The DICA Endoscopic Classification for Diverticular Disease of the Colon Shows a Significant Interobserver Agreement among Community Endoscopists: an International Study.


Journal

Journal of gastrointestinal and liver diseases : JGLD
ISSN: 1842-1121
Titre abrégé: J Gastrointestin Liver Dis
Pays: Romania
ID NLM: 101272825

Informations de publication

Date de publication:
19 Dec 2019
Historique:
received: 31 10 2019
accepted: 14 12 2019
entrez: 14 1 2020
pubmed: 14 1 2020
medline: 23 6 2020
Statut: epublish

Résumé

The Diverticular Inflammation and Complication Assessment (DICA) endoscopic classification of diverticulosis and diverticular disease (DD) is currently available. It scores severity of the disease as DICA 1, DICA 2 and DICA 3. Our aim was to assess the agreement on this classification in an international endoscopists community setting. A total of 96 doctors (82.9% endoscopists) independently scored a set of DD endoscopic videos. The percentages of overall agreement on DICA score and a free-marginal multirater kappa (κ) coefficient were reported as statistical measures of interrater agreement. Overall agreement in using DICA was 91.8% with a free-marginal kappa of 88% (95% CI 80-95). The overall agreement levels were: DICA 1, 85.2%; DICA 2, 96.5%; DICA 3, 99.5%. The free marginal κ was: DICA 1 = 0.753, DICA 2 = 0.958, DICA 3 = 0.919. The agreement about the main endoscopic items was 83.4% (k 67%) for diverticular extension, 62.6% (k 65%) for number of diverticula for each district, 86.8% (k 82%) for presence of inflammation, and 98.5 (k 98%) for presence of complications. The overall interrater agreement in this study ranges from good to very good. DICA score is a simple and reproducible endoscopic scoring system for diverticulosis and DD.

Sections du résumé

BACKGROUND AND AIMS
The Diverticular Inflammation and Complication Assessment (DICA) endoscopic classification of diverticulosis and diverticular disease (DD) is currently available. It scores severity of the disease as DICA 1, DICA 2 and DICA 3. Our aim was to assess the agreement on this classification in an international endoscopists community setting.
METHODS
A total of 96 doctors (82.9% endoscopists) independently scored a set of DD endoscopic videos. The percentages of overall agreement on DICA score and a free-marginal multirater kappa (κ) coefficient were reported as statistical measures of interrater agreement.
RESULTS
Overall agreement in using DICA was 91.8% with a free-marginal kappa of 88% (95% CI 80-95). The overall agreement levels were: DICA 1, 85.2%; DICA 2, 96.5%; DICA 3, 99.5%. The free marginal κ was: DICA 1 = 0.753, DICA 2 = 0.958, DICA 3 = 0.919. The agreement about the main endoscopic items was 83.4% (k 67%) for diverticular extension, 62.6% (k 65%) for number of diverticula for each district, 86.8% (k 82%) for presence of inflammation, and 98.5 (k 98%) for presence of complications.
CONCLUSIONS
The overall interrater agreement in this study ranges from good to very good. DICA score is a simple and reproducible endoscopic scoring system for diverticulosis and DD.

Identifiants

pubmed: 31930224
doi: 10.15403/jgld-558
doi:

Types de publication

Journal Article Multicenter Study Validation Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

