Image documentation of endoscopic findings in ulcerative colitis: photographs or video clips?
BACKGROUND
Previous studies have shown deficiencies in the endoscopy reports and substantial interobserver variation in the assessments of endoscopic findings. The aim of this study was to determine how to perform systematic digital image documentation in ulcerative colitis and to evaluate if mucosal inflammation is assessed equally on a still image and on a video clip.


METHODS
Eighteen video clips and their corresponding photographs that visualize different severities of ulcerative colitis were shown in randomized order to 20 experienced endoscopists. They assessed the mucosal inflammation of each image twice on a visual analog scale. Three comparisons were performed between the video clips, the photographs, and the video clips to the photographs, respectively.


RESULTS
The mean score of the inflammation of the video clips at tape 1 and 2 was 4.74: 95% confidence interval (CI)[4.41, 5.08] and 4.90: 95% CI[4.56, 5.24), respectively, and of the photographs 4.53: 95% CI[4.19, 4.88] and 4.43: 95% CI[4.09, 4.77], respectively. The first answer explains 83% of the variation in the second answer for all comparisons, and the agreement index ranged from 0.38 to 0.42.


CONCLUSIONS
The mucosal inflammation might be documented nearly as well with a still image as on a video clip. Systematic use of still images probably improves the endoscopy reports by adding more objective information about the mucosal inflammation.
de Lange
Thomas
T
Department of Gastroenterology, Ullevaal University Hospital, Oslo, Norway.
Larsen
Stig
S
Aabakken
Lars
L
D003093:Colitis, Ulcerative / Q000175:diagnosis*; D003106:Colon / Q000473:pathology; D003113:Colonoscopy / Q000379:methods*; D004282:Documentation / Q000379:methods*; D006801:Humans; D007089:Image Enhancement; D015588:Observer Variation; D010781:Photography / Q000379:methods*; D011446:Prospective Studies; D011897:Random Allocation; D012007:Rectum / Q000473:pathology; D014741:Video Recording