INTEROBSERVER AGREEMENT BETWEEN TUTOR AND FELLOW AFTER 6 MONTHS OF TRAINING IN ENDOSCOPIC ULTRASOUND

Introduction: We aimed to compare the efficacy of endoscopic ultrasound elastography (EUS-EG) with that of magnifying chromoendoscopy (MCE) and endoscopic ultrasonography (EUS) for the diagnosis of the depth of invasion in colorectal neoplasms. This is an important clinical issue as the depth of invasion is associated with the risk of metastasis. Methods: Consecutive patients with suspected superficial colorectal neoplasms, evaluated by MCE, EUS, and EUS-EG, for whom endoscopic submucosal dissection was considered, were enrolled in 2018 (derivation study) and in 2019–2020 (validation study). The primary clinical endpoint was the diagnostic yield differentiating intramucosal and shallow submucosal neoplasms from deep submucosal (dSM) and advanced colorectal cancers. In addition, inter- and intra-observer agreements of the elastic score of colorectal neoplasm (ES-CRN) were evaluated by 2 expert and 2 non-expert endoscopists. Results: Thirty-one (33 lesions) and 50 (55 lesions) patients were enrolled in the derivation and validation studies, respectively. Sensitivity, specificity, positive, and negative predictive values, and accuracy of assessment of the depth of submucosal or deeper invasion in the derivation and validation groups were as follows: EUS-EG, 100/88.2/86.7/100/93.3% and 77.8/86.1/73.7/88.6/83.3%; MCE, 66.7/94.4/90.9/77.3/81.8% and 84.2/91.4/84.2/91.4/88.9%; and EUS, 93.3/77.8/77.8/93.3/84.8% and 89.5/65.7/58.6/92.0/74.1%, respectively. For the 2 expert endoscopists, interobserver agreement for the ES-CRN (first and second assessments) in the derivation group was 0.84 and 0.78, respectively; these values were 0.73 and 0.49, respectively, for the 2 non-expert endoscopists. Discussion/Conclusion: All 3 modalities presented similar diagnostic yield. Inter- and intra-observer agreements of the ES-CRN were substantial, even for non-expert endoscopists. Therefore, EUS-EG may be a useful modality in determining the depth of invasion in colorectal neoplasms.

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Sa1529 Interobserver Agreement and Diagnostic Accuracy in Experienced and Non-Experienced Endosonographers in the Interpretation of Contrast-Enhanced Harmonic Endoscopic Ultrasound (EUS) and Elastography EUS of Solid Pancreatic Lesions

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2012.04.318 ◽

2012 ◽

Vol 75 (4) ◽

pp. AB192

Author(s):

Julio Iglesias-Garcia ◽

Joao B. Cruz-Soares ◽

BjöRn Lindkvist ◽

Jose Larino-Noia ◽

Enrique Dominguez-Munoz

Keyword(s):

Diagnostic Accuracy ◽

Endoscopic Ultrasound ◽

Interobserver Agreement ◽

Contrast Enhanced

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Conventional Versus Rosemont Endoscopic Ultrasound Criteria for Chronic Pancreatitis: Comparing Interobserver Reliability and Intertest Agreement

Canadian Journal of Gastroenterology ◽

10.1155/2011/302382 ◽

2011 ◽

Vol 25 (5) ◽

pp. 261-264 ◽

Cited By ~ 29

Author(s):

Bruce Kalmin ◽

Brenda Hoffman ◽

Robert Hawes ◽

Joseph Romagnuolo

Keyword(s):

