Inter-observer variability on the value of endoscopic images for the documentation of upper gastrointestinal endoscopy - our center experience

Abstract

Objective: Endoscopy is an essential and invaluable diagnostic tool in the arsenal of every gastroenterologist. ESGE presented additional guidelines for standardized image documentation in upper and lower GI endoscopy. Clinical disagreement is a well-known challenge in most, if not all, fields of medicine. It is important to address disagreement in order to find ways of minimizing it. Clinical disagreement in gastroscopy can be illustrated by studying the observer variability.

Methods: We retrospectively recruited 120 random patients that underwent conventional upper gastrointestinal endoscopy between 2021-2022 in our Department of Gastroenterology, all of them performed by one endoscopist. As part of the study, all video-endoscopic recordings were stored using one internal server. In order to study interobserver variability, four physicians (endoscopists and gastroenterologist specialists) with varying endoscopy experience were invited to complete the questionnaire.

Results: The interobserver variability in our study ranged from moderate to very good, with the highest level of agreement in response to questions regarding characteristic findings such as normal mucosa, oesophagitis Class A Los Angeles, hiatal hernia for the oesophagus endoscopic evaluation, benign ulcer niche in gastric antrum, normal gastric corpus mucosa, intestinal metaplasia and angiodysplasia in gastric corpus. The question on atrophic mucosa in the first and second part of the duodeum was the most difficult to agree upon.

Conclusion: In the present study found that the variability between observers in the assessment of images obtained from patients that underwent conventional upper gastrointestinal endoscopy in our center was acceptably good.

Keywords: Documentation, endoscopy, gastrointestinal, image, observer variation