Inter-Observer Agreement in the Endoscopic Classification of Colorectal Laterally Spreading Tumors: A Multicenter Study Between Experts and Trainees

Background and Aim The risk of cancer varies with the subtype of colorectal “laterally spreading tumors” (LSTs). However, visual interpretations vary among endoscopists. The aim of this study was to evaluate inter-observer agreement and accuracy in the endoscopic classification of LST subtypes among...

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Published in:Digestive diseases and sciences 2014-10, Vol.59 (10), p.2550-2556
Main Authors: Lee, Yoo Jin, Kim, Eun Soo, Park, Kyung Sik, Cho, Kwang Bum, Lee, Mi-Young, Kim, Sung Kook, Jeon, Seong Woo, Jung, Min Kyu, Jang, Byung Ik, Kim, Kyeong Ok, Lee, Si-Hyung, Kim, Eun Young, Kwon, Joong Goo, Jung, Jin Tae, Yang, Chang Heon, Kim, Wan Jung, Kim, Hyun Jin, Seo, Hyang Eun
Format: Article
Language:English
Subjects:
Biochemistry
Colorectal Neoplasms - classification
Colorectal Neoplasms - epidemiology
Colorectal Neoplasms - pathology
Endoscopy, Gastrointestinal - standards
Gastroenterology
Health aspects
Hepatology
Humans
Medicine
Medicine & Public Health
Observer Variation
Oncology
Original Article
Pneumoviridae
Transplant Surgery
Tumors
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Summary:Background and Aim The risk of cancer varies with the subtype of colorectal “laterally spreading tumors” (LSTs). However, visual interpretations vary among endoscopists. The aim of this study was to evaluate inter-observer agreement and accuracy in the endoscopic classification of LST subtypes among experts and trainees. Methods In total, 40 LST images were collected and reviewed independently by 14 gastroenterology experts and 10 trainees. All investigators recorded their findings as one of the following four categories: homogeneous, nodular mixed, flat-elevated, and pseudo-depressed. Agreement was assessed in terms of the kappa (κ) statistic and AC1 estimate. Accuracy is reported as percentage agreement with the gold standard, based on the gross morphology of the resected specimens. Results Of the possible 91 pair-wise κ estimates among experts, 41 (45.1 %) were >0.75, indicating excellent agreement, while only 2 (4.44 %) of the 45 pair-wise κ estimates among trainees were >0.75. Agreements for individual LST subtypes in the trainee group were significantly lower than those in the expert group. The κ and AC1 estimates showed similar values in individual subtypes of LSTs. The overall accuracy of LST was also significantly higher for the experts than the trainees (85.9 vs. 72.5 %, P  
ISSN:0163-2116
1573-2568
DOI:10.1007/s10620-014-3206-3