International validation of a PEACE scale assessing cleanliness during esophagogastroduodenoscopy to improve the quality of inspection during endoscopy
Notice bibliographique
Résumé
Aims Upper gastrointestinal (UGI) endoscopy quality depends on the capability to detect mucosal pathologies. Proper visibility is necessary to identify lesions and subtle mucosal abnormalities. The PEACE scale (Polprep: Effective Assessment of Cleanliness in Esophagogastroduodenoscopy) was recently created to assess UGI cleanliness. Cleanliness assessed using the PEACE scoring system was directly related to detection of clinically significant pathologies 1 . The aim of this study was to validate the concordance of the PEACE scoring system globally. Methods A group of 16 international experts participated in the study. Prior to the video assessment, the experts underwent training on the PEACE scale scores using 21 photographs and 8 videos. In a single round between April and June 2023, the experts assessed 39 videos of three segments (esophagus, stomach, duodenum). The cleanliness of the mucosa on each video was rated using the PEACE scale – from 0 to 3 (0=completely obscured, 1=poor visibility, 2=good visibility, 3=excellent visibility). To evaluate agreement of all scores (0 – 3) intraclass correlation coefficient (ICC 2.1) was used. The agreement on adequate (scores 2 and 3) and inadequate (scores 0 and 1) cleanliness was assessed with Conger's kappa value. ICC values 0.5 – 0.75 were considered as moderate, 0.75 – 0.9 as good, and>0.9 as excellent. Kappa values 0.33 – 0.5 were considered as fair, 0.5 – 0.67 as moderate, 0.67 – 0.9 as substantial, and over 0.9 as almost perfect. Results The overall agreement on PEACE scores was good (0.82 95% CI 0.75 – 0.89). The agreement was good in esophagus (0.84; 95% CI 0.71 – 0.95), and stomach (0.81; 95% CI 0.69 – 0.91) and moderate in duodenum (0.69; 95% CI 0.51 – 0.87). The concordance between Eastern and Western experts was comparable (0.86; 95% CI 0.79 – 0.92 and 0.80; 95% CI 0.72 – 0.88 respectively) being good in both cases. The overall agreement in identification of inadequate cleanliness (scores 0 and 1) was substantial (0.75; 95% CI 0.65 – 0.85). It was substantial in stomach and esophagus (stomach 0.77; 95% CI 0.62 – 0.93 and esophagus 0.68; 95% CI 0.23 – 1) and moderate in duodenum (0.55; 95% CI 0.32 – 0.79). The agreement on adequate vs inadequate cleanliness was similar among the Western and Eastern experts (Western: 0.74; 95% CI 0.64 – 0.84 and Eastern: 0.70; 95% CI 0.55 – 0.85) being substantial in both cases. [ 1 ] Conclusions Assessment of mucosal cleanliness of the UGI tract using the PEACE scale shows high concordance for both overall scoring and for identification of adequate cleanliness. This scale allows the implementation of a simple, uniform method to assess and document cleanliness during esophagogastroduodenoscopy (similar to the Boston Bowel Preparation Scale for colonoscopy). The scale being validated among international experts with high concordance, can be used in clinical practice. Publication History Article published online: 15 April 2024 © 2024. European Society of Gastrointestinal Endoscopy. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany
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 | 0,032 | 0,033 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,003 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 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; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».