Córdova Henry, Barreiro-Alonso Eva, Castillo-Regalado Edgar, Cubiella Joaquín, Delgado-Guillena Pedro, Díez Redondo Pilar, Galdín Martin, García-Rodríguez Ana, Hernández Luis, Huerta Alain, Jover Rodrigo, Núñez Henar, Rodríguez-D'Jesús Antonio, Seoane Agustín, Surís Gerard, Tejedor-Tejada Javier, Jiménez Sánchez Javier, Martín Francisco, Moreira Leticia, Carballal Sabela, Rivero Liseth, Da Fieno Angella, Casanova Gherzon, Luzko Scheid Irina, Llach Joan, Fernández-Esparrach Gloria
Endoscopy Unit, Gastroenterology Department, Hospital Clínic of Barcelona, IDIBAPS, CIBEREHD, University of Barcelona, Barcelona, Spain.
Department of Gastroenterology, Hospital Universitario Central de Asturias and Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.
Gastroenterol Hepatol. 2024 Mar;47(3):246-252. doi: 10.1016/j.gastrohep.2023.05.011. Epub 2023 May 24.
There are few scales with prospective validation for the assessment of the upper gastrointestinal mucosal cleanliness during an esophagogastroduodenoscopy (EGD). The aim of this study was to develop a valid and reproducible cleanliness scale for use during an EGD.
We developed a cleanliness scale (Barcelona scale) with a score (0-2 points) of five segments of the upper gastrointestinal tract with thorough cleaning techniques (esophagus, fundus, body, antrum, and duodenum). First, 125 photos (25 of each area) were assessed, and a score was assigned to each image by consensus among 7 experts endoscopists. Subsequently, 100 of the 125 images were selected and the inter- and intra-observer variability of 15 previously trained endoscopists was evaluated using the same images at two different times.
In total, 1500 assessments were performed. In 1336/1500 observations (89%) there was agreement with the consensus score, with a mean kappa value of 0.83 (0.45-0.96). In the second evaluation, in 1330/1500 observations (89%) there was agreement with the consensus score, with a mean kappa value of 0.82 (0.45-0.93). The intra-observer variability was 0.89 (0.76-0.99).
The Barcelona cleanliness scale is a valid measure and reproducible with minimal training. Its application in clinical practice is a significant step to standardize the quality of the EGD.
在食管胃十二指肠镜检查（EGD）期间，用于评估上消化道黏膜清洁度的前瞻性验证量表较少。本研究的目的是开发一种在EGD期间使用的有效且可重复的清洁度量表。
我们开发了一种清洁度量表（巴塞罗那量表），对上消化道的五个节段（食管、胃底、胃体、胃窦和十二指肠）采用彻底清洁技术进行评分（0 - 2分）。首先，评估了125张照片（每个区域25张），7位内镜专家通过共识为每张图像打分。随后，从125张图像中选取100张，15名之前经过培训的内镜医师在两个不同时间使用相同图像评估观察者间和观察者内的变异性。
总共进行了1500次评估。在1336/1500次观察中（89%）与共识评分一致，平均kappa值为0.83（0.45 - 0.96）。在第二次评估中，1330/1500次观察中（89%）与共识评分一致，平均kappa值为0.82（0.45 - 0.93）。观察者内变异性为0.89（0.76 - 0.99）。
巴塞罗那清洁度量表是一种有效的测量方法，只需极少培训即可重复。其在临床实践中的应用是使EGD质量标准化的重要一步。
