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KMID : 0359020060330040197
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Korean Journal of Gastrointestinal Endoscopy
2006 Volume.33 No. 4 p.197 ~ p.203
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Interobserver Variation in the Endoscopic Diagnosis of Gastroesophageal Reflux Disease
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Lee Jun-Haeng
Choi Myung-Gyu
Chun Hoon-Jai
Lee Jong-Soo
Rhee Poong-Lyul
Park Young-Tae
Kim Dong-Kee
Song Ki-Jun
Lee Sang-In
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Abstract
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Background/Aims: A diagnosis of gastroesophageal reflux disease (GERD) is based on the typical symptoms, such as acid regurgitation and heartburn. However, there is a very high inter-observer variation in the evaluation of GERD patients.
Methods: The endoscopic images of forty-two cases with reflux symptoms (2 still images and 15-second video images per case) were analyzed by 18 experienced endoscopists and 22 trainees. The findings were classified into the following: (1) 6 groups (modified LA classification: 4 LA groups, minimal, and normal), (2) erosinve and non-erosive, and (3) confluent erosive and others. The level of inter-observer variation is expressed as a kappa value.
Results: The level of inter-observer agreement of the 18 experienced endoscopists for classifying the patients into 6 groups was fairly low (kappa=0.364). However, when the findings were classified into the 2 groups suggested in the Genval workshop (NERD, A, or B versus C or D), the level of inter- observer agreement increased substantially (kappa=0.710). The kappa value of the 22 trainees for classifying the patients into 6 groups was 0.402.
Conclusions: Modified LA classification with minimal change lesions showed a fairly low level of agreement. The problem caused by inter-observer variations decreased significantly when the findings were classified into two groups. (Korean J Gastrointest Endosc 2006;33:197?203)
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KEYWORD
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Gastroesophageal reflux disease, LA classification, Minimal change
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