Chronic Pancreatitis ◽

Endoscopic Retrograde Cholangiopancreatography ◽

Endoscopic Ultrasound ◽

Interobserver Agreement ◽

Interobserver Reliability ◽

False Negative ◽

Kappa Statistic ◽

Weighted Kappa ◽

Endoscopic Retrograde ◽

Exact Test

BACKGROUND: The Rosemont criteria (RC) were recently proposed by expert consensus to standardize endoscopic ultrasound (EUS) features and thresholds for diagnosing chronic pancreatitis (CP); however, they are cumbersome and are not validated.OBJECTIVE: To determine interobserver agreement between RC and conventional criteria (CC), and to assess intertest agreement in the diagnosis of CP.METHODS: Thirty-six consecutive patients who underwent EUS for abdominal pain or pancreatitis were retrospectively reviewed. Anonymized images were independently chosen as best representations of the pancreatic body and reviewed by three experts who recorded the presence of CC and RC features. Agreement (proportion and kappa statistic) between CC and RC was calculated. Interobserver agreement within the CC and RC was assessed. Secondary comparisons with endoscopic retrograde cholangiopancreatography were made where available.RESULTS: Using CC, 60 readings (83.3%) were negative for CP, while 12 readings (16.7%) were positive. Using RC, 59 readings (81.9%) were negative for CP, while 13 (18.1%) were positive. The weighted kappa for interobserver agreement for CC (four categories: normal/low probability, indeterminate, high probability or calcific) was 0.50, with 80.0% overall agreement, versus 0.27 and 68.1% for the four RC categories (normal, indeterminate, suggestive of and consistent with). Agreement on a positive diagnosis with CC was 86.1% (P=0.38 [McNemar’s exact test]), with a kappa of 0.47; for RC, agreement was lower at 80.6% (P=0.016 [McNemar’s exact test]), with a kappa of 0.38. For patients who underwent endoscopic retrograde cholangiopancreatography (n=12), false-negative and false-positive rates between CC and RC did not appear to be different.CONCLUSIONS: The RC do not appear to achieve the goals of improving accuracy and interobserver agreement for diagnosing CP.

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ENDOSCOPIC ULTRASOUND FEATURES OF PANCREATIC FLUID COLLECTIONS AND THEIR IMPACT ON THERAPEUTIC DECISIONS: AN INTEROBSERVER AGREEMENT STUDY

Endoscopy ◽

10.1055/a-1640-4365 ◽

2021 ◽

Author(s):

Carlo Fabbri ◽

Todd Baron ◽

Giulia Gibiino ◽

Paolo Giorgio Arcidiacono ◽

Cecilia Binda ◽

...

Keyword(s):

Endoscopic Ultrasound ◽

Interobserver Agreement ◽

Morphological Characteristics ◽

Solid Component ◽

Therapeutic Approaches ◽

Endoscopic Necrosectomy ◽

Pancreatic Fluid ◽

Therapeutic Decisions ◽

Fluid Collections ◽

Agreement Study

Background and study aims: A validated classification of endoscopic ultrasound (EUS) morphological characteristics and consequent therapeutic intervention(s) in pancreatic and peripancreatic fluid collections (PFCs) is lacking. We performed an interobserver agreement study among expert endosonographers assessing EUS related PFCs features and therapeutic approaches utilized. Patients and methods: Fifty EUS videos of PFCs were independently reviewed by 12 experts and evaluated for PFC type, percentage of solid component, presence of infection, recognition and communication of the main pancreatic duct (MPD), stent choice for drainage, and direct endoscopic necrosectomy (DEN) performance and timing. The Gwet’s AC1 coefficient was used to assess interobserver agreement. Results: A moderate agreement was found for lesion type (AC1, 0.59), presence of infection (AC1, 0.41), and need for DEN (AC1, 0.50), while fair or poor agreements were stated for percentage of solid component (AC1, 0.15) and MPD recognition (AC1, 0.31). Substantial agreement was rated for ability to assess PFC-MPD communication (AC1, 0.69), decision between placing a plastic versus lumen-apposing metal stent (AC1, 0.62), and timing of DEN (AC1, 0.75). Conclusions: Interobserver agreement between expert endosonographers regarding morphological features of PFCs appeared suboptimal, while decisions on therapeutic approaches seemed more homogeneous. Studies to achieve standardization of the diagnostic endosonographic criteria and therapeutic approaches to PFCs are warranted.

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