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Intra and inter-observer agreement on polyp detection in colon capsule endoscopy evaluations.

ABSTRACT: Background:Colon capsule endoscopy is a promising technique for evaluation of the colon, but its reproducibility is still unknown. Objective:This study assesses intra and inter-observer agreement in evaluations of colon capsule endoscopy videos. Methods:Forty-two complete colon capsule endoscopy investigations were analysed by three experts and two beginners. Intra-observer agreement was assessed in paired readings of two experts and two beginners. Agreement was determined by the intraclass correlation coefficient: poor (<0.5), moderate (0.5-0.75), good (0.75-0.9) and excellent (>0.9). Results:Agreement on 'indication for a following colonoscopy' based on the number and size of detected polyps and bowel cleansing quality was poor among all observers. Agreement among experts on the detection of large polyps and number of polyps was moderate, but agreement on bowel cleansing quality was poor. Beginners were in moderate agreement with the experts on polyp detection. Intra-observer agreement in experts was moderate to excellent for the detection of large polyps (?10?mm), excellent for the number of polyps, and poor to moderate for bowel cleansing quality. Intra-observer agreement in beginners was poor to moderate for all variables. Conclusions:This study shows a poor agreement on 'indication for a following colonoscopy', but a high intra and inter-observer agreement for polyp detection among experts, as well as a moderate agreement between beginners and experts.Trial registration: NCT02303756.

SUBMITTER: Buijs MM

PROVIDER: S-EPMC6297930 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

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Intra and inter-observer agreement on polyp detection in colon capsule endoscopy evaluations.

Buijs Maria Magdalena MM Kroijer Rasmus R Kobaek-Larsen Morten M Spada Cristiano C Fernandez-Urien Ignacio I Steele Robert Jc RJ Baatrup Gunnar G

United European gastroenterology journal 20180911 10

<h4>Background</h4>Colon capsule endoscopy is a promising technique for evaluation of the colon, but its reproducibility is still unknown.<h4>Objective</h4>This study assesses intra and inter-observer agreement in evaluations of colon capsule endoscopy videos.<h4>Methods</h4>Forty-two complete colon capsule endoscopy investigations were analysed by three experts and two beginners. Intra-observer agreement was assessed in paired readings of two experts and two beginners. Agreement was determined ...[more]

PMID: 30574327

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Project description:BackgroundColorectal cancer is a leading cause of mortality and morbidity in Ontario. Most cases of colorectal cancer are preventable through early diagnosis and the removal of precancerous polyps. Colon capsule endoscopy is a non-invasive test for detecting colorectal polyps.ObjectivesThe objectives of this analysis were to evaluate the cost-effectiveness and the impact on the Ontario health budget of implementing colon capsule endoscopy for detecting advanced colorectal polyps among adult patients who have been referred for computed tomographic (CT) colonography.MethodsWe performed an original cost-effectiveness analysis to assess the additional cost of CT colonography and colon capsule endoscopy resulting from misdiagnoses. We generated diagnostic accuracy data from a clinical evidence-based analysis (reported separately), and we developed a deterministic Markov model to estimate the additional long-term costs and life-years lost due to false-negative results. We then also performed a budget impact analysis using data from Ontario administrative sources. One-year costs were estimated for CT colonography and colon capsule endoscopy (replacing all CT colonography procedures, and replacing only those CT colonography procedures in patients with an incomplete colonoscopy within the previous year). We conducted this analysis from the payer perspective.ResultsUsing the point estimates of diagnostic accuracy from the head-to-head study between colon capsule endoscopy and CT colonography, we found the additional cost of false-positive results for colon capsule endoscopy to be $0.41 per patient, while additional false-negatives for the CT colonography arm generated an added cost of $116 per patient, with 0.0096 life-years lost per patient due to cancer. This results in an additional cost of $26,750 per life-year gained for colon capsule endoscopy compared with CT colonography. The total 1-year cost to replace all CT colonography procedures with colon capsule endoscopy in Ontario is about $2.72 million; replacing only those CT colonography procedures in patients with an incomplete colonoscopy in the previous year would cost about $740,600 in the first year.LimitationsThe difference in accuracy between colon capsule endoscopy and CT colonography was not statistically significant for the detection of advanced adenomas (≥ 10 mm in diameter), according to the head-to-head clinical study from which the diagnostic accuracy was taken. This leads to uncertainty in the economic analysis, with results highly sensitive to changes in diagnostic accuracy.ConclusionsThe cost-effectiveness of colon capsule endoscopy for use in patients referred for CT colonography is $26,750 per life-year, assuming an increased sensitivity of colon capsule endoscopy. Replacement of CT colonography with colon capsule endoscopy is associated with moderate costs to the health care system.

Project description:BACKGROUND: The Back Pain Cohort of Southern Denmark (BaPa Cohort) was initiated with the aim of evaluating the clinical relevance of magnetic resonance imaging (MRI) in the diagnosis of early spondyloarthritis (SpA). In order to facilitate the collection of MRI data for this study, an electronic evaluation form was developed including both SpA-related and degenerative axial changes. The objective of the current study was to assess the intra- and inter-observer agreement of the MRI changes assessed. METHODS: Three radiologists evaluated 48 MRI scans of the whole spine and the sacroiliac joints from a subsample of the BaPa Cohort, consisting of patients with non-specific low back pain and patients with different stages of SpA features. The spine was evaluated for SpA-related and degenerative MRI changes and the SIJ for SpA-related changes. Inter- and intra-observer agreements were calculated with kappa statistics. In the interpretation of the kappa coefficient, the standards for strength of agreement reported by Landis and Koch were followed. RESULTS: A total of 48 patients, 40% men and mean age of 31 years (range 18-40 years), were evaluated once by all three readers and re-evaluated by two of the readers after 4-12 weeks. For MRI changes in the spine, substantial to almost perfect observer agreement was found for the location and the size of vertebral signal changes and for disc degeneration and disc contour. For the sacroiliac joints, substantial or almost perfect observer agreement was found for the grading of bone marrow oedema and fatty marrow deposition, the depth of bone marrow oedema and for subchondral sclerosis. Global assessment of the SpA diagnosis had substantial to almost perfect observer agreements. CONCLUSION: The acceptable agreement for key MRI changes in the spine and sacroiliac joints makes it possible to use these MRI changes in the BaPa Cohort study and other studies investigating MRI changes in patients with non-specific low back pain and suspected SpA.

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Intra and inter-observer agreement on polyp detection in colon capsule endoscopy evaluations.

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Intra and inter-observer agreement on polyp detection in colon capsule endoscopy evaluations.

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