[Intra- and interobserver variation in capsule endoscopy reviews].
BACKGROUND
It is unclear which professional groups can and should perform reviews of capsule endoscopy (CE) exams of the GI tract. We investigate whether a junior doctor or an endoscopy nurse can review CE films with the same diagnostic results as a specialist.


METHODS
An endoscopy nurse and a junior doctor, both with no CE experience, reviewed 30 CE films twice and noted their findings. A distinction was made between clinically important and non-important findings. An endoscopy specialist and the Given Imaging Review Service reviewed the films once each, and their findings were used as the study's gold standard. Time consumption, intra- and interobserver agreement, sensitivity and specificity were assessed.


RESULTS
The junior doctor improved in speed from 1st to 2nd review, but the nurse did not. Both performed poorly compared with Given Imaging Review Service regarding diagnostic accuracy. The junior doctor improved in diagnostic accuracy from 1st to 2nd review, while the nurse did not. The nurse showed a decrease in sensitivity from 1st to 2nd review from 89% to 62%, whereas the junior doctor's sensitivity increased from 48% to 62%. Both missed many pathological findings and their results were not reproducible.


CONCLUSIONS
The nurse and junior doctor did not obtain the same diagnostic results as the gold standard. The results raise questions of whether nurses or junior doctors should perform capsule endoscopy reviews.
Laursen
Emilie Lund
EL
Københavns Universitet, Det Biovidenskabelige Fakultet, Institut for Produktionsdyr og Heste, Gentofte Hospital. emilielundlaursen@hotmail.com
Ersbøll
Annette Kjaer
AK
Rasmussen
Anne Mette Odgaard
AM
Christensen
Else Hove
EH
Holm
Jakob
J
Hansen
Mark Berner
MB
D053704:Capsule Endoscopy / Q000592:standards*; D002983:Clinical Competence; D003951:Diagnostic Errors; D006801:Humans; D007410:Intestinal Diseases / Q000473:pathology*; D007421:Intestine, Small / Q000473:pathology; D008505:Medical Staff, Hospital; D009726:Nurses; D015588:Observer Variation; D012680:Sensitivity and Specificity