胃肠内镜中的不良事件：在真实的 5 年环境中验证 AGREE 分类。
Adverse events in gastrointestinal endoscopy: Validation of the AGREE classification in a real-life 5-year setting.
机构信息
Dipartimento di Promozione Della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza (PROMISE), Gastroenterology and Hepatology Unit, Piazza delle Cliniche 2, Palermo 90127, Italy; Azienda Provinciale per i Servizi Sanitari (APSS), Gastroenterology and Digestive Endoscopy Unit, Santa Chiara Hospital, Largo Medaglie D'Oro 9, Trento 38122, Italy.
Azienda Provinciale per i Servizi Sanitari (APSS), Gastroenterology and Digestive Endoscopy Unit, Santa Chiara Hospital, Largo Medaglie D'Oro 9, Trento 38122, Italy; Gastroenterology Unit, G.B. Grassi Hospital (ASL Roma 3), Via Gian Carlo Passeroni 28, 00122 Lido di Ostia, Roma, Italy.
出版信息
Dig Liver Dis. 2023 Jul;55(7):933-937. doi: 10.1016/j.dld.2023.04.007. Epub 2023 Apr 24.
BACKGROUND
The novel AGREE classification for adverse events (AEs) in gastrointestinal (GI) endoscopy has not yet been validated in a real-world setting.
AIMS
Our study aims to evaluate the correlation between the grades of AEs in the ASGE and AGREE classifications and to assess the interobserver agreement of the two classification systems.
METHODS
The correlation and association between the AE grades of the ASGE and AGREE classifications were analyzed using the Spearman rank correlation test and the chi-squared analysis, respectively. A weighted Cohen's kappa coefficient analysis was performed to determine the interobserver agreement of both classification systems.
RESULTS
We prospectively collected the AEs that occurred in our endoscopy unit over the past five years. A total of 226 AEs (226/84,863, 0.3%) occurred. There was a correlation between the ASGE and AGREE classifications (ρ = 0.61) and a moderately significant association (p < 0.01, Cramer's V = 0.7). The interobserver agreement for the ASGE classification was fair (kappa 0.60, 95% confidence interval [CI]: 0.54, 0.67), whereas it was good for the AGREE classification (kappa 0.80, 95% CI: 0.62, 0.87).
CONCLUSIONS
The AGREE classification was validated for the first time in a real-world setting and showed a positive correlation and higher interobserver agreement than the ASGE classification.
背景
胃肠道内镜不良事件（AE）的新型 AGREE 分类尚未在真实环境中得到验证。
目的
本研究旨在评估 ASGE 和 AGREE 分类系统中 AE 分级之间的相关性，并评估这两种分类系统的观察者间一致性。
方法
使用 Spearman 秩相关检验和卡方分析分别分析 ASGE 和 AGREE 分类的 AE 分级之间的相关性和关联。使用加权 Cohen's kappa 系数分析来确定两种分类系统的观察者间一致性。
结果
我们前瞻性地收集了过去五年中我们内镜科室发生的 AE。共发生 226 例 AE（226/84863，0.3%）。ASGE 和 AGREE 分类之间存在相关性（ρ=0.61）和中度显著关联（p<0.01，Cramer's V=0.7）。ASGE 分类的观察者间一致性为中等（kappa 0.60，95%置信区间[CI]：0.54，0.67），而 AGREE 分类的观察者间一致性良好（kappa 0.80，95% CI：0.62，0.87）。
结论
AGREE 分类首次在真实环境中得到验证，与 ASGE 分类相比，其显示出阳性相关性和更高的观察者间一致性。
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