title: Can we improve the detection rate and interobserver agreement in capsule endoscopy?
abstract: BACKGROUND
  Data about strategies for improving the diagnostic ability of capsule endoscopy readers are lacking.
  
  
  OBJECTIVE
  (1) To evaluate the detection rate and the interobserver agreement among readers with different experience; (2) to verify the impact of a specific training (hands-on training plus expert tutorial) on these parameters.
  
  
  METHODS
  17 readers reviewed 12 videos twice; between the two readings they underwent the training. The identified small bowel findings were described by a simplified version of Structured Terminology and classifies as clinically significant/non-significant. Findings identified by the readers were compared with those identified by three experts (Reference Standard).
  
  
  RESULTS
  The Reference Standard identified 26 clinically significant findings. The mean detection rate of overall readers for significant findings was low (about 50%) and did not change after the training (46.2% and 46.4%, respectively). There was no difference in the detection rate among readers with different experience. The interobserver agreement with the Reference Standard in describing significant findings was moderate (k = 0.44; CI95%: 0.39-0.50) and did not change after the training (k = 0.44; CI95%: 0.38-0.49) or stratifying readers according to their experience.
  
  
  CONCLUSIONS
  Both the interobserver agreement and the detection rate of significant findings are low, regardless of the readers' experience. Our training did not significantly increase the performance of readers with different experience.
authors.affiliation: Ospedale Valduce, UO Gastroenterologia, Como, Italy. ema.rondo@gmail.com
authors.forename: Emanuele
authors.initials: E
authors.lastname: Rondonotti
authors.forename: Marco
authors.initials: M
authors.lastname: Soncini
authors.forename: Carlo Maria
authors.initials: CM
authors.lastname: Girelli
authors.forename: Antonio
authors.initials: A
authors.lastname: Russo
authors.forename: Giovanni
authors.initials: G
authors.lastname: Ballardini
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Bianchi
authors.forename: Paolo
authors.initials: P
authors.lastname: Cantù
authors.forename: Laura
authors.initials: L
authors.lastname: Centenara
authors.forename: Pietro
authors.initials: P
authors.lastname: Cesari
authors.forename: Claudio Camillo
authors.initials: CC
authors.lastname: Cortelezzi
authors.forename: Claudio
authors.initials: C
authors.lastname: Gozzini
authors.forename: Guido
authors.initials: G
authors.lastname: Lupinacci
authors.forename: Marta
authors.initials: M
authors.lastname: Maino
authors.forename: Giovanna
authors.initials: G
authors.lastname: Mandelli
authors.forename: Nicola
authors.initials: N
authors.lastname: Mantovani
authors.forename: Dario
authors.initials: D
authors.lastname: Moneghini
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Morandi
authors.forename: Rocco
authors.initials: R
authors.lastname: Putignano
authors.forename: Renzo
authors.initials: R
authors.lastname: Schalling
authors.forename: Maria
authors.initials: M
authors.lastname: Tatarella
authors.forename: Pasquale
authors.initials: P
authors.lastname: Vitagliano
authors.forename: Federica
authors.initials: F
authors.lastname: Villa
authors.forename: Stefania
authors.initials: S
authors.lastname: Zatelli
authors.forename: Dario
authors.initials: D
authors.lastname: Conte
authors.forename: Enzo
authors.initials: E
authors.lastname: Masci
authors.forename: Roberto
authors.initials: R
authors.lastname: de Franchis
mesh_terms: D053704:Capsule Endoscopy / Q000193:education / Q000592:standards*; D002983:Clinical Competence; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis*; D007421:Intestine, Small / Q000473:pathology*; D059032:Learning Curve; D015588:Observer Variation; D012015:Reference Standards