Belvis Jiménez María, Hergueta-Delgado Pedro, Gómez Rodríguez Blas, Maldonado Pérez Belén, Castro Laria Luisa, Rodríguez-Téllez Manuel, Morales Barroso Maria Luisa, Galván Fernández Maria Dolores, Guerra Veloz Maria, Jiménez García Victoria Alejandra, Romero-Castro Rafael, Benítez-Roladán Antonio, Castro Márquez Cristina, Aparcero López Reyes, Garrido-Serrano Antonio, Caunedo-Álvarez Ángel, Argüelles-Arias Federico
Gastroenterology Department, University Hospital Virgen Macarena, Seville, Spain.
Seville University, Seville, Spain.
Endosc Int Open. 2021 Feb;9(2):E130-E136. doi: 10.1055/a-1313-6968. Epub 2021 Jan 25.
Endoscopy plays an essential role in managing patients with ulcerative colitis (UC), as it allows us to visualize and assess the severity of the disease. As such assessments are not always objective, different scores have been devised to standardize the findings. The main aim of this study was to assess the interobserver variability between the Mayo Endoscopy Score (MES), Ulcerative Colitis Endoscopy Index of Severity (UCEIS) and Ulcerative Colitis Colonoscopy Index of Severity (UCCIS) analyzing the severity of the endoscopic lesions in patients with ulcerative colitis. This was a single-cohort observational study in which a colonoscopy was carried out on patients with UC, as normal clinical practice, and a video was recorded. The results from the video were classified according to the MES, UCEIS and UCCIS by three endoscopic specialists independently, and they were compared to each other. The Mayo Endoscopy Score (MES) was used to assess the clinical situation of the patient. The therapeutic impact was analyzed after colonoscopy was carried out. Sixty-seven patients were included in the study. The average age was 51 (SD ± 16.7) and the average MES was 3.07 (SD ± 2.54). The weighted Kappa index between endoscopists A and B for the MES was 0.8; between A and C 0.52; and between B and C 0.49. The intraclass correlation coefficient for UCEIS was 0.92 among the three endoscopists (CI 95 %: 0.83-0.96) and 0.96 for UCCIS among the three endoscopists (CI 95 % 0.94-0.97). A change in treatment for 34.3 % of the patients was implemented on seeing the results of the colonoscopy. There was an adequate, but not perfect, correlation between the different endoscopists for MES, UCEIS, UCCIS. This was higher with the last two scores. Thus, there is still some subjectivity to be minimized through special training, on assessing the seriousness of the endoscopic lesions in patients with UC.
内镜检查在溃疡性结肠炎（UC）患者的管理中起着至关重要的作用，因为它使我们能够观察并评估疾病的严重程度。由于此类评估并非总是客观的，因此已设计出不同的评分系统来规范检查结果。本研究的主要目的是通过分析溃疡性结肠炎患者内镜病变的严重程度，评估梅奥内镜评分（MES）、溃疡性结肠炎内镜严重程度指数（UCEIS）和溃疡性结肠炎结肠镜检查严重程度指数（UCCIS）之间的观察者间差异。这是一项单队列观察性研究，按照常规临床操作对UC患者进行结肠镜检查并录制视频。三位内镜专家独立根据MES、UCEIS和UCCIS对视频结果进行分类，并相互比较。梅奥内镜评分（MES）用于评估患者的临床状况。在进行结肠镜检查后分析治疗效果。67名患者纳入研究。平均年龄为51岁（标准差±16.7），平均MES为3.07（标准差±2.54）。内镜医师A和B之间关于MES的加权Kappa指数为0.8；A和C之间为0.52；B和C之间为0.49。三位内镜医师之间UCEIS的组内相关系数为0.92（95%置信区间：0.83 - 0.96），UCCIS的组内相关系数为0.96（95%置信区间0.94 - 0.97）。34.3%的患者在看到结肠镜检查结果后改变了治疗方案。不同内镜医师之间对于MES、UCEIS、UCCIS存在适度但并非完美的相关性。后两个评分的相关性更高。因此，在评估UC患者内镜病变的严重程度时，仍存在一些主观性，需要通过特殊培训将其降至最低。