39-44

Investigateurs

Leonardo Allegretta (L)
Nadia Alatavilla (N)
Pedro Amaro (P)
Maria Laura Annunziata (ML)
Franz Barbero (F)
Giuseppe Basile (G)
Giuliano Bedogni (G)
Valerio Belfiori (V)
Stefano Benvenuti (S)
Carmelo Bertolami (C)
Marco Bisello (M)
Mouna Boudabous El Dammak (M)
Rosamaria Bozzi (R)
Marisa Buono (M)
Gibevra Cambie (G)
Erminio Capezzuto (E)
Carlo Casamassima (C)
Ani Chavoushian (A)
Ricardo Ciofani (R)
Cinzia Citarella (C)
Debora Compare (D)
Bogdan Cotruta (B)
Ferdinando D'Amico (F)
Meyno Den Dulk (M)
Barbara Elzbieta Dyrda (BE)
Virginia Festa (V)
Sara Gallina (S)
Rossella Grasso (R)
Jozef Hanzel (J)
Jomni Mohamed Taieb (JM)
Maria Antonia Lai (MA)
Giovanni Latella (G)
Daniele Lisi (D)
Lucia Lodi (L)
Stefania Marangi (S)
Alessandro Mardegan (A)
Wojciech Marlicz (W)
Attilio Maurano (A)
Giuseppe Milazzo (G)
Valentin Militaru (V)
Stefania Miraglia (S)
Fabio Monica (F)
Alex Moskalev (A)
Antonino Natale (A)
Christelle Nicolas (C)
Andrea Pancetti (A)
Antonio Penna (A)
Angelo Santo Pepe (AS)
Marcello Pisano (M)
Stefano Pontone (S)
Marta Prati (M)
Antonio Prisco (A)
Letterio Rando (L)
Eduardo Rodriguez Hernandez (E)
Ottorino Rosatti (O)
Giacomo Rossi (G)
Giovanni Rubis Passoni (G)
Valerio Papa (V)
Noel Salgado Nesme (N)
Luigi Schiffino (L)
Dario Schillaci (D)
Giuseppe Selvaggi (G)
Fabrizio Taborchi (F)
Alessandro Tornar (A)
Frantisek Trebuna (F)
Ciro Triggiani (C)
Filippo Vasile Testai (F)
Roberto Vassallo (R)
Alessandra Violi (A)

Auteurs

Antonio Tursi (A)

Gastroenterology Service, ASL BAT, Andria (BT), Italy. antotursi@tiscali.it.

Giovanni Brandimarte (G)

Division of Internal Medicine and Gastroenterology, "Cristo Re" Hospital, Rome, Italy. giovannibrandimarte56@gmail.com.

Francesco Di Mario (F)

Department of Medicine and Surgery, Gastroenterology Unit, University of Parma, Parma, Italy. francesco.dimario@unipr.it.

Angel Lanas (A)

Service of Digestive Diseases, University Clinic Hospital Lozano Blesa, University of Zaragoza, IIS Aragón, Zaragoza, Spain. angel.lanas@gmail.com.

Carmelo Scarpignato (C)

Faculty of Medical Sciences, United Campus of Malta, San Ġiljan, Malta. scarpi@tin.it.

Mauro Bafutto (M)

Consultório, R, 46 - 25 Clin de Gastroentero (St Coimbra) Goiânia, Goiás (GO), Brazil. maurobafutto@yahoo.com.br.

Giovanni Barbara (G)

Department of Clinical Medicine, Section of Gastroenterology, "S. Orsola" Hospital, University of Bologna, Bologna, Italy. giovanni.barbara@unibo.it.

Gabrio Bassotti (G)

Department of Clinical and Experimental Medicine, Gastroenterology and Hepatology Section, "Santa Maria della Misericordia" Hospital, University of Perugia, San Sisto (PG), Italy. gabassot@tin.it.

Gian Andrea Binda (GA)

Department of Surgery, "Galliera" Hospital, Genoa, Italy. gianbinda1@me.com.

Alberto Biondi (A)

Department of Surgical Sciences, First General Surgery Unit, Catholic University - "A. Gemelli" University Hospital, Rome, Italy. alberto.biondi@policlinicogemelli.it.

Sebastiano Biondo (S)

Department of General and Digestive Surgery, Colorectal Unit, Bellvitge University Hospital and IDIBELL, University of Barcelona, Barcelona, Spain. sbn.biondo@gmail.com.

Claudio Cassieri (C)

Division of Internal Medicine and Gastroenterology, "Cristo Re" Hospital, Rome, Italy. claudio.cassieri@libero.it.

Antonio Crucitti (A)

Division of General Surgery, "Cristo Re" Hospital, Rome, Italy. antonio.crucitti@unicatt.it.

Dan L Dumitrascu (DL)

2nd Medical Department, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Romania. ddumitrascu@umfcluj.ro.

Walter Elisei (W)

Division of Gastroenterology, ASL Roma 6, Albano Laziale (Roma), Italy. walter_elisei@hotmail.com.

