a Department of Gastroenterology and Hepatology , Erasmus MC University Medical Center , Rotterdam , The Netherlands.
b Department of Radiology , Erasmus MC University Medical Center , Rotterdam , The Netherlands.
Expert Rev Med Devices. 2018 Aug;15(8):605-610. doi: 10.1080/17434440.2018.1496818. Epub 2018 Jul 18.
Visible light spectroscopy (VLS) performed during upper gastrointestinal endoscopy allows measuring mucosal oxygen saturation levels to determine gastrointestinal ischemia. We aimed to determine the observer variability of VLS.
This is a single-center prospective study of 24 patients planned for usual care upper endoscopy. To test intraobserver variability, VLS measurements were performed in duplicate by a single endoscopist in 12 patients. For interobserver variability analysis, in another 12 patients VLS measurements were repeatedly and independently performed by two endoscopists in the same patient during the same endoscopy session. Observer variability was assessed with intraclass correlation coefficient (ICC) and clinical disagreement defined as >5% difference between first and second set of VLS measurements.
The intraobserver reliability was excellent (ICC antrum 0.77, duodenal bulb 0.81 and duodenum 0.84) with clinical disagreement only in antrum (3% of all intraobserver measurements). The interobserver reliability was good for the duodenal bulb (ICC 0.70) without clinical disagreement; however, interobserver reliability was fair for duodenum (ICC 0.49) and antrum (ICC 0.56) with clinical disagreement occurring in 11% of all interobserver measurements.
The observer reliability of VLS is fair to good with intraobserver reliability being better than interobserver reliability. This supports the use of VLS for detection of gastrointestinal ischemia.
上消化道内镜检查时进行可视光谱（VLS）可以测量黏膜氧饱和度水平，以确定胃肠道缺血情况。我们旨在确定 VLS 的观察者变异性。
这是一项针对 24 例计划接受常规上消化道内镜检查的患者的单中心前瞻性研究。为了测试观察者内变异性，在 12 例患者中由同一位内镜医生重复进行 VLS 测量，进行两次重复测量。为了进行观察者间变异性分析，在另外 12 例患者中，在同一次内镜检查期间，两位内镜医生在同一位患者中重复且独立地进行 VLS 测量。观察者间变异性通过组内相关系数（ICC）进行评估，临床差异定义为两次 VLS 测量值之间的差异>5%。
观察者内可靠性极好（胃窦部 ICC 0.77、十二指肠球部 0.81 和十二指肠部 0.84），仅在胃窦部出现临床差异（所有观察者内测量值的 3%）。十二指肠球部的观察者间可靠性良好（ICC 0.70），无临床差异；然而，十二指肠部和胃窦部的观察者间可靠性为中等（ICC 分别为 0.49 和 0.56），所有观察者间测量值中有 11%存在临床差异。
VLS 的观察者可靠性为中等至良好，观察者内可靠性优于观察者间可靠性。这支持使用 VLS 检测胃肠道缺血。
