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- Title
ORIGINAL ARTICLE Numerical modification of the Los Angeles classification of gastroesophageal reflux disease fails to decrease observer variation.
- Authors
Kusano, Motoyasu; Sugimoto, Sayaka; Kawamura, Osamu; Minashi, Keiko; Maeda, Masaki; Shimoyama, Yasuyuki; Ino, Kyoko; Mimura, Naoko; Higuchi, Tatsuya; Kon, Yoichi; Kikuchi, Kazuma; Shirota, Tohko; Mizuide, Masahumi; Oshimoto, Naoko; Toki, Munetoshi; Ohwada, Tsuneo; Mori, Masatomo
- Abstract
We previously reported that a new endoscopic classification of gastroesophageal reflux disease, the Los Angeles classification, showed considerable observer variation depending on the experience of the endoscopist. In the present study, we evaluated some modifications of the classification to determine whether we could decrease observer variation. Fifty endoscopic photographs, each showing four images of the squamo-columnar junction, were prospectively obtained from 50 consecutive patients with gastroesophageal reflux disease. Two groups of eight endoscopists divided by their endoscopic experience, group 1 (100–500 procedures) and group 2 (more than 500 procedures), assessed the photographs using classifications with the following modifications: (i) addition of grade O to describe healed mucosal breaks and setting grade B as more than 5 mm or 10 mm; or (ii) addition of grade O and setting grade D as 75–99% or 100% circumferential. Changing the definition of grade B or grade D did not increase the kappa values for either group of observers. These modifications of the Los Angeles classification were unable to decrease observer variation.
- Subjects
ENDOSCOPY; GASTROESOPHAGEAL reflux; ESOPHAGUS diseases; DIAGNOSIS; DISEASES; MEDICINE
- Publication
Digestive Endoscopy, 2004, Vol 16, Issue 1, p9
- ISSN
0915-5635
- Publication type
Article
- DOI
10.1111/j.1443-1661.2004.00302.x