P0358 The effects of reading experience on small intestine capsule endoscopy scoring of Crohn’s disease
Bibliographic record
Abstract
Abstract Background Small bowel capsule endoscopy (SBCE) is a less invasive modality for the evaluation of small bowel lesions in Crohn’s disease (CD). The CD small bowel lesions that are visualized include inflammation and stenosis, and standardized scores are used for objective assessment of activity. On the other hand, it is not clear whether experience or individual differences influence the scoring. We assessed the correlation of each investigator and interobserver agreement in the SBCE scores. Methods Retrospective study including 15 CD patients who underwent SBCE from 2015 to 2022 after confirming patency with a patency capsule. The patient information was blinded and assessed independently by three physicians, with no experience reading SBCE (Beginner A), less than 10 years of experience (Intermediate B), and more than 10 years of experience (Expert C). The activity of inflammation was calculated independently by individual physicians according to Lewis score (LS), capsule endoscopy Crohn’s disease activity index (CECDAI), and Crohn’s disease activity in capsule endoscopy (CDACE). The correlation was compared between the scores for each investigator individually. The interobserver agreement of scores between physicians (A to C) and those with at least 10 years of reading experience and at least 500 SBCE scoring experiences (Expert D as standard control) for LS > 350 and CDACE > 420 scores, which have been reported to predict relapse outcome, were compared using kappa coefficients for each. The correlation between LS, CECDAI, and CDACE scores and Harvey-Bradshaw index (HBI) and CRP was assessed by Expert D as the standard. Results Seven male patients, median age (min-max) 21 (14-72) years, disease duration 4 (2-38) months, HBI 3 (0-9), Montreal Classification B1: 14 (93.3%), B2: 1 (6.7%), L1: 4 (26.7%), L3: 11 (73.3%). Reading time differed significantly among readers, with the beginner taking the longest (median reading time of 60 minutes for the beginner, p<0.0001). The correlation between each score per investigator regardless of experience was good, with the highest correlation between CECDAI and CDACE (Beginner A: ρ=0.87, Intermediate B: ρ=0.90, Expert C: ρ=0.93, Expert D: ρ=0.91, Spearman’s rank correlation coefficient). All physicians (A to C) showed moderate to high concordance (kappa coefficient 0.47 to 0.84) with Expert D for CDACE > 420. However, all physicians (A to C) did not show agreement with Expert D (kappa coefficient -0.05 to 0.11) for LS>350. There is no correlation was found between each score and HBI or CRP. Conclusion Reading time was affected by experience of SBCE, but the intraobserver correlation of each score was observed regardless of years of experience. Interobserver agreement was higher in CDACE compared to LS.
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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 | 0.007 | 0.026 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 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".