Endoscopy is routinely performed in patients with inflammatory bowel disease to evaluate disease severity and guide important clinical decisions.
However, variability in the interpretation of endoscopic findings can significantly impact patient management.
Dr Samuel Raimundo Fernandes and colleagues from Portugal invited 58 gastroenterologists to participate in an online survey including pictures and video recordings of colonoscopies performed in patients with ulcerative colitis and Crohn’s disease.
|Interrater agreement for ulcerative colitis mucosal healing was 0.57 |
|Inflammatory Bowel Diseases|
The team asked participants to rate the colorectal mucosa in patients with ulcerative colitis using the Mayo endoscopic subscore, and the neo-terminal ileum and anastomosis in operated patients with Crohn’s disease using the Rutgeerts score.
The researchers found interrater agreements for ulcerative colitis mucosal healing and complete mucosal healing were 0.57 and 0.89 and for Crohn’s disease postoperative recurrence, and interrater agreements for severe postoperative recurrence were 0.44 and 0.54, respectively.
Unexpectedly, although clinical information significantly influenced the interrater agreement, participant expertise and consultation of scores did not produce significant changes in the interrater agreement.
Dr Fernandes team concludes, "A high rate of disagreement in endoscopic scoring was found in this study, even among experienced physicians."
"The variability in the assessment of mucosal healing and postoperative recurrence may translate into relevant differences in patient management."