title: Endoscopic experience improves interobserver agreement in the grading of esophagitis by Los Angeles classification: conventional endoscopy and optimal band image system.
abstract: OBJECTIVE
  Interobserver variation by experience was documented for the diagnosis of esophagitis using the Los Angeles classification. The aim of this study was to evaluate whether interobserver agreement can be improved by higher levels of endoscopic experience in the diagnosis of erosive esophagitis.
  
  
  METHODS
  Endoscopic images of 51 patients with gastroesophageal reflux disease (GERD) symptoms were obtained with conventional endoscopy and optimal band imaging (OBI). Endoscopists were divided into an expert group (16 gastroenterologic endoscopic specialists guaranteed by the Korean Society of Gastrointestinal Endoscopy) and a trainee group (individuals with fellowships, first year of specialty training in gastroenterology). All endoscopists had no or minimal experience with OBI. GERD was diagnosed using the Los Angeles classification with or without OBI.
  
  
  RESULTS
  The mean weighted paired κ statistics for interobserver agreement in grading erosive esophagitis by conventional endoscopy in the expert group was better than that in the trainee group (0.51 vs 0.42, p<0.05). The mean weighted paired k statistics in the expert group and in the trainee group based on conventional endoscopy with OBI did not differ (0.42, 0.42).
  
  
  CONCLUSIONS
  Interobserver agreement in the expert group using conventional endoscopy was better than that in the trainee group. Endoscopic experience can improve the interobserver agreement in the grading of esophagitis using the Los Angeles classification.
authors.affiliation: Department of Internal Medicine, Yeungnam University School of Medicine, Daegu, Korea.
authors.forename: Si Hyung
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Yeungnam University School of Medicine, Daegu, Korea.
authors.forename: Byung Ik
authors.initials: BI
authors.lastname: Jang
authors.affiliation: Department of Internal Medicine, Yeungnam University School of Medicine, Daegu, Korea.
authors.forename: Kyeong Ok
authors.initials: KO
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Seong Woo
authors.initials: SW
authors.lastname: Jeon
authors.affiliation: Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea.
authors.forename: Joong Goo
authors.initials: JG
authors.lastname: Kwon
authors.affiliation: Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea.
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea.
authors.forename: Jin Tae
authors.initials: JT
authors.lastname: Jung
authors.affiliation: Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Kyung Sik
authors.initials: KS
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Kwnag Bum
authors.initials: KB
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Eun Soo
authors.initials: ES
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea.
authors.forename: Chang Geun
authors.initials: CG
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Dongguk University School of Medicine, Daegu, Korea.
authors.forename: Chang Heon
authors.initials: CH
authors.lastname: Yang
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D004941:Esophagitis / Q000145:classification / Q000473:pathology*; D004945:Esophagoscopy / Q000592:standards*; D005762:Gastroenterology / Q000592:standards*; D005764:Gastroesophageal Reflux / Q000145:classification / Q000473:pathology; D006801:Humans; D015588:Observer Variation; D012189:Retrospective Studies
keywords: Agreement; Experience; Gastroesophageal reflux