Open AccessEndoscopic Assessment of the Duodenum in Dogs with Inflammatory Bowel Disease
Author(s) -
Slovak J.E.,
Wang C.,
Morrison J.A.,
Deitz K.L.,
LeVine D.N.,
Otoni C.,
King R.R.,
Gerber L.E.,
Hanson K.R.,
Lundberg A.P.,
Jergens A.E.
Publication year - 2014
Publication title -
journal of veterinary internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.356
H-Index - 103
eISSN - 1939-1676
pISSN - 0891-6640
DOI - 10.1111/jvim.12424
Subject(s) - medicine , endoscopy , duodenum , kappa , inflammatory bowel disease , gastroenterology , clinical trial , colonoscopy , radiology , disease , colorectal cancer , cancer , philosophy , linguistics
Background Endoscopy is performed for direct inspection of the mucosa and acquisition of biopsies in dogs with inflammatory bowel disease ( IBD ). Aim 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 and Clinical Importance Interobserver agreement of IBD mucosal appearance from endoscopic findings benefitted from operator experience.