A142 INTER-OBSERVER AGREEMENT AND THE ROLE OF EDUCATIONAL TRAINING ON THE ENDOSCOPIC SCORING OF CROHN’S DISEASE
Bibliographic record
Abstract
As the management of inflammatory bowel disease (IBD) focuses on the importance of mucosal healing, endoscopic scoring systems such as the Simple Endoscopic Score for Crohn’s Disease (SES-CD) are becoming important tools in the objective measurement of inflammation. Concern regarding inter-observer variability and feasibility has limited use of the SES-CD in the clinical setting. The study goal is to determine whether an educational program teaching endscopic scoring will improve performance and inter-observer agreement among trainees. Gastroenterology residents were provided with videos of seven ileocolonoscopies representative of a range of ileal and colonic Crohn’s disease severity. Participants individually scored the videos using the SES-CD. The residents then participated in a 1-hour educational session involving a didactic lecture with examples using the SES-CD led by a faculty member with expertise in IBD. Participants then re-scored the same videos. Five videos chosen randomly were also scored by IBD experts. Inter-observer agreement among gastroenterology trainees and expert scorers was calculated using the intra-class correlation coefficient (ICC) obtained from the total SES-CD scores. Six gastroenterology residents completed the pre-training SES-CD scoring, attended the training session, and completed the post-training re-scoring. Three IBD expert scorers completed the scoring. The table below shows the inter-observer agreement among the different groups for the pre- and post-training scenarios. There was no change in inter-observer agreement among trainees or all scorers after the educational session. Among gastroenterology trainees and between trainees and expert scorers, there was good inter-observer agreement for SES-CD scores. There was very good inter-observer agreement among expert scorers. A 1-hour training session on endoscopic scoring did not improve inter-observer agreement. This study supports routine use of the SES-CD in the clinical setting to improve reporting consistency and aid in clinical evaluation however, a more intensive educational program to improve endoscopic scoring accuracy among trainees should be developed. Intra-class correlation coefficients and inter-observer agreement among gastroenterology trainees and IBD experts using the SES-CD ICC: intra-class correlation coefficients University of Toronto Gastroenterology Training Program
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.157 | 0.261 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".