Prospective evaluation of third-generation small bowel capsule endoscopy videos by independent readers demonstrates poor reproducibility of cleanliness classifications - 11/11/21
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Highlights |
• | The main difficulty in comparing the different preparations is the lack of a reliable and reproducible tool that can assess SB cleanliness quality. |
• | Three scores (quantitative index, qualitative evaluation, and overall adequacy assessment) are sometimes used for evaluation. |
• | Our validation study was based on the expert's consensual reading of 156 complete third-generation SB-CE video recordings. |
• | All three scores showed fair to moderate intra-observer reproducibility and fair to substantial inter-observer reproducibility. |
• | These results call for the development and evaluation of new cleanliness assessment scores or methods. |
Abstract |
Objective |
The detection of lesions during small bowel (SB) capsule endoscopy (CE) depends on the cleanliness of the intestine. Quality reporting and comparison of different preparation methods require reliable scores. Three scores known as quantitative index (QI), qualitative evaluation (QE), and overall adequacy assessment (OAA), have been proposed to assess SB cleanliness, and are sometimes used in clinical practice and in clinical trials. However, none of these scores has received any external validation. The aim of our study was to re-assess the reproducibility of these three specific scores.
Methods |
One-hundred-and-fifty-five complete third-generation SB-CE video recordings were extracted from a multicenter randomized controlled trial (PREPINTEST) which evaluated three modalities of SB preparation for CE. Three experts independently read the 155 SB-CE video recordings twice, in a random order, over 48 -h periods at 6-week intervals, using the QI, QE and OAA scores. Cohen’s linearly weighted kappa coefficients were calculated to assess intra-observer and inter-observer agreements.
Results |
Intra-observer reproducibility was fair to moderate, with kappa coefficients between 0.37 and 0.46 for QI, 0.41 and 0.51 for QE, 0.41 and 0.50 for OAA. Inter-observer reproducibility was fair to substantial according to kappa coefficients between experts varying from 0.40 to 0.64, 0.29 to 0.65, and 0.52 to 0.71, for QI, QE and OAA, respectively.
Conclusions |
QI, QE and OAA scores, currently used for evaluation of the quality of the preparation of SB-CE, are not sufficiently reproducible. Other scores or methods are therefore needed for SB-CE cleanliness assessment.
Le texte complet de cet article est disponible en PDF.Keywords : Capsule endoscopy, Gastrointestinal bleeding, Preparation, Small bowel, Scoring.
Plan
Vol 45 - N° 6
Article 101612- novembre 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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