Romańczyk Marcin, Desai Madhav, Kamiński Michal F, Abe Seiichiro, Alkandari Asma A, Beyna Torsten, Bisschops Raf, Budzyń Krzysztof, Bugdol Monika, Grover Samir C, Gyawali C Prakash, Inoue Haruhiro, Iyer Prasad G, Messmann Helmut, Ragunath Krish, Saito Yutaka, Srinivasan Sachin, Teshima Christopher, Yadlapati Rena, Hassan Cesare, Sharma Prateek
Department of Gastroenterology, Faculty of Medicine, Academy of Silesia, Katowice, Poland.
Department of Gastroenterology and Hepatology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
Clin Transl Gastroenterol. 2025 Jan 1;16(1):e00786. doi: 10.14309/ctg.0000000000000786.
The performance of a high quality esophagogastroduodenoscopy (EGD) is dependent on the mucosal cleanliness. Recently, the Polprep: Effective Assessment of Cleanliness in EGD (PEACE) scale was created to assess the degree of mucosal cleanliness during EGD. The aim of this study was to validate this scoring system in a cohort of international endoscopists.
In total, 39 EGD videos, with different degrees of mucosal cleanliness were retrieved from a previously conducted prospective trial. All experts rated the cleanliness of the mucosa on each video using the PEACE scale. To evaluate agreement of all scores (0-3), intraclass correlation coefficient 2.1 was used. The agreement on adequate (scores 2 and 3) and inadequate (scores 0 and 1) cleanliness was assessed using kappa values.
Videos evaluating esophagus, stomach, and duodenum cleanliness were reviewed by 16 endoscopists. The PEACE scores demonstrated good agreement (intraclass correlation coefficient 0.82, 95% CI 0.75-0.89), especially for esophagus (0.84; 95% CI 0.71-0.95) and stomach (0.81; 95% CI 0.69-0.91), while agreement was moderate for the duodenum (0.69; 95% CI 0.51-0.87). The agreement was similar between Eastern (0.86; 95% CI 0.79-0.92) and Western experts (0.80; 95% CI 0.72-0.88). Similarly, agreement regarding adequate cleanliness was comparable between Eastern (0.70; 95% CI 0.55-0.85) and Western (0.74; 95% CI 0.64-0.84) endoscopists being overall 0.75 (95% CI 0.65-0.85).
The PEACE scoring system is a simple and reliable scale to assess the cleanliness during EGD. The score is now validated among international experts with high concordance, justifying its use in clinical practice.
高质量的食管胃十二指肠镜检查（EGD）的实施取决于黏膜清洁度。最近，创建了Polprep：EGD清洁度有效评估（PEACE）量表，以评估EGD期间黏膜清洁度的程度。本研究的目的是在一组国际内镜医师中验证该评分系统。
总共从先前进行的一项前瞻性试验中检索了39段具有不同程度黏膜清洁度的EGD视频。所有专家使用PEACE量表对每个视频中黏膜的清洁度进行评分。为了评估所有评分（0-3）的一致性，使用了组内相关系数2.1。使用kappa值评估关于足够清洁度（评分2和3）和不足清洁度（评分0和1）的一致性。
16位内镜医师对评估食管、胃和十二指肠清洁度的视频进行了审查。PEACE评分显示出良好的一致性（组内相关系数0.82，95%置信区间0.75-0.89），尤其是食管（0.84；95%置信区间0.71-0.95）和胃（0.81；95%置信区间0.69-0.91），而十二指肠的一致性为中等（0.69；95%置信区间0.51-0.87）。东方专家（0.86；95%置信区间0.79-0.92）和西方专家（0.80；95%置信区间0.72-0.88）之间的一致性相似。同样，东方（0.70；95%置信区间0.55-0.85）和西方（0.74；95%置信区间0.64-0.84）内镜医师之间关于足够清洁度的一致性总体为0.7（95%置信区间0.65-0.85）。
PEACE评分系统是一种简单可靠的量表，用于评估EGD期间的清洁度。该评分现已在国际专家中得到验证，具有高度一致性，证明其可用于临床实践。
