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validation of the ulcerative colitis endoscopic index of severity 

November's publication of Gastroenterology reports on the reliability and initial validation of the ulcerative colitis endoscopic index of severity.

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Dr Simon Travis and colleagues from England studied the reliability of the previously described Ulcerative Colitis Endoscopic Index of Severity (UCEIS), and validated it with an independent cohort of investigators.

The researchers created a new library of 57 videos of flexible sigmoidoscopy and stratified them based on disease severity.

The team randomly assigned 25 investigators to assess 28 videos.

Investigators were blinded to clinical details except for 2 of 4 duplicated videos.

There were 3 descriptors (“vascular pattern”, “bleeding”, and “erosions and ulcers”) comprising the UCEIS that were scored with a visual analogue scale (VAS) to assess overall severity.

The research team found a high level of correlation between UCEIS scores and overall assessment of severity.

Internal consistency was 0.86
Gastroenterology

The team observed that internal consistency was 0.86.

Intrainvestigator and interinvestigator reliability ratios for UCEIS scores were 0.96 and 0.88, respectively.

The team noted that intrainvestigator agreement in determination of the UCEIS score was good, with individual descriptors ranging from a κ of 0.47 to 0.87.

Interinvestigator agreement in determination of UCEIS scores was moderate, with descriptors ranging from a κ of 0.48 to 0.54.

The researchers found that intrainvestigator variability in determining UCEIS scores did not change appreciably when a video was presented with clinical details.

Dr Travis' team comments, "The UCEIS and its components show satisfactory intrainvestigator and interinvestigator reliability."

"Among investigators, the UCEIS accounted for a median of 86% of the variability in evaluation of overall severity on the VAS when assessing the endoscopic severity of UC and was unaffected by knowledge of clinical details."

Gastroenterology 2013: 145(5): 987-995
28 October 2013

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