Comparison of the Mayo Endoscopy Score and the Ulcerative Colitis Endoscopy Index of Severity and the Ulcerative Colitis Colonoscopy Index of Severity

Abstract Background and study aims: Endoscopy plays an essential role in managing patients with ulcerative colitis (UC), as it allows us to visualize and assess the severity of the disease. As such assessments are not always objective, different scores have been devised to standardize the findings. The main aim of this study was to assess the interobserver variability between the Mayo Endoscopy Score (MES), Ulcerative Colitis Endoscopy Index of Severity (UCEIS) and Ulcerative Colitis Colonoscopy Index of Severity (UCCIS) analyzing the severity of the endoscopic lesions in patients with ulcerative colitis. Patients and methods: This was a single-cohort observational study in which a colonoscopy was carried out on patients with UC, as normal clinical practice, and a video was recorded. The results from the video were classified according to the MES, UCEIS and UCCIS by three endoscopic specialists independently, and they were compared to each other. The Mayo Endoscopy Score (MES) was used to assess the clinical situation of the patient. The therapeutic impact was analyzed after colonoscopy was carried out. Results: Sixty-seven patients were included in the study. The average age was 51 (SD ± 16.7) and the average MES was 3.07 (SD ± 2.54). The weighted Kappa index between endoscopists A and B for the MES was 0.8; between A and C 0.52; and between B and C 0.49. The intraclass correlation coefficient for UCEIS was 0.92 among the three endoscopists (CI 95 %: 0.83–0.96) and 0.96 for UCCIS among the three endoscopists (CI 95 % 0.94–0.97). A change in treatment for 34.3 % of the patients was implemented on seeing the results of the colonoscopy. Conclusions: There was an adequate, but not perfect, correlation between the different endoscopists for MES, UCEIS, UCCIS. This was higher with the last two scores. Thus, there is still some subjectivity to be minimized through special training, on assessing the seriousness of the endoscopic lesions in patients with UC.

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Assessment of the nursing care product (APROCENF): a reliability and construct validity study

Revista Latino-Americana de Enfermagem ◽

10.1590/1518-8345.1495.2860 ◽

2017 ◽

Vol 25 (0) ◽

Cited By ~ 3

Author(s):

Danielle Fabiana Cucolo ◽

Márcia Galan Perroca

Keyword(s):

Construct Validity ◽

Nursing Care ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Principal Component ◽

Weighted Kappa ◽

Kappa Index ◽

Rater Reliability ◽

Care Product ◽

Spearman’S Correlation

ABSTRACT Objectives: to verify the reliability and construct validity estimates of the "Assessment of nursing care product" scale (APROCENF) and its applicability. Methods: this validation study included a sample of 40 (inter-rater reliability) and 172 (construct validity) assessments performed by nurses at the end of the work shift at nine inpatient services of a teaching hospital in the Brazilian Southeast. The data were collected between February and September/2014 with interruptions. Cronbach's alpha and Spearman's correlation coefficients were calculated, as well as the intraclass correlation and the weighted kappa index (inter-rater reliability). Exploratory factor analysis was used with principal component extraction and varimax rotation (construct validity). Results: the internal consistency revealed an alpha coefficient of 0.85, item-item correlation ranging between 0.13 and 0.61 and item-total correlation between 0.43 and 0.69. Inter-rater equivalence was obtained and all items evidenced significant factor loadings. Conclusion: this research evidenced the reliability and construct validity of the scale to assess the nursing care product. Its application in nursing practice permits identifying improvements needed in the production process, contributing to management and care decisions.

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Interobserver variability in the interpretation of computed tomography following aneurysmal subarachnoid hemorrhage

Journal of Neurosurgery ◽

10.3171/2011.7.jns11725 ◽

2011 ◽

Vol 115 (6) ◽

pp. 1191-1196 ◽

Cited By ~ 18

Author(s):

George M. Ibrahim ◽

Stefan Weidauer ◽

R. Loch Macdonald

Keyword(s):

Subarachnoid Hemorrhage ◽

Interobserver Variability ◽

Aneurysmal Subarachnoid Hemorrhage ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Ct Scanning ◽

