P176 Expert consensus on acquisition and reporting of intestinal ultrasonography activity in Crohn’s disease. A prospective inter-rater agreement study
Notice bibliographique
Résumé
Abstract Background Intestinal ultrasonography (IUS) is a promising cross-sectional imaging modality used to assess transmural disease and complications in Crohn’s disease (CD). Although recently positioned as a first-line modality for evaluation as per ECCO guidelines, standard measurements, reproducibility and nomenclature have not yet been clearly established. The aim of this study was to evaluate the inter-rater agreement for parameters identified as important by experts through Delphi consensus. Methods IUS parameters demonstrating inflammatory activity were systematically reviewed in the literature and presented to IUS experts. Individual parameters were selected by a blinded Delphi consensus panel to establish relative contribution to inflammatory activity in CD. Weighted grading of each parameter was further established by expert consensus. Image acquisition for optimal measurement was established by consensus. Two phases for evaluating inter-rater variability were undertaken. Phase 1: blind review by 8 readers of 20 de-identified CD cases. Cases with poor agreement were reviewed to clarify discrepancy and improve agreement. Phase 2: an additional 30 de-identified CD cases blindly were reviewed by 12 independent expert readers. Inter-rater agreement was evaluated for all 4 key parameters. Statistics were performed using Stata 16. Bowel wall thickness (BWT) was assessed using intraclass correlation coefficient (ICC) and the ordinal parameters using weighted Cohens Kappa. Results The Delphi process reduced 12 activity parameters to 4 key contributors including BWT, color Doppler signal (CDI), inflammatory fat and bowel wall echostratification (Figure 1). BWT was regarded as pathologic if the average of 4 measurements were > 3 mm for the small and large bowel, and grades of the additional parameters established (Table 1). Bowel wall thickness was comprised of 2 measurements in cross section and 2 in longitudinal orientation (Figure 2). Interobserver agreement was almost perfect for BWT: ICC=0.91 (95% CI 0.83 to 0.96) p = 0.001, while there was moderate agreement for CDI κ=0.60 (95% CI 0.48–0.72) p = 0.001. Agreement for inflammatory fat detection was also moderate with κ= 0.50 (95% CI 0.33–0.66) p = 0.001, while stratification was fair κ= 0.39 (95% CI 0.26–0.53) p = 0.001. Conclusion This expert consensus-based IUS activity score clearly establishes the reproducibility of this standardised approach to measure inflammatory activity in patients with CD. Using our method, BWT which is known as the most important parameter, is highly reproducible with CDI and inflammatory fat demonstrating moderate reproducibility. This score may provide the foundation for the future incorporation of IUS in research studies and clinical trials.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,284 | 0,341 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,002 | 0,002 |
| Bibliométrie | 0,006 | 0,004 |
| Études des sciences et des technologies | 0,002 | 0,002 |
| Communication savante | 0,002 | 0,002 |
| Science ouverte | 0,002 | 0,007 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; l’étiquette directe de Gemma et le classifieur distillé Codex s’accordent sur ce qui est montré ici.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».