Territorial Gastroenterology Service, ASL BAT, Andria, BT, Italy.
Division of Internal Medicine and Gastroenterology, "Cristo Re" Hospital, Rome, Italy.
J Gastrointestin Liver Dis. 2019 Mar;28(1):23-27. doi: 10.15403/jgld.2014.1121.281.dic.
An endoscopic classification of Diverticular Disease (DD), called DICA (Diverticular Inflammation and Complication Assessment) is currently available. It scores severity of the disease as DICA 1, DICA 2 and DICA 3. Our aim was to assess the agreement levels for this classification among an endoscopist community setting.
A total of 66 endoscopists independently scored a set of DD endoscopic videos. The percentages of overall agreement on the DICA score and a free-marginal multirater kappa (κ) coefficient were reported as statistical measures of the inter-rater agreement.
The overall agreement levels were: 70.2% for DICA 1, 70.5% for DICA 2, 81.3% for DICA 3. The free marginal κ was: 0.553 for DICA 1, 0.558 for DICA 2, 0.719 for DICA 3. The agreement levels among the expert group were: 78.8% for DICA 1, 80.2% for DICA 2, 88.5% for DICA 3. The free marginal κ among the expert group were: 0.682 for DICA 1, 0.712 for DICA 2, 0.828 for DICA 3. The agreement of expert raters on the single item of the DICA classification was superior to the agreement of the overall group.
The overall inter-rater agreement for DICA score in this study ranges from moderate to good, with a significant improvement in the expert subgroup of raters. Diverticular Inflammation and Complication Assessment is a simple and reproducible endoscopic scoring system.
目前有一个名为 DICA（憩室炎和并发症评估）的内镜下憩室疾病分类，它将疾病的严重程度分为 DICA 1、DICA 2 和 DICA 3。我们的目的是评估内镜医师群体中这种分类的一致性水平。
共有 66 名内镜医师独立对一组憩室疾病内镜视频进行评分。DICA 评分的总体一致性百分比和自由边际多评估者 κ 系数（κ）被报告为评估者间一致性的统计指标。
DICA 1 的总体一致性水平为 70.2%，DICA 2 为 70.5%，DICA 3 为 81.3%。自由边际 κ 为：DICA 1 为 0.553，DICA 2 为 0.558，DICA 3 为 0.719。专家组的一致性水平为：DICA 1 为 78.8%，DICA 2 为 80.2%，DICA 3 为 88.5%。专家组的自由边际 κ 分别为：DICA 1 为 0.682，DICA 2 为 0.712，DICA 3 为 0.828。专家评估者对 DICA 分类单项的一致性优于总体评估者的一致性。
本研究中 DICA 评分的总体评估者间一致性为中等至良好，专家评估者亚组的一致性显著提高。憩室炎和并发症评估是一种简单且可重复的内镜评分系统。