Weighted Kappa ◽

Standardized Assessments ◽

Ct Scans ◽

Perfect Agreement

Object Numerous abnormal findings may be evident on CT scans after aneurysmal subarachnoid hemorrhage (SAH). Here, the authors assess the interobserver variability in the radiological interpretation of the initial CT scan following SAH. Methods Two experienced reviewers, a neurosurgeon and a neuroradiologist, independently prospectively reviewed the initial CT scans of 413 patients enrolled in the CONSCIOUS-1 trial. Measured variables included SAH, intraventricular hemorrhage, intracerebral hemorrhage, subdural hematoma, chronic infarction, midline shift, and hydrocephalus. To assess interobserver variability, weighted kappa values and intraclass correlation coefficients (ICCs) were calculated and Bland-Altman analysis was performed. Results Moderate to substantial agreement was found for most of the CT scanning findings. There was fair to moderate interobserver agreement between reviewers when determining the extent of SAH based on a descriptive categorical classification (kappa 0.41; 95% CI 0.33–0.49), and better agreement when a semiquantitative scale was used (ICC 0.56; 95% CI 0.49–0.62). There was poor agreement between reviewers for the presence of hydrocephalus (kappa 0.34; 95% CI 0.20–0.48), but substantial to near perfect agreement on ventriculocranial ratio measurements (ICC 0.77; 95% CI 0.72–0.81). Conclusions The authors' findings suggest that there is considerable interobserver variability in the interpretation of CT scans after SAH. Quantitative measures may reduce interobserver variability in comparison with qualitative or categorical scales. Variability in interpretation of CT scans has implications for patient care and conduct of clinical trials. It may be beneficial to develop standardized assessments to ensure consistent evaluation of measured variables.

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Development and Relative Validity of a Semiquantitative Food Frequency Questionnaire to Estimate Dietary Intake among a Multi-Ethnic Population in the Malaysian Cohort Project

Nutrients ◽

10.3390/nu13041163 ◽

2021 ◽

Vol 13 (4) ◽

pp. 1163

Author(s):

Suzana Shahar ◽

Mohd Razif Shahril ◽

Noraidatulakma Abdullah ◽

Boekhtiar Borhanuddin ◽

Mohd Arman Kamaruddin ◽

...

Keyword(s):

Vitamin C ◽

Correlation Coefficient ◽

Food Frequency Questionnaire ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Weighted Kappa ◽

Dietary Intakes ◽

Food Frequency ◽

Relative Validity ◽

Spearman’S Correlation

Measuring dietary intakes in a multi-ethnic and multicultural setting, such as Malaysia, remains a challenge due to its diversity. This study aims to develop and evaluate the relative validity of an interviewer-administered food frequency questionnaire (FFQ) in assessing the habitual dietary exposure of The Malaysian Cohort (TMC) participants. We developed a nutrient database (with 203 items) based on various food consumption tables, and 803 participants were involved in this study. The output of the FFQ was then validated against three-day 24-h dietary recalls (n = 64). We assessed the relative validity and its agreement using various methods, such as Spearman’s correlation, weighed Kappa, intraclass correlation coefficient (ICC), and Bland–Altman analysis. Spearman’s correlation coefficient ranged from 0.24 (vitamin C) to 0.46 (carbohydrate), and almost all nutrients had correlation coefficients above 0.3, except for vitamin C and sodium. Intraclass correlation coefficients ranged from −0.01 (calcium) to 0.59 (carbohydrates), and weighted Kappa exceeded 0.4 for 50% of nutrients. In short, TMC’s FFQ appears to have good relative validity for the assessment of nutrient intake among its participants, as compared to the three-day 24-h dietary recalls. However, estimates for iron, vitamin A, and vitamin C should be interpreted with caution.

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Linear Mandibular Measurements: Comparison between Orthopantomograms and Lateral Cephalograms

The Cleft Palate-Craniofacial Journal ◽

10.1597/07-123.1 ◽

2009 ◽

Vol 46 (2) ◽

pp. 147-153 ◽

Cited By ~ 24

Author(s):

E. M. Ongkosuwito ◽

M. M. J. Dieleman ◽

A. M. Kuijpers-Jagtman ◽

P. G. H. Mulder ◽

J. W. van Neck

Keyword(s):

