title: Development and validation of an endoscopic activity score for canine inflammatory bowel disease.
abstract: The aim of this study was to develop and prospectively validate a simple endoscopic score of disease activity for dogs with inflammatory bowel disease (IBD). Archived endoscopic still images and video recordings of gastric, duodenal, and colonic endoscopic examinations were displayed to novice and experienced endoscopists for assessment of inflammatory activity using established descriptions. The mucosal appearances evaluated were normal tissue, erosions, friability, increased granularity, lymphangiectasia (duodenum), and mass (colon). Fleiss and Cohen's Kappa statistics were used to estimate the inter-observer agreement of the index. For duodenal assessment, there were statistically significant (P <0.05) differences in inter-observer agreement, with experienced endoscopists performing better than novice endoscopists in the accurate identification of mucosal appearance of the duodenum. In contrast, there was no significant difference between novice and experienced endoscopists in their interpretation of gastric (P = 0.10) and colonic (P = 1.0) mucosal appearances. Validation studies using endoscopic video clips to assess the same endoscopic parameters by quantitative (lesion number and severity) and qualitative (presence of mucosal lesions) methods showed moderate-to-substantial agreement between experienced endoscopists. Based on the observations that the quantitative and qualitative scores of mucosal appearances are virtually identical, and that qualitative assessment was performed more quickly and objectively than quantitative assessment, we propose a simple endoscopic activity score based on qualitative criteria alone in dogs with inflammatory bowel disease.
authors: Department of Veterinary Clinical Science, College of Veterinary Medicine Washington State University, PO Box 646610, Pullman, WA 99164, USA. Electronic address: jeslovak@vetmed.wsu.edu.
authors: J E
authors: JE
authors: Slovak
authors: Department of Veterinary Diagnostic and Production Animal Medicine, College of Veterinary Medicine Iowa State University, 1600 S. 16th St, Ames, IA 50011, USA.
authors: C
authors: C
authors: Wang
authors: Department of Veterinary Diagnostic and Production Animal Medicine, College of Veterinary Medicine Iowa State University, 1600 S. 16th St, Ames, IA 50011, USA.
authors: Y
authors: Y
authors: Sun
authors: VCA Arboretum View Animal Hospital, 2551 Warrenville Rd, Downers Grove, IL 60515, USA.
authors: C
authors: C
authors: Otoni
authors: Department of Veterinary Clinical Science, College of Veterinary Medicine Iowa State University, 1600 S. 16th St, Ames, IA 50011, USA.
authors: J
authors: J
authors: Morrison
authors: Department of Veterinary Clinical Science, College of Veterinary Medicine Iowa State University, 1600 S. 16th St, Ames, IA 50011, USA.
authors: K
authors: K
authors: Deitz
authors: Department of Veterinary Clinical Science, College of Veterinary Medicine Iowa State University, 1600 S. 16th St, Ames, IA 50011, USA.
authors: D
authors: D
authors: LeVine
authors: Department of Veterinary Clinical Science, College of Veterinary Medicine Iowa State University, 1600 S. 16th St, Ames, IA 50011, USA.
authors: A E
authors: AE
authors: Jergens
mesh_terms: D000818:Animals; D004283:Dog Diseases / Q000175:diagnosis* / Q000473:pathology; D004285:Dogs; D004386:Duodenum / Q000473:pathology*; D016099:Endoscopy, Gastrointestinal / Q000662:veterinary*; D005260:Female; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis / Q000473:pathology / Q000662:veterinary*; D007413:Intestinal Mucosa / Q000473:pathology; D008297:Male; D015588:Observer Variation; D014741:Video Recording
keywords: CIBDAI; Gastrointestinal endoscopy; IBD; Inter-observer agreement; Mucosal appearance