Article (Scientific journals)
Interobserver Variation Study of the Rutgeerts Score to Assess Endoscopic Recurrence after Surgery for Crohn's Disease.
Marteau, Philippe; Laharie, David; Colombel, Jean-Frederic et al.
2016In Journal of Crohn's and Colitis, 10 (9), p. 1001-5
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Copyright © 2016 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com


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Keywords :
Crohn's disease; Endoscopy; Rutgeerts score; postoperative endoscopic recurrence; reproducibility
Abstract :
[en] BACKGROUND: After resection surgery for Crohn's disease, recurrence of endoscopic lesions at the site of the anastomosis or in the neoterminal ileum is graded according to the Rutgeerts score (RS). The goal of this study was to test the interobserver variability for RS. METHODS: Thirteen trained endoscopists evaluated the RS on 39 videotapes of patients who had undergone resection for Crohn's disease with an ileocolonic anastomosis 6 months earlier. Videotapes were randomly assigned to endoscopists through a balanced incomplete block design. Each videotape was scored independently by four endoscopists, and each endoscopist evaluated 12 videotapes, making a total of 156 videotape assessments. Reproducibility levels of the RS were assessed through unweighted kappa estimates among multiple raters. The proportion of inappropriate therapeutic initiation was estimated by randomly selecting one endoscopist for each videorecording, assuming that the majority of endoscopists correctly classified endoscopic recurrence. RESULTS: The kappa estimates were 0.43 (95% confidence interval: 0.33-0.52) for the RS on a 5-grade scale, 0.47 (0.28-0.66) for RS < i2 vs. >/= i2, and 0.64 (0.42-0.85) for RS </= i2 vs. > i2. The percentages of inappropriate therapeutic initiation were 12.8% (3.8-21.9) when initiation was triggered by a RS >/= i2 and 8.3% (1.1-15.6) when initiation was triggered by a RS > i2 (p = 0.41). CONCLUSION: The reproducibility of the RS was moderate, especially when differentiating <i2 from >/=i2, which may lead to incorrect therapeutic decisions in >10% of patients.
Disciplines :
Gastroenterology & hepatology
Author, co-author :
Marteau, Philippe
Laharie, David
Colombel, Jean-Frederic
Martin, Laurence
Coevoet, Hugues
Allez, Matthieu
Cadiot, Guillaume
Bourreille, Arnaud
Carbonnel, Franck
Bouhnik, Yoram
Coffin, Benoit
Duclos, Bernard
Dupas, Jean Louis
Moreau, Jacques
Louis, Edouard  ;  Université de Liège > Département des sciences cliniques > Hépato-gastroentérologie
Mary, Jean-Yves
More authors (6 more) Less
Language :
English
Title :
Interobserver Variation Study of the Rutgeerts Score to Assess Endoscopic Recurrence after Surgery for Crohn's Disease.
Publication date :
2016
Journal title :
Journal of Crohn's and Colitis
ISSN :
1873-9946
eISSN :
1876-4479
Publisher :
Elsevier, United Kingdom
Volume :
10
Issue :
9
Pages :
1001-5
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
Copyright (c) 2016 European Crohn's and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.
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