Interobserver Variability ◽

Intraclass Correlation ◽

Kappa Statistics ◽

Magnification Factor ◽

Linear Measurements ◽

Lateral Cephalogram ◽

X Ray ◽

Lateral Cephalograms ◽

Left And Right ◽

Cephalometric Measurements

Objective: To investigate the reliability of length measurements of the mandible by comparing orthopantomograms (OPTs) with lateral cephalograms. Design: Observational study. Setting: OPTs and lateral cephalograms were taken of 20 human dry skulls. Four orthodontists and four maxillofacial surgeons located landmarks on all radiographs using a computer program for cephalometric measurements. Intraobserver and interobserver variability in locating landmarks was assessed, as well as positioning of the skulls prior to radiography between the x-ray assistants. Magnification differences between the left and right side of the mandible on the OPT were determined for five skulls. Kappa statistics were used to calculate the intraclass correlation coefficient for intraobserver and interobserver differences. An F test was used to assess differences between methods and between type of observer. Results: No significant differences were found in the magnification factor of the left and right side of the mandible. Compared with a lateral cephalogram, the OPT had comparable reliability in measuring mandibular distances condylion-gonion, gonion-menton, and condylion-menton. No significant differences were observed between the x-ray assistants in taking the OPTs and lateral cephalograms or in repositioning the skulls. Significant differences were found between orthodontists and maxillofacial surgeons for landmark measurements. Conclusion: An OPT is as reliable as a lateral cephalogram for linear measurements of the mandible (condylion-gonion, gonion-menton, and condylion-menton).

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Tu1983 The Investigation of Medium- to Long-Term Prognosis of Ulcerative Colitis Patients Using Ulcerative Colitis Endoscopic Index of Severity (UCEIS)

Gastroenterology ◽

10.1016/s0016-5085(16)33376-5 ◽

2016 ◽

Vol 150 (4) ◽

pp. S997

Author(s):

Mari Arai ◽

Makoto Naganuma ◽

Shinya Sugimoto ◽

Hiroki Kiyohara ◽

Keiko Ohno ◽

...

Keyword(s):

Ulcerative Colitis ◽

Index Of Severity ◽

Long Term Prognosis

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Development and psychometric evaluation of the Thirst Distress Scale for patients with heart failure

European Journal of Cardiovascular Nursing ◽

10.1177/1474515117728624 ◽

2017 ◽

Vol 17 (3) ◽

pp. 226-234 ◽

Cited By ~ 5

Author(s):

Nana Waldréus ◽

Tiny Jaarsma ◽

Martje HL van der Wal ◽

Naoko P Kato

Keyword(s):

Heart Failure ◽

Psychometric Properties ◽

Intraclass Correlation ◽

Psychometric Testing ◽

Psychometric Evaluation ◽

Weighted Kappa ◽

Patients With Heart Failure ◽

Using Data ◽

Test Retest Reliability ◽

Distress Scale

Background: Patients with heart failure can experience thirst distress. However, there is no instrument to measure this in patients with heart failure. The aim of the present study was to develop the Thirst Distress Scale for patients with Heart Failure (TDS-HF) and to evaluate psychometric properties of the scale. Methods and results: The TDS-HF was developed to measure thirst distress in patients with heart failure. Face and content validity was confirmed using expert panels including patients and healthcare professionals. Data on the TDS-HF was collected from patients with heart failure at outpatient heart failure clinics and hospitals in Sweden, the Netherlands and Japan. Psychometric properties were evaluated using data from 256 heart failure patients (age 72±11 years). Concurrent validity of the scale was assessed using a thirst intensity visual analogue scale. Patients did not have any difficulties answering the questions, and time taken to answer the questions was about five minutes. Factor analysis of the scale showed one factor. After psychometric testing, one item was deleted. For the eight item TDS-HF, a single factor explained 61% of the variance and Cronbach’s alpha was 0.90. The eight item TDS-HF was significantly associated with the thirst intensity score ( r=0.55, p<0.001). Regarding test-retest reliability, the intraclass correlation coefficient was 0.88, and the weighted kappa values ranged from 0.29–0.60. Conclusion: The eight-item TDS-HF is valid and reliable for measuring thirst distress in patients with heart failure.

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Simultaneous Monitoring of the Middle Cerebral and Basilar Arteries to Detect Right-to-Left Shunts Using Transcranial Doppler by Agitated Saline Administration

10.21203/rs.3.rs-956948/v1 ◽

2021 ◽

Author(s):

Min Kim ◽

So Young Park ◽

Ji Man Hong

Keyword(s):

