title: Inter-observer agreement in endoscopic scoring systems: preliminary report of an ongoing study from the Italian Group for Inflammatory Bowel Disease (IG-IBD).
abstract: BACKGROUND
  Endoscopic activity has become a therapeutic endpoint in inflammatory bowel disease. Aim of this study was to evaluate inter-observer agreement for endoscopic scores in a real-life setting.
  
  
  METHODS
  14 gastroenterologists with experience in inflammatory bowel disease care and endoscopic scoring reviewed videos of ulcerative colitis (n=13) and postoperative (n=10) and luminal (n=8) Crohn's disease. The Mayo subscore for ulcerative colitis, Rutgeerts score for postoperative Crohn's disease, Crohn's disease endoscopic index of severity (CDEIS), and the simple endoscopic score-Crohn's disease (SES-CD) for luminal Crohn's disease were calculated. A subset of five endoscopic clips were assessed by 30 general gastroenterologists without specific experience in endoscopic scores. Kappa statistics and intraclass correlation coefficients were used to measure agreement.
  
  
  RESULTS
  Mayo subscore agreement was suboptimal: kappas were 0.53 (95% confidence interval 0.47-0.56) and 0.71 (0.67-0.76) for the two groups. Rutgeerts score agreement was fair: kappas were 0.57 (0.51-0.65) and 0.67 (0.60-0.72). Agreements for CDEIS and SES-CD were good: intraclass correlation coefficients for the two groups were 0.83 (0.54-1.00) and 0.67 (0.36-0.97) for CDEIS and 0.93 (0.76-1.00) and 0.68 (0.35-0.97) for SES-CD, respectively.
  
  
  CONCLUSIONS
  The reproducibility of endoscopic scores in inflammatory bowel disease remains suboptimal, which could potentially have major effects on therapeutic choices.
authors.affiliation: Gastroenterology Unit, Mauriziano Hospital Turin, Italy. Electronic address: mdaperno@teletu.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Daperno
authors.affiliation: Bolzano Hospital, Bolzano, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Comberlato
authors.affiliation: Cancer Research and Cure Institute "Casa Sollievo Sofferenza", San Giovanni Rotondo (FG), Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Bossa
authors.affiliation: University Tor Vergata, Rome, Italy.
authors.forename: Livia
authors.initials: L
authors.lastname: Biancone
authors.affiliation: University Hospital "Careggi", Florence, Italy.
authors.forename: Andrea G
authors.initials: AG
authors.lastname: Bonanomi
authors.affiliation: University Hospital "L. Sacco", Milan, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Cassinotti
authors.affiliation: "San Camillo-Forlanini" Hospitals, Rome, Italy.
authors.forename: Rocco
authors.initials: R
authors.lastname: Cosintino
authors.affiliation: Hospital "Cardarelli", Naples, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Lombardi
authors.affiliation: "San Camillo-Forlanini" Hospitals, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Mangiarotti
authors.affiliation: Catholic University "S. Cuore", Columbus Integrated Complex, Rome, Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Papa
authors.affiliation: "Sandro Pertini" Hospital, Rome, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Pica
authors.affiliation: University of Bologna, "S. Orsola Malpighi" Hospital, Bologna, Italy.
authors.forename: Fernando
authors.initials: F
authors.lastname: Rizzello
authors.affiliation: University of Padua, Padua, Italy.
authors.forename: Renata
authors.initials: R
authors.lastname: D'Incà
authors.affiliation: United Hospitals "Villa Sofia-Cervello", Palermo, Italy.
authors.forename: Ambrogio
authors.initials: A
authors.lastname: Orlando
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D003093:Colitis, Ulcerative / Q000188:drug therapy / Q000473:pathology; D003424:Crohn Disease / Q000188:drug therapy / Q000473:pathology; D003625:Data Collection; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005762:Gastroenterology / Q000592:standards / Q000639:trends; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology*; D007558:Italy; D008297:Male; D015588:Observer Variation; D017064:Process Assessment, Health Care; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
chemical_list: D000305:Adrenal Cortex Hormones
keywords: CDEIS; Endoscopic scores; Interobserver agreement; Mayo endoscopic subscore; Rutgeerts’ score; SES-CD