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To prospectively evaluate interobserver agreement for small bowel ultrasound (SBUS) in newly diagnosed and relapsing Crohn’s disease.
A subset of patients recruited to a prospective trial comparing the diagnostic accuracy of MR enterography and SBUS underwent a second SBUS performed by one of a pool of six practitioners, who recorded the presence, activity and location of small bowel and colonic disease. Detailed segmental mural and extra-mural observations were also scored. Interobserver variability was expressed as percentage agreement with a construct reference standard, split by patient cohort, grouping disease as present or absent. Prevalence adjusted bias adjusted kappa (PABAK), and simple percentage agreement between practitioners, irrespective of the reference standard, were calculated.
Thirty-eight patients (11 new diagnosis, 27 relapse) were recruited from two sites. Overall percentage agreement for small bowel disease presence against the consensus reference was 82% (52–95% (95%CI)), kappa coefficient (κ) 0.64, (substantial agreement) for new diagnosis and 81%, κ 0.63 (substantial agreement) for the relapsing cohort. Agreement for colonic disease presence was 64%, κ 0.27 (fair agreement) in new diagnosis and 78%,κ 0.56 (moderate agreement) in the relapsing cohort. Simple agreement between practitioners was 84% and 87% for small bowel and colonic disease presence respectively. Practitioners agreed on small bowel disease activity in 24/27 (89%) where both identified disease. Kappa agreement for detailed mural observations ranged from κ 0.00 to 1.00.
There is substantial practitioner agreement for small bowel disease presence in newly diagnosed and relapsing CD patients, supporting wider dissemination of enteric US.
Panés J, Bouzas R, Chaparro M, et al. Systematic review: the use of ultrasonography, computed tomography and magnetic resonance imaging for the diagnosis, assessment of activity and abdominal complications of Crohn’s disease. Aliment Pharmacol Ther 2011; 34:125–45. CrossRef
Horsthuis K, Bipat S, Bennink RJ, et al. Inflammatory Bowel Disease Diagnosed with US, MR, Scintigraphy and CT: Meta-analysis of Prospective Studies. Radiology 2008; 247:64–79. CrossRef
Horsthuis K, Bipat S, Stokkers PCF, et al. Magnetic resonance imaging for evaluation of disease activity in Crohn’s disease: a systematic review. Eur Radiol 2009; 19:1450–60. CrossRef
Taylor SA, Mallett S, Bhatnagar G, et al. Diagnostic accuracy of magnetic resonance enterography and small bowel ultrasound for the extent and activity of newly diagnosed and relapsed Crohn’ s disease (METRIC): a multicentre trial Lancet Gastroenterol hepatol 2018: 3:548-558.
Miles A, Bhatnagar G, Halligan S, et al. Magnetic resonance enterography, small bowel ultrasound and colonoscopy to diagnose and stage Crohn’s disease: patient acceptability and perceived burden. Eur Radiol 2019;29:1083-1093 CrossRef
Bhatnagar G, Von Stempel C, Halligan S, et al Utility of MR enterography and ultrasound for the investigation of small bowel Crohn’s disease. J Magn Reson Imaging 2017; 45:1573–88. CrossRef
Maconi G, Radice E. Greco S, et al. Bowel ultrasound in Crohn’s disease. Best Pract Res Clin Gastroenterol 2006; 20:93–112. CrossRef
Esteban JM, Maldonado L, Sanchiz V, et al. Activity of Crohn’s disease assessed by colour Doppler ultrasound analysis of the affected loops. Eur Radiol 2001; 11:1423–8. CrossRef
Nylund K, Leh S, Immervoll H, et al. Crohn’s disease: Comparison of in vitro ultrasonographic images and histology. Scand J Gastroenterol 2008; 43:719–26. CrossRef
Maconi G, Greco S, Duca P, et al. Prevalence and clinical significance of sonographic evidence of mesenteric fat alterations in Crohn’s disease. Inflamm Bowel Dis 2008; 14:1555–61. CrossRef
Fraquelli M, Sarno A, Girelli C, et al. Reproducibility of bowel ultrasonography in the evaluation of Crohn’s disease. Dig Liver Dis 2008; 40:860–6. CrossRef
Dillman JR, Smith EA, Sanchez R, et al. Prospective cohort study of ultrasound-ultrasound and ultrasound-MR enterography agreement in the evaluation of pediatric small bowel Crohn disease. Pediatr Radiol 2016:46:490-7 CrossRef
Parente F, Greco S, Molteni M, et al. Oral contrast enhanced bowel ultrasonography in the assessment of small intestine Crohn’s disease. A prospective comparison with conventional ultrasound, x ray studies, and ileocolonoscopy. Gut 2004; 53:1652–7. CrossRef
Taylor S, Mallett S, Bhatnagar G, et al. METRIC (MREnterography or ulTRasound in Crohn’s disease): a study protocol for a multicentre, non-randomised, single-arm, prospective comparison study of magnetic resonance enterography and small bowel ultrasound compared to a reference standard in those. BMC Gastroenterol 2014; 14:142. CrossRef
Cammarota T, Sarno A, Robotti D, B et al. US evaluation of patients affected by IBD: How to do it, methods and findings. Eur J Radiol 2009; 69:429–37. CrossRef
Landis J, Koch G. The measurement of observer agreement for categorical data. Biometrics 1977;33:159–74. CrossRef
- Observer agreement for small bowel ultrasound in Crohn’s disease: results from the METRIC trial
Stuart A. Taylor
METRIC study investigators
- Springer US
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