Transcranial Doppler ◽

Valsalva Maneuver ◽

Weighted Kappa ◽

Tier 2 ◽

Kappa Index ◽

Evaluation Tool ◽

Saline Administration ◽

Basilar Arteries ◽

Ischemic Attack ◽

Tier 3

Abstract Transcranial Doppler (TCD) is an easy, non-invasive, and real-time monitoring device for detecting right-to-left shunts (RLS). Nonetheless, it has limited benefits in patients with poor temporal windows. Therefore, we aimed to investigate whether the basilar artery (BA) window was as effective as the middle cerebral artery (MCA) in detecting RLS during TCD monitoring. Overall, we enrolled 344 patients with stroke, transient ischemic attack, headache, or dizziness. MCA and BA were monitored using a modified headset. To investigate the feasibility of the suboccipital window in detecting RLS, we instituted an evaluation tool with three tiers to evaluate microembolic signals (MESs) during TCD monitoring. Tier 1: TCD monitoring of the MCA (bilaterally) in the resting state, tier 2: TCD monitoring of the MCA (bilaterally) while performing the Valsalva maneuver, and tier 3: TCD monitoring of the index MCA and BA while performing the Valsalva maneuver. In tiers 2 and 3, a high agreement rate of 0.8076 and 0.8068 (p<0.001), respectively, on the weighted kappa index, and a high intra-class correlation coefficient of 0.9822 and 0.9860 (p<0.001), respectively, were observed on detecting MESs. Our data suggests that the BA window is as effective as the MCA window for detecting RLS on TCD.

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Four-Dimensional CT Analysis of Dorsal Intercalated Segment Instability in patients with Suspected Scapholunate Instability

Journal of Wrist Surgery ◽

10.1055/s-0040-1722571 ◽

2021 ◽

Author(s):

Lionel Athlani ◽

Jonathan Granero ◽

Kamel Rouizi ◽

Gabriela Hossu ◽

Alain Blum ◽

...

Keyword(s):

Interobserver Variability ◽

Intraclass Correlation ◽

Threshold Values ◽

Level Of Evidence ◽

Ct Arthrography ◽

Scapholunate Instability ◽

Ct Analysis ◽

The Difference ◽

Dorsal Intercalated Segment Instability ◽

Work Up

Abstract Background In this study we sought to evaluate the contribution of dynamic four-dimensional computed tomography (4DCT) relative to the standard imaging work-up for the identification of the dorsal intercalated segment instability (DISI) in patients with suspected chronic scapholunate instability (SLI). Methods Forty patients (22 men, 18 women; mean age 46.5 ± 13.1 years) with suspected SLI were evaluated prospectively with radiographs, arthrography, and 4DCT. Based on radiographs and CT arthrography, three groups were defined: positive SLI (n = 16), negative SLI (n = 19), and questionable SLI (n = 5). Two independent readers used 4DCT to evaluate the lunocapitate angle (LCA) (mean, max, coefficient of variation [CV], and range values) during radioulnar deviation. Results The interobserver variability of the 4DCT variables was deemed excellent (intraclass correlation coefficient = 0.79 to 0.96). Between the three groups, there was no identifiable difference for the LCAmean. The LCAmax values were lower in the positive SLI group (88 degrees) than the negative SLI group (102 degrees). The positive SLI group had significantly lower LCAcv (7% vs. 12%, p = 0.02) and LCArange (18 vs. 27 degrees, p = 0.01) values than the negative SLI group. The difference in all the LCA parameters between the positive SLI group and the questionable SLI group was not statistically significant. When comparing the negative SLI and questionable SLI groups, the LCAcv (p = 0.03) and LCArange (p = 0.02) values were also significantly different. The best differentiation between patients with and without SLI was obtained with a LCAcv and LCArange threshold values of 9% (specificity of 63% and sensitivity of 62%) and 20 degrees (specificity of 71% and sensitivity of 63%), respectively. Conclusion In this study, 4DCT appeared as a quantitative and reproducible relevant tool for the evaluation of DISI deformity in cases of SLI, including for patients presenting with questionable initial radiography findings. Level of evidence This is a Level III study.

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Automatic, computer-aided determination of endoscopic and histological inflammation in patients with mild to moderate ulcerative colitis based on red density

Gut ◽

10.1136/gutjnl-2019-320056 ◽

2020 ◽

Vol 69 (10) ◽

pp. 1778-1786 ◽

Cited By ~ 10

Author(s):

Peter Bossuyt ◽

Hiroshi Nakase ◽

Séverine Vermeire ◽

Gert de Hertogh ◽

Tom Eelbode ◽

...

