Interobserver variation of colonoileoscopic findings in Crohn's disease.
BACKGROUND
Colonoileoscopy is increasingly used to evaluate Crohn's disease, but the reproducibility of endoscopic findings is not clear.


METHODS
The interobserver variation of endoscopic findings and the influence of experience on assessments were investigated in 82 colonoileoscopies in Crohn's disease.


RESULTS
In colonic assessment there was excellent agreement for most endoscopic features (kappa values > 0.75; p < 0.001). In ileal assessment agreement was excellent with regard to detection of large ulcers and strictures and endoscopic staging on the basis of ulcer size and stricture (kappa > 0.76; p < 0.001). Observer experience was an important factor in ileal assessments: agreement was excellent for 13 features within experienced pairs, compared with 3 when only 1 of a pair was experienced. In colonic assessment experience was less important.


CONCLUSIONS
The study showed that acceptable agreement can be obtained on some well-defined inflammatory lesions in Crohn's disease even when investigator experience is limited. Endoscopic staging on the basis of ulcer size and stricture, being excellently reproducible, can serve as a simple summarizing assessment.
Smedh
K
K
Dept. of Medico-Surgical Gastroenterology, University Hospital, Linköping, Sweden.
Olaison
G
G
Jönsson
K A
KA
Johansson
K E
KE
Skullman
S
S
Hallböök
O
O
D000328:Adult; D000368:Aged; D003113:Colonoscopy; D003424:Crohn Disease / Q000473:pathology*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D007082:Ileum / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results