title: Validation of the Prague C & M criteria for the endoscopic grading of Barrett's esophagus by gastroenterology trainees: a multicenter study.
abstract: BACKGROUND
  The Prague C & M criteria, developed for the endoscopic grading of Barrett's esophagus (BE), (C = circumferential length, M = maximal length) were previously validated among a panel of 29 expert endoscopists with a special interest in BE. Its performance among gastroenterology trainees is unknown.
  
  
  OBJECTIVE
  To test interobserver agreement among gastroenterology trainees for the Prague C & M criteria, identification of the gastroesophageal junction (GEJ) and the diaphragmatic hiatus.
  
  
  METHODS
  A prospective study.
  
  
  METHODS
  Two tertiary referral centers.
  
  
  METHODS
  Standardized endoscopic videos were used.
  
  
  METHODS
  Interobserver agreement.
  
  
  RESULTS
  Eighteen high-quality videos (normal esophagus, short and long lengths of BE, equally distributed) were independently evaluated by 18 gastroenterology trainees (year 1, n = 5; year 2, n = 6; year 3, n = 7) after administration of a formal teaching module by an expert endoscopist. Overall intraclass correlation coefficients for assessment of the C and M extent of the endoscopic BE segment above the GEJ were 0.94 (95% CI, 0.89-0.98) and 0.96 (95% CI, 0.94-0.98), respectively. The overall intraclass correlation coefficients for GEJ and diaphragmatic hiatus location recognition were 0.92 (0.86-0.96) and 0.90 (0.82-0.95), respectively. The year of training did not affect interobserver agreement.
  
  
  CONCLUSIONS
  The use of videos for endoscopic evaluation.
  
  
  CONCLUSIONS
  After standardized teaching, the Prague C & M criteria have high overall validity among gastroenterology trainees irrespective of the level of training for endoscopic evaluation of visualized BE lengths as well as key endoscopic landmarks.
authors.affiliation: Veterans Affairs Medical Center, Kansas City, Missouri 64128-2295, USA.
authors.forename: Babac
authors.initials: B
authors.lastname: Vahabzadeh
authors.forename: Anil B
authors.initials: AB
authors.lastname: Seetharam
authors.forename: Michael B
authors.initials: MB
authors.lastname: Cook
authors.forename: Sachin
authors.initials: S
authors.lastname: Wani
authors.forename: Amit
authors.initials: A
authors.lastname: Rastogi
authors.forename: Ajay
authors.initials: A
authors.lastname: Bansal
authors.forename: Dayna S
authors.initials: DS
authors.lastname: Early
authors.forename: Prateek
authors.initials: P
authors.lastname: Sharma
mesh_terms: D001471:Barrett Esophagus / Q000145:classification / Q000473:pathology*; D016001:Confidence Intervals; D004943:Esophagogastric Junction / Q000473:pathology; D004945:Esophagoscopy; D005762:Gastroenterology / Q000193:education*; D006801:Humans; D015588:Observer Variation; D011446:Prospective Studies; D015203:Reproducibility of Results; D014741:Video Recording