Keyword(s):

Ulcerative Colitis ◽

Disease Activity ◽

Objective Evaluation ◽

Second Phase ◽

Endoscopic Images ◽

Severity Scores ◽

Computer Based ◽

Index Of Severity ◽

Using Data ◽

Histological Factors

BackgroundThe objective evaluation of endoscopic disease activity is key in ulcerative colitis (UC). A composite of endoscopic and histological factors is the goal in UC treatment. We aimed to develop an operator-independent computer-based tool to determine UC activity based on endoscopic images.MethodsFirst, we built a computer algorithm using data from 29 consecutive patients with UC and 6 healthy controls (construction cohort). The algorithm (red density: RD) was based on the red channel of the red-green-blue pixel values and pattern recognition from endoscopic images. The algorithm was refined in sequential steps to optimise correlation with endoscopic and histological disease activity. In a second phase, the operating properties were tested in patients with UC flares requiring treatment escalation. To validate the algorithm, we tested the correlation between RD score and clinical, endoscopic and histological features in a validation cohort.ResultsWe constructed the algorithm based on the integration of pixel colour data from the redness colour map along with vascular pattern detection. These data were linked with Robarts histological index (RHI) in a multiple regression analysis. In the construction cohort, RD correlated with RHI (r=0.74, p<0.0001), Mayo endoscopic subscores (r=0.76, p<0.0001) and UC Endoscopic Index of Severity scores (r=0.74, p<0.0001). The RD sensitivity to change had a standardised effect size of 1.16. In the validation set, RD correlated with RHI (r=0.65, p=0.00002).ConclusionsRD provides an objective computer-based score that accurately assesses disease activity in UC. In a validation study, RD correlated with endoscopic and histological disease activity.

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P807 UCEIS is associated with PRO2, partial Mayo and SCCAI remission in UC: preliminary results from a prospective study

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz203.935 ◽

2020 ◽

Vol 14 (Supplement_1) ◽

pp. S631-S631

Author(s):

P A Golovics ◽

L Gonczi ◽

J Reinglass ◽

C Verdon ◽

W Afif ◽

...

Keyword(s):

Ulcerative Colitis ◽

Clinical Remission ◽

Roc Analysis ◽

Clinical Decision Making ◽

Activity Index ◽

Operating Characteristics ◽

Faecal Calprotectin ◽

Patient Reported ◽

Index Of Severity ◽

Active Disease

Abstract Background Optimal management of patients with ulcerative colitis (UC) requires the accurate assessment of disease activity. Endoscopic evaluation is considered the gold standard approach, but it is invasive. We aimed to determine the operating characteristics of the Ulcerative Colitis Endoscopic Index of Severity (UCEIS), to quantify the cut off most closely correlated with clinical remission or activity and determine agreement with the Mayo endoscopic subscore (MES), Baron score, clinical scores and biomarkers. Methods 136 patients were included prospectively (age: 48 (IQR38-61) years, duration 12 (4–19)years, 63 females, 53.7% extensive disease, 40.4% on biologicals) at the time of the colonoscopy. Ulcerative Colitis Endoscopic Index of Severity (UCEIS) Mayo endoscopic subscore (MES), Baron scores were calculated, as well as the2 item patient reported outcome (PRO), partial MAYO, Simple Clinical Colitis Activity Index (SCCAI). CRP and faecal calprotectin (FCAL) was available in 58.1 and 33.8% of patients. 20.7% had clinical flare, treatment was escalated in 17.8% of patients. ROC analysis and K-statistics were performed and Spearman’s correlation was calculated. Results UCEIS was strongly associated to PRO2 SF (AUC:0.866), RBS (AUC:0.921), PRO2 combined remission (AUC:0.905), partial MAYO (AUC:0.956) and SCCAI (AUC:0.907) remission in a ROC analysis. A UCEIS of ≤3 was identified as the best cut-off to identify RBS subscore of 0, or total PRO2 remission (RBS 0 and SF ≤1), partial MAYO (≤2) and SCCAI (≤2.5) remission, while a UCEIS≥4 identified active disease frequently needing change in medical therapy. A moderate agreement was found between UCEIS and MES (K=0.451) or Baron (K=0.499) scores. Correlation between FCAL and UCEIS (coeff:0.743, p < 0.0001) was strong, while modest only with CRP (coeff:0.333, p = 0.01). Conclusion A UCEIS was strongly associated with clinical remission defined as PRO2, SF, RBS, partial Mayo or SCCAI with best agreement with RBS and partial Mayo remission. A UCEIS of ≤3 was identified as a cut-off for quiescent disease, while a UCEIS≥4 identified active disease, which can support clinical decision-making based on endoscopic findings. Agreement between UCEIS and FCAL was strong, while agreement with UCEIS and MES/Baron scores was moderate.

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