Interobserver Variability and Accuracy of High-Definition Endoscopic Diagnosis for Gastric Intestinal Metaplasia among Experienced and Inexperienced Endoscopists.
10.3346/jkms.2013.28.5.744
- Author:
Yil Sik HYUN
1
;
Dong Soo HAN
;
Joong Ho BAE
;
Hye Sun PARK
;
Chang Soo EUN
Author Information
1. Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea. hands@hanyang.ac.kr
- Publication Type:Original Article ; Comparative Study ; Research Support, Non-U.S. Gov't
- Keywords:
Gastric Mucosa;
Metaplasia;
Gastroscopy;
Observer Variation;
Sensitivity;
Specificity
- MeSH:
Adult;
Aged;
Endoscopy, Gastrointestinal;
Female;
Humans;
Intestinal Mucosa/*pathology;
Male;
Metaplasia/*diagnosis/epidemiology;
Middle Aged;
Observer Variation;
Physicians;
Stomach/*pathology
- From:Journal of Korean Medical Science
2013;28(5):744-749
- CountryRepublic of Korea
- Language:English
-
Abstract:
Accurate diagnosis of gastric intestinal metaplasia is important; however, conventional endoscopy is known to be an unreliable modality for diagnosing gastric intestinal metaplasia (IM). The aims of the study were to evaluate the interobserver variation in diagnosing IM by high-definition (HD) endoscopy and the diagnostic accuracy of this modality for IM among experienced and inexperienced endoscopists. Selected 50 cases, taken with HD endoscopy, were sent for a diagnostic inquiry of gastric IM through visual inspection to five experienced and five inexperienced endoscopists. The interobserver agreement between endoscopists was evaluated to verify the diagnostic reliability of HD endoscopy in diagnosing IM, and the diagnostic accuracy, sensitivity, and specificity were evaluated for validity of HD endoscopy in diagnosing IM. Interobserver agreement among the experienced endoscopists was "poor" (kappa = 0.38) and it was also "poor" (kappa = 0.33) among the inexperienced endoscopists. The diagnostic accuracy of the experienced endoscopists was superior to that of the inexperienced endoscopists (P = 0.003). Since diagnosis through visual inspection is unreliable in the diagnosis of IM, all suspicious areas for gastric IM should be considered to be biopsied. Furthermore, endoscopic experience and education are needed to raise the diagnostic accuracy of gastric IM.
