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- W2050876614 abstract "Background: Enhanced Magnification Endoscopy (EME) is an endoscopic technique that combines the application of acetic acid to the surface of the esophagus and endoscopic imaging with a magnifying endoscope. This technique has been identified as highly accurate in predicting specialized intestinal metaplasia (SIM) in Barrett's esophagus based on surface pattern types. Previous investigators have noted that there is high inter-observer variability in identifying pattern types that may limit the utility of this technique. We sought to reexamine inter-observer variability in a group of images obtained as part of an ongoing, prospective study. Methods: 44 patients with GERD symptoms were prospectively evaluated with EME. Pictures were taken of representative pattern types. 50 endoscopic pictures were shown in a blinded fashion to four experienced endoscopists who are participating in a prospective trial of EME. Each endoscopist was asked to identify the pattern type based on previously published criteria and a provided atlas of previously published images. The patterns were Type I) round pits, a characteristic pit pattern of orderly arranged circular dots; II) reticular, pits circular or oval and regular in arrangement; III) villous, no pits present but a fine villiform appearance, with the villi having a regular arrangement; and IV) ridged, no pits present, but a thick convoluted appearance (cerebriform) with a regular arrangement of the villi. Results: The value of Cohen's Kappa corresponding to the agreement in pattern identification of the 4 observers on 50 endoscopic photographs is 0.41. All four observers agreed on the pattern type for 14 pictures (28%); three observers agreed 19 (38%) times; and only two observers agreed on the remaining 17 (34%). In the 33 patients where there was agreement between either 3 or 4 of the observers, the best agreement was seen in patients with predominantly type IV (figure). Conclusions: The previously published criteria for identifying SIM using EME are associated with a high level of inter-observer variability. Of the 4 described pattern types, it appears the best accuracy between observers is seen with Type IV. This inter-observer variability may limit the applicability of this type of technique in the diagnosis of SIM in endoscopically apparent Barrett's esophagus." @default.
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- W2050876614 date "2005-04-01" @default.
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- W2050876614 title "Inter-Observer Variability with Enhanced Magnification Endoscopy of the Squamocolumnar Junction" @default.
- W2050876614 doi "https://doi.org/10.1016/s0016-5107(05)01234-4" @default.
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