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Magnification endos...
Magnification endoscopy for diagnosis of nonerosive reflux disease: a proposal of diagnostic criteria and critical analysis of observer variability.
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- Edebo, Anders, 1968 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper,Institute of Clinical Sciences
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Tam, W (author)
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Bruno, M (author)
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van Berkel, A-M (author)
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Jönson, C (author)
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Schoeman, M (author)
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Tytgat, G (author)
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Dent, J (author)
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Lundell, L (author)
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(creator_code:org_t)
- Georg Thieme Verlag KG, 2007
- 2007
- English.
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In: Endoscopy. - : Georg Thieme Verlag KG. - 1438-8812 .- 0013-726X. ; 39:3, s. 195-201
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Abstract
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- BACKGROUND AND STUDY AIMS: This study tested the diagnostic value of high-resolution endoscopy for the recognition of subtle diagnostic esophageal mucosal changes in nonerosive reflux disease. PATIENTS AND METHODS: Ten control subjects and eleven patients with nonerosive reflux disease confirmed by a validated questionnaire, standard endoscopy, and 24-hour pH-metry participated in the study. Still images were collected by high-resolution endoscopes from the distal esophagus in a standardized manner, incorporating iodine staining. Assessments were repeated in the patients with reflux disease after 4 weeks of esomeprazole therapy. Interobserver variability in the recognition of the proposed criteria was initially evaluated by 27 endoscopists using an Internet-based process. After optimisation of image quality the evaluation was repeated face-to-face with six expert endoscopists. RESULTS: No criterion was identified in either assessment that was sufficiently sensitive and specific to patients with reflux disease to be clinically useful. The kappa value, used to assess interobserver variation, was acceptably high only for invisibility of palisade vessels (0.59). Triangular indentations, apical mucosal breaks, and pinpoint blood vessels at the squamocolumnar junction were identified more frequently in the patients with reflux disease ( P < 0.05). These changes and the invisibility of the palisade vessels were significantly less prevalent in reflux patients after therapy ( P < 0.01). CONCLUSIONS: Though some distal esophageal mucosal appearances observed with the high-resolution endoscope appeared to be related to nonerosive esophageal mucosal injury, none of these changes proved to be sufficiently sensitive and specific to justify their use as a diagnostic criterion for nonerosive reflux disease.
Keyword
- Adult
- Diagnosis
- Differential
- Endoscopy
- Gastrointestinal
- methods
- Female
- Gastroesophageal Reflux
- diagnosis
- metabolism
- Humans
- Image Enhancement
- Male
- Observer Variation
- Reproducibility of Results
Publication and Content Type
- ref (subject category)
- art (subject category)
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Endoscopy
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- By the author/editor
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Edebo, Anders, 1 ...
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Tam, W
-
Bruno, M
-
van Berkel, A-M
-
Jönson, C
-
Schoeman, M
-
show more...
-
Tytgat, G
-
Dent, J
-
Lundell, L
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show less...
- Articles in the publication
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Endoscopy
- By the university
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University of Gothenburg
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Karolinska Institutet