title: Endoscopic assessment of the duodenum in dogs with inflammatory bowel disease.
abstract: BACKGROUND
  Endoscopy is performed for direct inspection of the mucosa and acquisition of biopsies in dogs with inflammatory bowel disease (IBD).
  
  
  OBJECTIVE
  To evaluate the interobserver agreement in the endoscopic assessment of duodenal mucosa in dogs with IBD.
  
  
  METHODS
  Thirty-five archived endoscopic images of grossly normal (n = 6) and inflamed (n = 29) duodenal mucosa were displayed to 3 expert and 5 trainee endoscopists. Each image was assessed independently by endoscopists for mucosal abnormalities using established indices (of hyperemia, granularity, friability, lymphatic dilatation, and erosions) or interpreted as normal mucosa (trial 1). A repeated trial (trial 2) was performed with the same images presented in random order 1 month later, and accompanied by a visual template.
  
  
  RESULTS
  There was slight interobserver agreement in initial mucosal assessment for expert and trainee endoscopists in trial 1 (kappa ≤ 0.02, P > .05). Interobserver agreement improved in trial 2 for both expert and trainee endoscopists (kappa = 0.2, P > .05) for experts and (P < .05) for trainees. There was a significant (P < .01) improvement in trainee endoscopy scores of lesions from trial 1 to trial 2. Regression analysis showed a significant (P < .01) difference between expert versus trainee endoscopy scores in trial 1. Repeat lesion assessment aided by use of a visual template (trial 2) improved the overall scores of trainee endoscopists to near that of expert endoscopists (P = .06).
  
  
  CONCLUSIONS
  Interobserver agreement of IBD mucosal appearance from endoscopic findings benefitted from operator experience.
authors.affiliation: Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA.
authors.forename: J E
authors.initials: JE
authors.lastname: Slovak
authors.forename: C
authors.initials: C
authors.lastname: Wang
authors.forename: J A
authors.initials: JA
authors.lastname: Morrison
authors.forename: K L
authors.initials: KL
authors.lastname: Deitz
authors.forename: D N
authors.initials: DN
authors.lastname: LeVine
authors.forename: C
authors.initials: C
authors.lastname: Otoni
authors.forename: R R
authors.initials: RR
authors.lastname: King
authors.forename: L E
authors.initials: LE
authors.lastname: Gerber
authors.forename: K R
authors.initials: KR
authors.lastname: Hanson
authors.forename: A P
authors.initials: AP
authors.lastname: Lundberg
authors.forename: A E
authors.initials: AE
authors.lastname: Jergens
mesh_terms: D000818:Animals; D004283:Dog Diseases / Q000175:diagnosis* / Q000473:pathology; D004285:Dogs; D004384:Duodenoscopy / Q000662:veterinary*; D004386:Duodenum / Q000473:pathology*; D005260:Female; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis / Q000473:pathology / Q000662:veterinary*; D007413:Intestinal Mucosa / Q000473:pathology; D008297:Male; D015588:Observer Variation
keywords: Endoscopy; Inflammatory bowel disease; Mucosal assessment