Endoscopic Experience Improves Interobserver Agreement in the Grading of Esophagitis by Los Angeles Classification: Conventional Endoscopy and Optimal Band Image System

• Published in: Gut and liver Vol. 8; no. 2; pp. 154 - 159
• Main Authors: Si Hyung Lee, Byung Ik Jang, Kyeong Ok Kim, Seong Woo Jeon, Joong Goo Kwon, Eun Young Kim, Jin Tae Jung, Kyung Sik Park, Kwnag Bum Cho, Eun Soo Kim, Chang Geun Park, Chang Heon Yang, Deagugyeon
• Format: Journal Article
• Language: Korean
• Published: 대한소화기학회 30.03.2014
• Subjects: Agreement; Experience; Gastroesophageal reflux
• ISSN: 1976-2283; 2005-1212

Background/Aims: Interobserver variation by experiencewas documented for the diagnosis of esophagitis usingthe Los Angeles classification. The aim of this study was toevaluate whether interobserver agreement can be improvedby higher levels of endoscopic experience in the diagnosisof erosive esophagitis. Methods: Endoscopic images of51 patients with gastroesophageal reflux disease (GERD)symptoms were obtained with conventional endoscopy andoptimal band imaging (OBI). Endoscopists were divided intoan expert group (16 gastroenterologic endoscopic specialistsguaranteed by the Korean Society of GastrointestinalEndoscopy) and a trainee group (individuals with fellowships,first year of specialty training in gastroenterology). Allendoscopists had no or minimal experience with OBI. GERDwas diagnosed using the Los Angeles classification with orwithout OBI. Results: The mean weighted paired κ statisticsfor interobserver agreement in grading erosive esophagitisby conventional endoscopy in the expert group was betterthan that in the trainee group (0.51 vs 0.42, p<0.05). Themean weighted paired k statistics in the expert group and inthe trainee group based on conventional endoscopy with OBIdid not differ (0.42, 0.42). Conclusions: Interobserver agreementin the expert group using conventional endoscopy wasbetter than that in the trainee group. Endoscopic experiencecan improve the interobserver agreement in the grading ofesophagitis using the Los Angeles classification. (Gut Liver 2014;8:154-159)