Gastrointestinal Endoscopy
Volume 71, Issue 3 , Pages 519-526, March 2010

Multicenter comparison of the interobserver agreement of standard EUS scoring and Rosemont classification scoring for diagnosis of chronic pancreatitis

Current affiliations: Digestive Disease Institute, (T.S., J.J.V.), Quantitative Health Sciences (R.L.), Cleveland Clinic, Cleveland, OH, Gastroenterology Division (D.A.), University of Utah, Salt Lake City, UT, Division of Gastroenterology and Hepatology (M.A.A-H., J.D.), Indiana University, Indianapolis, IN, Digestive Health Center (J.C., G.M.), Wake Forest University, Division of Gastroenterology, Hepatology, and Nutrition (C.E.F.), University of Florida, Gainesville, FL, Division of Gastroenterology and Hepatology (M.K.), University of Virginia, Charlottesville, VA, Division of Gastroenterology, Hepatology, and Endoscopy (L.S.L.), Brigham and Women's Hospital, Boston MA, Department of Gastroenterology and Hepatology (M.J.L., M.D.T.), Mayo Clinic, Rochester MN, Division of Gastroenterology (C.R.P.), University of Michigan, Ann Arbor, MI, Digestive Disorders Center (G.I.P.), University of Pittsburgh Medical Center, Pittsburgh, PA, Division of Gastroenterology and Hepatology (R.J.S.), University of Colorado, Denver, CO, and Division of Gastroenterology and Hepatology (S.A.V.), Medical University of South Carolina, Charleston, SC, USA

Received 13 July 2009; accepted 14 October 2009.

Cleveland, Ohio, Salt Lake City, Utah, Indianapolis, Indiana, Winston-Salem, North Carolina, Gainesville, Florida, Charlottesville, Virginia, Boston, Massachusetts, Rochester, Minnesota, Ann Arbor, Michigan, Pittsburgh, Pennsylvania, Denver, Colorado, Charleston, South Carolina, USA

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

Gastrointestinal Endoscopy
Volume 71, Issue 3 , Pages 519-526, March 2010