Author of 1 Presentation
SS 6.4 - Expert consensus on acquisition and reporting of intestinal US activity in Crohn’s disease: a prospective inter-rater agreement study
Abstract
Purpose
Intestinal US (IUS) is a promising cross-sectional imaging modality used to assess transmural disease and complications in Crohn’s disease (CD). Standard measurements, reproducibility and nomenclature have not yet been clearly established. The aim of this study was to evaluate inter-rater agreement for important parameters by experts through Delphi consensus.
Material and methods
IUS parameters demonstrating inflammatory activity were selected by a blinded Delphi IUS experts consensus panel to establish relative contribution to inflammatory activity in CD. Phase 1: blind review by 8 readers of 20 de-identified CD cases. Cases with poor agreement were reviewed to clarify discrepancy and improve agreement. Phase 2: an additional 30 de-identified CD cases blindly were reviewed by 12 independent expert readers. Inter-rater agreement was evaluated for all 4 key parameters.
Results
The Delphi process reduced 12 activity parameters to 4 key contributors including BWT, color Doppler signal (CDI), inflammatory fat and bowel wall echo stratification. BWT was comprised of 2 measurements in cross section and 2 in longitudinal orientation. Interobserver agreement was almost perfect for BWT: ICC=0.91 (95%CI 0.83-0.96), p=0.001, moderate agreement for CDI, κ=0.60 (95%CI 0.48-0.72), p=0.001. Agreement for inflammatory fat was also moderate with κ=0.50 (95%CI 0.33-0.66), p=0.001, while stratification was fair κ=0.39 (95%CI 0.26-0.53), p=0.001.
Conclusion
This expert consensus-based IUS activity score clearly establishes the reproducibility of this standardized approach to measure inflammatory activity in CD. Using our method, BWT is highly reproducible with CDI and inflammatory fat demonstrating moderate reproducibility. This score may provide the foundation for the future incorporation of IUS in research studies and clinical trials.
Video-on-demand
Author of 1 Presentation
SS 6.4 - Expert consensus on acquisition and reporting of intestinal US activity in Crohn’s disease: a prospective inter-rater agreement study (ID 1084)
Abstract
Purpose
Intestinal US (IUS) is a promising cross-sectional imaging modality used to assess transmural disease and complications in Crohn’s disease (CD). Standard measurements, reproducibility and nomenclature have not yet been clearly established. The aim of this study was to evaluate inter-rater agreement for important parameters by experts through Delphi consensus.
Material and methods
IUS parameters demonstrating inflammatory activity were selected by a blinded Delphi IUS experts consensus panel to establish relative contribution to inflammatory activity in CD. Phase 1: blind review by 8 readers of 20 de-identified CD cases. Cases with poor agreement were reviewed to clarify discrepancy and improve agreement. Phase 2: an additional 30 de-identified CD cases blindly were reviewed by 12 independent expert readers. Inter-rater agreement was evaluated for all 4 key parameters.
Results
The Delphi process reduced 12 activity parameters to 4 key contributors including BWT, color Doppler signal (CDI), inflammatory fat and bowel wall echo stratification. BWT was comprised of 2 measurements in cross section and 2 in longitudinal orientation. Interobserver agreement was almost perfect for BWT: ICC=0.91 (95%CI 0.83-0.96), p=0.001, moderate agreement for CDI, κ=0.60 (95%CI 0.48-0.72), p=0.001. Agreement for inflammatory fat was also moderate with κ=0.50 (95%CI 0.33-0.66), p=0.001, while stratification was fair κ=0.39 (95%CI 0.26-0.53), p=0.001.
Conclusion
This expert consensus-based IUS activity score clearly establishes the reproducibility of this standardized approach to measure inflammatory activity in CD. Using our method, BWT is highly reproducible with CDI and inflammatory fat demonstrating moderate reproducibility. This score may provide the foundation for the future incorporation of IUS in research studies and clinical trials.