Marcin Romańczyk, Madhav Desai, Michal F Kamiński, Seiichiro Abe, Asma A Alkandari, Torsten Beyna, Raf Bisschops, Krzysztof Budzyń, Monika Bugdol, Samir C Grover, C Prakash Gyawali, Haruhiro Inoue, Prasad G Iyer, Helmut Messmann, Krish Ragunath, Yutaka Saito, Sachin Srinivasan, Christopher Teshima, Rena Yadlapati, Cesare Hassan, Prateek Sharma
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The aim of this study was to validate this scoring system in a cohort of international endoscopists.</p><p><strong>Methods: </strong>In total, 39 EGD videos, with different degrees of mucosal cleanliness were retrieved from a previously conducted prospective trial. All experts rated the cleanliness of the mucosa on each video using the PEACE scale. To evaluate agreement of all scores (0-3), intraclass correlation coefficient 2.1 was used. The agreement on adequate (scores 2 and 3) and inadequate (scores 0 and 1) cleanliness was assessed using kappa values.</p><p><strong>Results: </strong>Videos evaluating esophagus, stomach, and duodenum cleanliness were reviewed by 16 endoscopists. The PEACE scores demonstrated good agreement (intraclass correlation coefficient 0.82, 95% CI 0.75-0.89), especially for esophagus (0.84; 95% CI 0.71-0.95) and stomach (0.81; 95% CI 0.69-0.91), while agreement was moderate for the duodenum (0.69; 95% CI 0.51-0.87). The agreement was similar between Eastern (0.86; 95% CI 0.79-0.92) and Western experts (0.80; 95% CI 0.72-0.88). Similarly, agreement regarding adequate cleanliness was comparable between Eastern (0.70; 95% CI 0.55-0.85) and Western (0.74; 95% CI 0.64-0.84) endoscopists being overall 0.75 (95% CI 0.65-0.85).</p><p><strong>Discussion: </strong>The PEACE scoring system is a simple and reliable scale to assess the cleanliness during EGD. 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引用次数: 0
摘要
导读：高质量食管胃十二指肠镜检查（EGD）的效果取决于粘膜的清洁度。最近，Polprep：有效评估EGD中清洁度（PEACE）量表被创建，用于评估EGD期间粘膜清洁度。本研究的目的是在一组国际内窥镜医师中验证该评分系统。方法：从先前进行的前瞻性试验中检索到39个不同程度粘膜清洁度的EGD视频。所有专家使用PEACE量表对每个视频中的粘膜清洁度进行评分。为评价各评分（0-3）的一致性，采用类内相关系数2.1。使用kappa值评估适当（得分2和3）和不适当（得分0和1）清洁度的一致性。结果：16位内镜医师回顾了食管、胃和十二指肠清洁录像。PEACE评分表现出良好的一致性（类内相关系数0.82,95% CI 0.75-0.89），特别是食道(0.84；95% CI 0.71-0.95)和胃(0.81；95% CI 0.69-0.91)，而十二指肠的一致性中等(0.69；95% ci 0.51-0.87)。东航(0.86；95% CI 0.79-0.92)和西方专家(0.80；95% ci 0.72-0.88)。同样，关于足够清洁的一致性在东部(0.70；95% CI 0.55-0.85)和Western (0.74；（95% CI 0.64-0.84）内窥镜医师总体为0.75 （95% CI 0.65-0.85）。探讨：PEACE评分系统是一种简单可靠的评价体外循环洁净度的量表。该评分目前在国际专家中得到了高度一致性的验证，证明其在临床实践中的应用是合理的。
International Validation of a Novel PEACE Scale to Improve the Quality of Upper Gastrointestinal Mucosal Inspection During Endoscopy.
Introduction: The performance of a high quality esophagogastroduodenoscopy (EGD) is dependent on the mucosal cleanliness. Recently, the Polprep: Effective Assessment of Cleanliness in EGD (PEACE) scale was created to assess the degree of mucosal cleanliness during EGD. The aim of this study was to validate this scoring system in a cohort of international endoscopists.
Methods: In total, 39 EGD videos, with different degrees of mucosal cleanliness were retrieved from a previously conducted prospective trial. All experts rated the cleanliness of the mucosa on each video using the PEACE scale. To evaluate agreement of all scores (0-3), intraclass correlation coefficient 2.1 was used. The agreement on adequate (scores 2 and 3) and inadequate (scores 0 and 1) cleanliness was assessed using kappa values.
Results: Videos evaluating esophagus, stomach, and duodenum cleanliness were reviewed by 16 endoscopists. The PEACE scores demonstrated good agreement (intraclass correlation coefficient 0.82, 95% CI 0.75-0.89), especially for esophagus (0.84; 95% CI 0.71-0.95) and stomach (0.81; 95% CI 0.69-0.91), while agreement was moderate for the duodenum (0.69; 95% CI 0.51-0.87). The agreement was similar between Eastern (0.86; 95% CI 0.79-0.92) and Western experts (0.80; 95% CI 0.72-0.88). Similarly, agreement regarding adequate cleanliness was comparable between Eastern (0.70; 95% CI 0.55-0.85) and Western (0.74; 95% CI 0.64-0.84) endoscopists being overall 0.75 (95% CI 0.65-0.85).
Discussion: The PEACE scoring system is a simple and reliable scale to assess the cleanliness during EGD. The score is now validated among international experts with high concordance, justifying its use in clinical practice.
期刊介绍：
Clinical and Translational Gastroenterology (CTG), published on behalf of the American College of Gastroenterology (ACG), is a peer-reviewed open access online journal dedicated to innovative clinical work in the field of gastroenterology and hepatology. CTG hopes to fulfill an unmet need for clinicians and scientists by welcoming novel cohort studies, early-phase clinical trials, qualitative and quantitative epidemiologic research, hypothesis-generating research, studies of novel mechanisms and methodologies including public health interventions, and integration of approaches across organs and disciplines. CTG also welcomes hypothesis-generating small studies, methods papers, and translational research with clear applications to human physiology or disease.
Colon and small bowel
Endoscopy and novel diagnostics
Esophagus
Functional GI disorders
Immunology of the GI tract
Microbiology of the GI tract
Inflammatory bowel disease
Pancreas and biliary tract
Liver
Pathology
Pediatrics
Preventative medicine
Nutrition/obesity
Stomach.
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