背景:内镜评分是诊断溃疡性结肠炎(UC)和克罗恩病(CD)的关键组成部分。内镜评分的变异性会影响患者的试验资格和治疗效果的测量。在这项研究中,我们在系统评价和荟萃分析中研究了炎症性肠病内镜评分系统的观察者间和观察者间的变异性.
方法:我们纳入了观察性研究,这些研究使用UC(内窥镜Mayo评分[eMS],溃疡性结肠炎严重程度内镜指数[UCEIS])或CD(克罗恩病严重程度内镜指数[CDEIS],克罗恩病的简单内窥镜评分[SES-CD])在成人(≥18岁)中的系统,并以英文发表。协议的强度被归类为公平,中度,不错,非常好。
结果:共确认6003条记录。筛选后,我们的分析包括13项研究。eMS的总体观察者间协议率为0.58,0.66为UCEIS,CDEIS为0.80,SES-CD为0.78。这些系统的总体异质性(I2)范围为93.2%至99.2%。一些研究评估了观察者内部的协议率。eMS的总体效果大小为0.75,0.87对于UCEIS,CDEIS为0.89,SES-CD为0.91。
结论:eMS的观察者间协议率,UCEIS,CDEIS,SES-CD的范围从中度到良好。eMS的内部观察者协议率,UCEIS,CDEIS,SES-CD的范围从好到非常好。改善观察者间协议的解决方案可以允许更准确的患者评估,导致更富有,更准确的临床管理和临床试验数据。
这项研究检查了炎症性肠病内镜评分系统的观察者之间和观察者之间的差异(内镜Mayo评分,溃疡性结肠炎内镜严重程度指数,克罗恩病内镜严重程度指数,克罗恩病的简单内窥镜评分)的系统评价和荟萃分析。
BACKGROUND: Endoscopy scoring is a key component in the diagnosis of ulcerative colitis (UC) and Crohn\'s disease (CD). Variability in endoscopic scoring can impact patient trial eligibility and treatment effect measurement. In this study, we examine inter- and intraobserver variability of inflammatory bowel disease endoscopic scoring systems in a systematic
review and meta-analysis.
METHODS: We included observational studies that evaluated the inter- and intraobserver variability using UC (endoscopic Mayo Score [eMS], Ulcerative Colitis Endoscopic Index of Severity [UCEIS]) or CD (Crohn\'s Disease Endoscopic Index of Severity [CDEIS], Simple Endoscopic Score for Crohn\'s Disease [SES-CD]) systems among adults (≥18 years of age) and were published in English. The strength of agreement was categorized as fair, moderate, good, and very good.
RESULTS: A total of 6003 records were identified. After screening, 13 studies were included in our analysis. The overall interobserver agreement rates were 0.58 for eMS, 0.66 for UCEIS, 0.80 for CDEIS, and 0.78 for SES-CD. The overall heterogeneity (I2) for these systems ranged from 93.2% to 99.2%. A few studies assessed the intraobserver agreement rate. The overall effect sizes were 0.75 for eMS, 0.87 for UCEIS, 0.89 for CDEIS, and 0.91 for SES-CD.
CONCLUSIONS: The interobserver agreement rates for eMS, UCEIS, CDEIS, and SES-CD ranged from moderate to good. The intraobserver agreement rates for eMS, UCEIS, CDEIS, and SES-CD ranged from good to very good. Solutions to improve interobserver agreement could allow for more accurate patient assessment, leading to richer, more accurate clinical management and clinical trial data.
This study examined the inter- and intraobserver variability of inflammatory bowel disease endoscopic scoring systems (endoscopic Mayo Score, Ulcerative Colitis Endoscopic Index of Severity, Crohn’s Disease Endoscopic Index of Severity, Simple Endoscopic Score for Crohn’s Disease) in a systematic
review and meta-analysis.