Multicenter comparison of the interobserver agreement of standard EUS scoring and Rosemont classification scoring for diagnosis of chronic pancreatitis
Background
EUS has less than optimal interobserver agreement for the diagnosis of chronic pancreatitis. The newly developed Rosemont consensus scoring system includes weighted criteria and stricter definitions for individual features.
Objective
The primary aim was to compare the interobserver agreement of standard and Rosemont scoring.
Setting
Multiple tertiary-care institutions.
Intervention
Fifty EUS videos were interpreted by 14 experts. Each expert interpreted the videos on two occasions: First, the videos were read by using standard scoring (9 criteria). Second, after viewing a presentation of the Rosemont classification, the same experts re-read the videos by using Rosemont scoring.
Main Outcome Measurements
Fleiss' kappa (K) statistics are reported with 95% confidence intervals (CI).
Results
The interobserver agreement was “substantial” (K = 0.65 [95% CI, 0.52-0.77]) for Rosemont scoring and “moderate” (K = 0.54 [95% CI, 0.44-0.66]) for standard scoring; however, the difference was not statistically significant (P = 0.12).
Limitations
The sample size does not allow detection of differences in K of <0.25.
Conclusion
Use of the Rosemont classification did not significantly increase interobserver agreement for EUS diagnosis of chronic pancreatitis compared with standard scoring.
Abbreviations: CP, chronic pancreatitis, ePFT, endoscopic pancreatic function test, K, kappa
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DISCLOSURE: T. Stevens has received research support from Solvay Pharmaceuticals, Marietta, GA, and ChiRhoClin, Inc., Burtonsville, MD. J. Conway is a consultant to and has received research support from Olympus America, Centerville, PA. J. Dewitt is a consultant to Olympus America and has initiated research support from Cook Endoscopy, Winston-Salem, NC, and RedPath Integrated Pathology, Inc, Pittsburgh, PA. M. Kahaleh has received research support from Olympus America, Boston Scientific, Nattick, MA, ConMed, Utica, NY, Alveolus, Charlotte, NC, and Cook Endoscopy. J. Vargo is a consultant to and has received research support from Olympus America and Ethicon Endosurgery, Cincinnati, OH. G. Mishra is a consultant to Cook Endoscopy. The other authors have no disclosures relevant to this publication.
If you would like to chat with an author of this article, you may contact Dr. Stevens at stevent@ccf.org.
PII: S0016-5107(09)02697-2
doi:10.1016/j.gie.2009.10.043
© 2010 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.
