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. 2014 Mar;8(2):154-9.
doi: 10.5009/gnl.2014.8.2.154. Epub 2013 Nov 21.

Endoscopic experience improves interobserver agreement in the grading of esophagitis by Los Angeles classification: conventional endoscopy and optimal band image system

Si Hyung Lee  1 , Byung Ik Jang  1 , Kyeong Ok Kim  1 , Seong Woo Jeon  2 , Joong Goo Kwon  3 , Eun Young Kim  3 , Jin Tae Jung  3 , Kyung Sik Park  4 , Kwnag Bum Cho  4 , Eun Soo Kim  4 , Chang Geun Park  5 , Chang Heon Yang  6 ; DeaguGyeongbook Gastrointestinal Study Group
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Endoscopic experience improves interobserver agreement in the grading of esophagitis by Los Angeles classification: conventional endoscopy and optimal band image system

Si Hyung Lee et al. Gut Liver. 2014 Mar.

Abstract

Background/aims: Interobserver variation by experience was documented for the diagnosis of esophagitis using the Los Angeles classification. The aim of this study was to evaluate whether interobserver agreement can be improved by higher levels of endoscopic experience in the diagnosis of erosive esophagitis.

Methods: Endoscopic images of 51 patients with gastroesophageal reflux disease (GERD) symptoms were obtained with conventional endoscopy and optimal band imaging (OBI). Endoscopists were divided into an expert group (16 gastroenterologic endoscopic specialists guaranteed by the Korean Society of Gastrointestinal Endoscopy) and a trainee group (individuals with fellowships, first year of specialty training in gastroenterology). All endoscopists had no or minimal experience with OBI. GERD was diagnosed using the Los Angeles classification with or without OBI.

Results: The mean weighted paired κ statistics for interobserver agreement in grading erosive esophagitis by conventional endoscopy in the expert group was better than that in the trainee group (0.51 vs 0.42, p<0.05). The mean weighted paired k statistics in the expert group and in the trainee group based on conventional endoscopy with OBI did not differ (0.42, 0.42).

Conclusions: Interobserver agreement in the expert group using conventional endoscopy was better than that in the trainee group. Endoscopic experience can improve the interobserver agreement in the grading of esophagitis using the Los Angeles classification.

Keywords: Agreement; Experience; Gastroesophageal reflux.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
(A) A still image obtained using conventional endoscopy in a patient without erosive esophagitis. (B) A still image of optimal band imaging in the same patient.
See this image and copyright information in PMC

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