Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 21 January 2018

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Observer consistency for grading of esophagitis by endoscopists

Reproducibility in grading esophagitis is good for both expert endoscopists and trainees, find researchers in the November issue of Gastrointestinal Endoscopy.

News image

fiogf49gjkf04

In this study, researchers from the United States evaluated intra- and inter-observer variability in the endoscopic scoring of esophagitis.

They assessed 2 grading schemes; the Los Angeles and Hetzel-Dent scales.

The team randomly displayed 325 endoscopic photographs of esophagitis, or healed esophagitis, to 9 endoscopist evaluators (4 experts, 5 trainees) by means of a CD-ROM. Each photograph was shown twice.

The evaluators scored each photograph by using both classification schemes.

For experts, intra-observer reproducibility was greater using both Los Angeles and Hetzel-Dent classifications.
Gastrointestinal Endoscopy
The research team used the kappa statistic as a measure of consistency.

The team found that for the trainees, intra-observer reproducibility was good (kappa = 0.436) when using the Los Angeles classification, but marginal ( kappa = 0.395) when using the Hetzel-Dent classification.

However, for the experts, intra-observer reproducibility was better when using both the Los Angeles (kappa = 0.545) and Hetzel-Dent classification (kappa = 0.552).

They also determined that inter-observer consistency for trainees was good when using both classifications (Los Angeles, kappa = 0.459; Hetzel-Dent, kappa = 0.427).

Again, for the expert evaluators, intra-observer reproducibility was better when using both classifications (Los Angeles, kappa = 0.556, Hetzel-Dent, kappa = 0.571).

When using the Los Angeles classification, only 5% and 8% of the photographs were interpreted to be more than 1 grade different from the mean for experts and trainees, respectively.

This same consistency was found by using the Hetzel-Dent classification scheme (experts 5%, trainees 10%).

Dr John Pandolfino's team concluded, "Reproducibility in grading esophagitis was good for both expert endoscopists and fellows, although there was greater consistency among the experts".

"Both the Los Angeles and Hetzel-Dent scoring systems are reproducible".

In a related editorial in the same publication, Dr Worth Boyce, from Florida, USA, discusses the need for an accurate endoscopic diagnosis of reflux esophagitis.

Dr Boyce states, that in order to achieve this, "A generally accepted classification or grading scheme that is easily understood and minimizes the degree of inter-observer disagreement is essential".

Gastrointest Endosc 2002; 56: 639-43, 775-8
29 October 2002

Go to top of page Email this page Email this page to a colleague

 19 January 2018 
Ileoanal pouch microbiota
 19 January 2018 
Predicting the risk of early surgery in Crohn’s
 19 January 2018 
Lifestyle intervention vs gastric bypass for obesity and diabetes
 18 January 2018 
Sleeve gastrectomy vs Roux-en-Y gastric bypass
 18 January 2018 
Healthcare costs of liver cancer in the USA
 18 January 2018 
High-risk adenomas at colonoscopy
 17 January 2018 
“Weekend effect” in upper GI hemorrhage
 17 January 2018 
Gut dysbiosis and non-antibiotic prescription medications
 17 January 2018 
Reducing surgical infections in high-outlier colorectal unit
 16 January 2018 
Bundle of care in GI cancer surgery
 16 January 2018 
Anxiety about colonoscopy
 16 January 2018 
Thiopurines and colorectal neoplasia in IBD
 15 January 2018 
Risks of death after liver transplants for liver cancer
 15 January 2018 
Recent advances in hepatocellular carcinoma
 15 January 2018 
Ileostomy output using telemedicine
 12 January 2018 
Surveillance protocols after colorectal cancer resection
 12 January 2018 
Biologic therapy by pregnant women with IBD and infant vaccines
 12 January 2018 
Biologic therapies for IBD in the USA
 11 January 2018 
Genetic risk factors in GERD
 11 January 2018 
Predictor of colorectal adenoma
 11 January 2018 
Ectopic pregnancy in IBD 
 10 January 2018 
Fecal immunochemical tests for colorectal cancer screening
 10 January 2018 
Risk factors for advanced NAFLD
 10 January 2018 
Dyspepsia prevalence with gastroesophageal reflux–type symptoms
 09 January 2018 
Screening intervals for people with family histories of colorectal cancer
 09 January 2018 
Financial impact of colorectal cancer
 09 January 2018 
Current practice and future research in autoimmune hepatitis
 08 January 2018 
Reliability of the IBD index
 08 January 2018 
Improving prognosis in patients with primary sclerosing cholangitis
 08 January 2018 
Aprepitant and nausea with gastroparesis
 05 January 2018 
Autoimmune pancreatitis and IBD
 05 January 2018 
Primary nonresponse to infliximab therapy
 05 January 2018 
Anesthesia assistance in outpatient colonoscopy
 04 January 2018 
Dietary polyphenols in the etiology of IBD
 04 January 2018 
Yoga vs low-FODMAP in IBS
 04 January 2018 
Local esophageal food allergen injections in eosinophilic esophagitis
 03 January 2018 
Population health management for IBD
 03 January 2018 
GERD in asthma and COPD
 03 January 2018 
Critical research gaps in colorectal cancer
 22 December 2017 
Costs of extrahepatic manifestations of Hep C
 22 December 2017 
Cholera vaccine and risk of death in colorectal cancer
 22 December 2017 
Colonoscopy after colorectal cancer resection
 21 December 2017 
Human oral microbiome and pancreatic cancer risk
 21 December 2017 
Health management for IBD
 21 December 2017 
PPI and Alzheimer's disease
 20 December 2017 
Management of abnormal liver blood tests
 20 December 2017 
Incidence of biopsy-verified celiac disease
 20 December 2017 
Osteoporotic fractures in Barrett's esophagus
 19 December 2017 
Alcohol abstinence and alcoholic hepatitis
 19 December 2017 
Family burden of pediatric Crohn's in the USA
 19 December 2017 
Early readmission in IBD patients
 18 December 2017 
Colorectal cancer mortality with low-risk adenomas at colonoscopy
 18 December 2017 
Disease activity indices in celiac disease
 18 December 2017 
Smoking behaviour predicted the risk of surgery in Crohn's
 15 December 2017 
Molecular classification of Crohn's disease
 15 December 2017 
Medical cannabinoid legalization policy and vomiting
 15 December 2017 
Inflammatory diet pattern and colorectal cancer risk
 14 December 2017 
PPIs and gastric cancer after H.pylori eradication
 14 December 2017 
H. pylori eradication therapies in countries with clarithromycin resistance
 13 December 2017 
Disease severity in NAFLD

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2018 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us