1. Validation of the Prague C&M Criteria for the endoscopic grading of Barrett's esophagus among gastroenterology trainees: A multicenter study
- Author
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Sachin Wani, Anil B. Seetharam, Babac Vahabzadeh, Dayna S. Early, Amit Rastogi, Ajay Bansal, Prateek Sharma, and Michael B. Cook
- Subjects
medicine.medical_specialty ,Intraclass correlation ,Video Recording ,Diaphragmatic breathing ,Gastroenterology ,Article ,Barrett Esophagus ,Internal medicine ,Confidence Intervals ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Esophagus ,Grading (education) ,Prospective cohort study ,Observer Variation ,business.industry ,Reproducibility of Results ,medicine.disease ,Confidence interval ,medicine.anatomical_structure ,Multicenter study ,Barrett's esophagus ,Esophagogastric Junction ,Esophagoscopy ,business - Abstract
Background The Prague C & M criteria, developed for the endoscopic grading of Barrett's esophagus (BE), (C = circumferential length, M=maximal length) were previously validated among a panel of 29 expert endoscopists with a special interest in BE. Its performance among gastroenterology trainees is unknown. Objective To test interobserver agreement among gastroenterology trainees for the Prague C & M criteria, identification of the gastroesophageal junction (GEJ) and the diaphragmatic hiatus. Design A prospective study. Setting Two tertiary referral centers. Patients and Interventions Standardized endoscopic videos were used. Main Outcome Measurements Interobserver agreement. Results Eighteen high-quality videos (normal esophagus, short and long lengths of BE, equally distributed) were independently evaluated by 18 gastroenterology trainees (year 1, n=5; year 2, n=6; year 3, n=7) after administration of a formal teaching module by an expert endoscopist. Overall intraclass correlation coefficients for assessment of the C and M extent of the endoscopic BE segment above the GEJ were 0.94 (95% CI, 0.89-0.98) and 0.96 (95% CI, 0.94-0.98), respectively. The overall intraclass correlation coefficients for GEJ and diaphragmatic hiatus location recognition were 0.92 (0.86-0.96) and 0.90 (0.82-0.95), respectively. The year of training did not affect interobserver agreement. Limitations The use of videos for endoscopic evaluation. Conclusion After standardized teaching, the Prague C & M criteria have high overall validity among gastroenterology trainees irrespective of the level of training for endoscopic evaluation of visualized BE lengths as well as key endoscopic landmarks.
- Published
- 2012