><abstract>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. (Inflamm Bowel Dis 2009;)</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>19575359</pmid><doi>10.1002/ibd.21000</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Inflammatory bowel diseases, 2010-02, Vol.16 (2), p.192-197 |
| issn | 1078-0998 1536-4844 |
| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; Oxford University Press Journals All Titles (1996-Current) |
| subjects | Colitis, Ulcerative - diagnosis Colitis, Ulcerative - pathology Colon - pathology Colonoscopy - statistics & numerical data Data Interpretation, Statistical disease activity endoscopic activity index Humans kappa statistics Observer Variation Reproducibility of Results Severity of Illness Index ulcerative colitis |
| title | Comparison of several activity indices for the evaluation of endoscopic activity in UC: Inter‐ and intraobserver consistency |
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