Inter-observer agreement in endoscopic scoring systems: Preliminary report of an ongoing study from the Italian Group for Inflammatory Bowel Disease (IG-IBD)

Daperno, Marco; Comberlato, Michele; Bossa, Fabrizio; Biancone, Livia; Bonanomi, Andrea; Cassinotti, A.; Cosintino, R.; Lombardi, G; Mangiarotti, R.; Papa, Alfredo; Pica, Roberta; Rizzello, Fernando; D’Incà, R.; Orlando, Ambrogio

doi:10.1016/j.dld.2014.07.010

Cited by 95 publications

(47 citation statements)

References 40 publications

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“…The limiting problems of this approach are limited by the fact that: (a) endoscopic scores are quite complex, lack a formal validation, and their reproducibility in IBD remains suboptimal, which could potentially have major effects on therapeutic choices 5, 6, 20 ; (b) there are numerous histological scores (only a couple fully validated), strongly influenced by treatments, and often complex to use in clinical practice 7–9 .…”

Section: Discussionmentioning

confidence: 99%

Usefulness of Different Pathological Scores to Assess Healing of the Mucosa in Inflammatory Bowel Diseases: A Real Life Study

Villanacci

Antonelli

Lotti

et al. 2017

Sci Rep

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The concept of remission for patients with inflammatory bowel diseases has recently evolved, and should also include histological healing of the mucosa, difficult to evaluate since there is no agreement on pathological scores and those available are quite complex to use in the daily routine. We evaluated the possible usefulness of a simplified pathological score to assess histological healing of the mucosa in inflammatory bowel diseases patients compared with four commonly proposed pathological scores. Slides from 24 patients (12 Crohn’s disease, 12 ulcerative colitis, age range 24–62 years), pre- and post-treatment with biological agents and displaying endoscopic remission were assessed by two pathologists. Pre- and post-treatment results and the time employed to calculate the various scores were obtained. All scores were useful to document highly significant post-treatment decreases of histological activity. However, the simplified score needed significant less time to be calculated for each slide, had high inter-rater agreement, and avoided subjectivity from the pathologists. The simplified score is easy to calculate and seems apt to document histological healing of the mucosa, in a manner similar to the more complex scores. It remains to be established whether this score could simplify the daily routinary practice in this context.

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Section: Discussionmentioning

confidence: 99%

Usefulness of Different Pathological Scores to Assess Healing of the Mucosa in Inflammatory Bowel Diseases: A Real Life Study

Villanacci

Antonelli

Lotti

et al. 2017

Sci Rep

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“…The CDEIS and the SES-CD are robust validated indices and they show high reproducibility among central readers 5 6. The absence of validated score thresholds associated with specific prognostic values or with endoscopic healing represents a weakness of both CDEIS and SES-CD.…”

Section: Discussionmentioning

confidence: 99%

“…Another limitation of the Rutgeerts’ score is when the anastomosis cannot be reached. Recently, its reproducibility was tested and agreement was fair (κ 0.57) among 14 IBD specialists 6. The pragmatic appeal of the score has been demonstrated by its widespread use in clinical trials and clinical practice.…”

Section: Introductionmentioning

confidence: 99%

IOIBD technical review on endoscopic indices for Crohn's disease clinical trials

Vuitton

Marteau

Sandborn

et al. 2015

Gut

158

102

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At the end of the voting process, the investigators ranked first a >50% decrease in Simple Endoscopic Score for Crohn's Disease (SES-CD) or Crohn's Disease Endoscopic Index of Severity for the definition of endoscopic response, and an SES-CD 0-2 for the definition of endoscopic remission in CD. All experts agreed on a Rutgeerts' score i0-i1 for the definition of endoscopic remission after surgery.

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“…Examination of individual factors revealed that stenosis and superficial ulceration grading had low inter-rater (0.48, 0.65) and intra-rater agreement (0.63, 0.78), respectively. Reproducibility of the Rutgeerts’ score has also been questioned, as a recent study of 14 IBD specialists found a Rutgeerts’ score agreement to be marginal, κ=0.57 30 .…”

Section: Limitations Of Ileocolonoscopy For Disease Activity Assessmentmentioning

confidence: 99%

Endoscopy and cross-sectional imaging for assessing Crohn׳s disease activity

Stidham

Cross

2016

Techniques in Gastrointestinal Endoscopy

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Crohn’s disease (CD) is principally characterized by chronic and recurrent inflammation of the gastrointestinal tract, most commonly found in the ileo-colonic region. The chronicity and severity of intestinal inflammation together contribute to progressive, cumulative, deep, transmural intestinal damage, including stricturing, obstruction, abscesses, and fistulae. Both intestinal inflammation and its chronic complications result in a range of symptoms subsequently leading to patient presentations with diarrhea, abdominal pain, and anemia related to intestinal blood loss. Measuring disease activity and severity are essential for decision of treatment intensity early in the disease course and longitudinal monitoring of therapeutic efficacy. This review will summarize the transition from subjective symptoms driving disease activity indices, into increasingly objective and quantitative measures of intestinal injury by direct mucosal assessment (endoscopy), cross-sectional imaging, and surrogate biomarkers. Specific commentary on intestinal stricture and perianal fistula assessment and management are presented in accompanying sections of this series.

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Inter-observer agreement in endoscopic scoring systems: Preliminary report of an ongoing study from the Italian Group for Inflammatory Bowel Disease (IG-IBD)

Cited by 95 publications

References 40 publications

Usefulness of Different Pathological Scores to Assess Healing of the Mucosa in Inflammatory Bowel Diseases: A Real Life Study

Usefulness of Different Pathological Scores to Assess Healing of the Mucosa in Inflammatory Bowel Diseases: A Real Life Study

IOIBD technical review on endoscopic indices for Crohn's disease clinical trials

Endoscopy and cross-sectional imaging for assessing Crohn׳s disease activity

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