Assessment and validation of the new capsule endoscopy Crohn's disease activity index (CECDAI)
Assessment and validation of the new capsule endoscopy Crohn's disease activity index (CECDAI)
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DOI：
10.1007/s10620-007-0084-y
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发表时间：
2008-07-01
影响因子：
3.1
通讯作者：
Niv, Yaron
中科院分区：
文献类型：
--
作者：
Gal, Eyal;Geller, Alex;Niv, Yaron
背景胶囊内镜是一种用于小肠病理检测的相对较新的成像工具。通过胶囊式内窥镜对克罗恩病严重程度的评估尚未标准化，并且在解释结果时受到观察者间差异的限制。目的开发、评估和验证一种新的、简单的胶囊内镜克罗恩病活动指数（CECDAI），以便对小肠胶囊内镜检查结果的严重程度进行分级。方法该系统包括根据通过时间将小肠分为近端和远端段，然后根据三个参数对每个段进行评级：炎症（A），疾病程度（B）和狭窄（C）。通过将炎症分项评分乘以疾病分项评分并加上狭窄分项评分（A x B + C）计算节段评分;通过将两个节段评分相加计算最终评分：CECDAI =（A1 x B1 + C1）+（A2 x B2 + C2）。在本研究中，4名资深内窥镜医师（2名具有胶囊式内窥镜判读经验）独立审查了20例克罗恩病患者的编码胶囊式内窥镜视频，并根据CECDAI对其进行了评级。采用斯皮尔曼相关性检验分析观察者间变异性。结果20例患者CECDAI总分为0~26分。每两个观察者之间分配的总分的相关性为0.867（0.700 - 1.000 =强关联; WHO分类; P <0.0001）。所有观察员的分项评分和总分一致性的Kappa统计量如下：A1，0.31 +/-0.05; B1，0.25 +/-0.05; C1（无病例）; A2，0.51 +/-0.05; B2，0.57 +/-0.05; C2，0.27 +/-0.07。所有考官都报告说，该系统简单易学，易于应用。结论CECDAI评分可作为一种方便、可靠和可重复的诊断和随访工具，供经验丰富的内镜医师用于评价小肠克罗恩病患者。
Background Capsule endoscopy is a relatively new imaging tool for the detection of small bowel pathology. The assessment of the severity of Crohn's disease by capsule endoscopy is not standardized and is limited by interobserver variations in interpreting the findings. Aim To develop, assess and validate a new, simple capsule endoscopy Crohn's disease activity index (CECDAI) in order to grade the severity of small bowel capsule endoscopy findings. Methods The system involves dividing the small bowel into proximal and distal segments according to transit time and then rating each segment on the basis of three parameters: inflammation (A), extent of disease (B) and presence of strictures (C). The segmental score is calculated by multiplying the inflammation subscore by the disease-subextent score and adding the stricture subscore (A x B + C); the final score is calculated by adding the two segmental scores: CECDAI = (A1 x B1 + C1) + (A2 x B2 + C2). In the present study, four senior endoscopists (two with experience in capsule endoscopy interpretation) independently reviewed coded capsule endoscopy videos of 20 patients with Crohn's disease and rated them according to the CECDAI. Interobserver variability was analyzed by Spearman's correlation test. Results The CECDAI total scores for the 20 patients ranged from 0 to 26. The correlation for the total score assigned between every two observers was 0.867 (0.700-1.000 = strong degree association; WHO classification; P < 0.0001). The Kappa statistics for agreement among all observers for the subscores and total scores were as follows: A1, 0.31 +/- 0.05; B1, 0.25 +/- 0.05; C1 (no cases); A2, 0.51 +/- 0.05; B2, 0.57 +/- 0.05; C2, 0.27 +/- 0.07. All examiners reported that the system was simple to learn and apply. Conclusions The CECDAI score may serve as a convenient, reliable and reproducible diagnostic and follow-up tool for use by experienced endoscopists in the evaluation of patients with Crohn's disease of the small bowel.