Ricardo Escalante (R)

Universidad Central de Venezuela, Loira Medical Center, Caracas, Venezuela. r_escalanteg@hotmail.com.

László Herszènyi (L)

2nd Department of Medicine, Semmelweis University, H-1088 Budapest, Hungary. herszenyi.laszlo@gmail.com.

Wolfgang Kruis (W)

Innere Medizin, Evangelische Krankenhaus Kalk, Cologne, Germany. wolfgang.kruis@googlemail.com.

Juozas Kupcinskas (J)

Department of Gastroenterology, Lithuanian University of Health Sciences, Kaunas, Lithuania. juozas.kupcinskas@lsmuni.lt.

Adi Lahat (A)

Department of Gastroenterology, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan 52651, Israel. zokadi@gmail.com.

Piera Giuseppina Lecca (PG)

Division of Internal Medicine and Gastroenterology, "Cristo Re" Hospital, Rome, Italy. giusilecca76@yahoo.it.

Giovanni Maconi (G)

Gastrointestinal Unit, Department of Clinical Sciences, "L.Sacco" University Hospital, Milan, Italy. giovanni.maconi@unimi.it.

Peter Malfertheiner (P)

Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University Hospital, Magdeburg, Germany. peter.malfertheiner@med.ovgu.de.

Andrea Mazzari (A)

Division of General Surgery, "Cristo Re" Hospital, Rome, Italy. and.mazzari@gmail.com.

Fermìn Mearìn (F)

Servicio Aparato Digestivo, Centro Médico Teknon, Barcelona, Spain. mearin@dr.teknon.es.

Tomica Milosavljeviċ (T)

Clinical Centre of Serbia, University of Belgrade, Serbia. tommilos@hotmail.com.

Gerardo Nardone (G)

Department of Clinical and Experimental Medicine, University "Federico II", Naples, Italy. nardone@unina.it.

Enio Chavez De Oliveira (E)

Av, 470 - Hosp. Ort. de Goiania (St Aeroporto), Goiânia, Goiás (GO), Brazil. eco1.br@gmail.com.

Alfredo Papa (A)

Division of Internal Medicine and Gastroenterology, C.I. "Columbus", Catholic University - "A. Gemelli" University Hospital, Rome, Italy. alfredo.papa@unicatt.it.

Savvas Papagrigoriadis (S)

Department of Colorectal Surgery, King's College Hospital, London, United Kingdom. lapasurgeon@gmail.com.

Miguel Pera (M)

Sección de Cirugía Gastrointestinal, Hospital Universitari del Mar, Barcelona, Spain. mpera@hospitaldelmar.cat.

Roberto Persiani (R)

Department of Surgical Sciences, First General Surgery Unit, Catholic University - "A. Gemelli" University Hospital, Rome, Italy. roberto.persiani@unicatt.it.

Marcello Picchio (M)

Division of General Surgery, "P. Colombo" Hospital, ASL Roma 6, Velletri (Roma), Italy. marcello.picchio.63@alice.it.

Jaroslaw Regula (J)

Department of Gastroenterology, Hepatology and Clinical Oncology, Medical Postgraduate Education Centre; Department of Gastrointestinal Oncology, Maria Sklodowska-Curie Clinical Oncology Institute, Warsaw, Poland. jregula@coi.waw.pl.

Davor Štimac (D)

Division of Internal Medicine, University Hospital, Rijeka, Croatia. davor.stimac@ri.t-com.hr.

Neil Stollman (N)

Division of Gastroenterology, Alta Bates Summit Medical Center, East Bay Center for Digestive Health, 300 Frank H Ogawa Plaza, Oakland, CA, USA. neil@stollman.com.

Lisa L Strate (LL)

Division of Gastroenterology, Department of Medicine, Harborview Medical Center, University of Washington Medical School, Seattle, Washington, USA. lisas@medicine.washington.edu.

Marjorie Md Walker (MM)

University of Newcastle, Faculty of Health and Medicine, School of Medicine and Public Health, Australian Gastrointestinal Research Alliance, Callaghan NSW 2308, Australia. marjorie.walker@newcastle.edu.au.

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