Bowel cleansing quality evaluation in colon capsule endoscopy: what is the reference standard?

IF 4.3 3区材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC

ACS Applied Electronic Materials Pub Date : 2024-10-23 eCollection Date: 2024-01-01 DOI:10.1177/17562848241290256

Benedicte Schelde-Olesen, Anastasios Koulaouzidis, Ulrik Deding, Ervin Toth, Konstantinos John Dabos, Abraham Eliakim, Cristina Carretero, Begoña González-Suárez, Xavier Dray, Thomas de Lange, Hanneke Beaumont, Emanuele Rondonotti, Uri Kopylov, Pierre Ellul, Enrique Pérez-Cuadrado-Robles, Alexander Robertson, Irene Stenfors, Alejandro Bojorquez, Stefania Piccirelli, Gitte Grunnet Raabe, Reuma Margalit-Yehuda, Isabel Barba, Giulia Scardino, Salome Ouazana, Thomas Bjørsum-Meyer

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引用次数: 0

Abstract

Background: The diagnostic accuracy of colon capsule endoscopy (CCE) depends on a well-cleansed bowel. Evaluating the cleansing quality can be difficult with a substantial interobserver variation.

Objectives: Our primary aim was to establish a standard of agreement for bowel cleansing in CCE based on evaluations by expert readers. Then, we aimed to investigate the interobserver agreement on bowel cleansing.

Design: We conducted an interobserver agreement study on bowel cleansing quality.

Methods: Readers with different experience levels in CCE and colonoscopy evaluated bowel cleansing quality on the Leighton-Rex scale and Colon Capsule CLEansing Assessment and Report (CC-CLEAR), respectively. All evaluations were reported on an image level. A total of 24 readers rated 500 images on each scale.

Results: An expert opinion-based agreement standard could be set for poor and excellent cleansing but not for the spectrum in between, as the experts agreed on only a limited number of images representing fair and good cleansing. The overall interobserver agreement on the Leighton-Rex full scale was good (intraclass correlation coefficient (ICC) 0.84, 95% CI (0.82-0.85)) and remained good when stratified by experience level. On the full CC-CLEAR scale, the overall agreement was moderate (ICC 0.62, 95% CI (0.59-0.65)) and remained so when stratified by experience level.

Conclusion: The interobserver agreement was good for the Leighton-Rex scale and moderate for CC-CLEAR, irrespective of the reader's experience level. It was not possible to establish an expert-opinion standard of agreement for cleansing quality in CCE images. Dedicated training in using the scales may improve agreement and enable future algorithm calibration for artificial intelligence supported cleansing evaluation.

Trial registration: All included images were derived from the CAREforCOLON 2015 trial (Registered with The Regional Health Research Ethics Committee (Registration number: S-20190100), the Danish data protection agency (Ref. 19/29858), and ClinicalTrials.gov (registration number: NCT04049357)).

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结肠胶囊内窥镜检查中的肠道清洁质量评估：参考标准是什么？

背景：结肠胶囊内窥镜（CCE）诊断的准确性取决于肠道是否清洁干净。评估肠道清洁质量很困难，观察者之间的差异很大：我们的主要目的是根据专家读者的评价，为 CCE 中的肠道清洁建立一个一致标准。然后，我们旨在调查观察者之间在肠道清洁方面的一致性：设计：我们进行了一项关于肠道清洁质量的观察者间一致性研究：方法：在 CCE 和结肠镜检查方面具有不同经验水平的阅读者分别根据 Leighton-Rex 量表和结肠胶囊清洁评估和报告（CC-CLEAR）对肠道清洁质量进行评估。所有评价均以图像为单位进行报告。共有 24 位读者对每种量表的 500 张图像进行了评分：结果：基于专家意见的一致标准可用于较差和极佳的清洁度，但不能用于介于两者之间的范围，因为专家们只对代表一般和良好清洁度的有限数量的图像达成一致。Leighton-Rex全量表的总体观察者间一致性良好（类内相关系数（ICC）0.84，95% CI (0.82-0.85)），按经验水平分层后，一致性依然良好。在完整的 CC-CLEAR 量表中，总体一致性为中等（ICC 0.62，95% CI (0.59-0.65)），按经验水平分层后仍为中等：结论：无论读者的经验水平如何，Leighton-Rex量表的观察者间一致性良好，CC-CLEAR量表的观察者间一致性中等。对于 CCE 图像的清洁质量，无法建立专家意见一致的标准。使用量表的专门培训可能会提高一致性，并使未来人工智能支持的清洁评估算法校准成为可能：所有纳入的图像均来自 CAREforCOLON 2015 试验（已在地区健康研究伦理委员会（注册号：S-20190100）、丹麦数据保护机构（编号：19/29858）和 ClinicalTrials.gov（注册号：NCT04049357）注册）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

ACS Applied Electronic Materials Multiple-

CiteScore

7.20

自引率

4.30%

发文量

567