Colon Capsule CLEansing Assessment and Report (CC-CLEAR): a new approach for evaluation of the quality of bowel preparation in capsule colonoscopy.,Gastrointestinal Endoscopy

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Colon Capsule CLEansing Assessment and Report (CC-CLEAR): a new approach for evaluation of the quality of bowel preparation in capsule colonoscopy.
Gastrointestinal Endoscopy ( IF 6.7 ) Pub Date : 2020-06-11 , DOI: 10.1016/j.gie.2020.05.062
Rui de Sousa Magalhães ₁ , Cátia Arieira ₁ , Pedro Boal Carvalho ₁ , Bruno Rosa ₁ , Maria João Moreira ₁ , José Cotter ₁

Affiliation

Background and Aims

Current colon capsule (CC) cleansing grading scales rely on subjective parameters and lack proper interobserver agreement. We should strive for higher intra- and interobserver agreement for the evaluation of the cleansing quality of CCs. Here we sought to validate a new grading scale for the evaluation of CC cleansing.

Methods

For the new grading scale, named Colon Capsule CLEansing Assessment and Report (CC-CLEAR), the colon was divided in 3 segments: right-sided, transverse, and left-sided colon. Each segment was scored according to an estimation of the percentage of visualized mucosa (0, <50%; 1, 50%-75%; 2, >75%; 3, >90%). The overall cleansing classification was a sum of each segment score, grading between excellent (8-9), good (6-7), and inadequate (0-5). Any segment scoring ≤1 resulted in inadequate overall classification. Videos were reviewed and scored using CC-CLEAR and the Leighton-Rex grading scale by 2 experienced operators blinded to each other. Kendall's coefficient evaluated inter- and intraobserver agreement.

Results

We included 58 consecutive CCs, corresponding to 75.9% women, with a mean age of 65 years. Overall cleansing CC-CLEAR classifications were as follows: reader A, 22.4% (n = 13) excellent, 31% (n = 18) good, and 46.5% (n = 27) inadequate; and reader B, 24.1% (n = 14) excellent, 22.4% (n = 13) good, and 53.4% (n = 31) inadequate. CC-CLEAR interobserver agreement was superior to the Leighton-Rex scale (Kendall’s W .911 vs .806, respectively; P < .01). The intraobserver agreement for CC-CLEAR was excellent for both readers (P > .01).

Conclusions

CC-CLEAR is a new practical and reliable grading scale for the evaluation of bowel preparation quality using a CC, with excellent inter- and intraobserver agreement.

中文翻译：

结肠胶囊Cleansing评估和报告（CC-CLEAR）：一种用于评估胶囊结肠镜检查中肠准备质量的新方法。

背景和目标

当前的结肠囊（CC）清洁分级量表取决于主观参数，并且缺乏适当的观察者之间的共识。我们应该争取更高的观察者内部和观察者之间的一致性，以评估CC的清洁质量。在这里，我们试图验证一种用于CC清洁评估的新等级量表。

方法

对于新的分级量表，称为结肠胶囊Cleansing评估和报告（CC-CLEAR），将结肠分为3个部分：右侧，横向和左侧结肠。根据对可视化粘膜百分比的估计对每个部分评分（0，<50％； 1、50％-75％； 2，> 75％； 3，> 90％）。总体清洁分类是每个部分得分的总和，等级介于（8-9分），（6-7分）和（0-5分）之间。任何细分得分≤1都会导致总体分类不足。视讯由CC-CLEAR和Leighton-Rex分级量表进行审查，并由2位经验丰富的操作员进行视线评分，彼此视而不见。肯德尔系数评估了观察者之间和观察者内部的一致性。

结果

我们纳入了58个连续CC，相当于75.9％的女性，平均年龄为65岁。总体清洁CC-CLEAR分类如下：读者A，22.4％（n = 13）优秀，31％（n = 18）好和46.5％（n = 27）不够；和阅读器B分别为24.1％（n = 14）优秀，22.4％（n = 13）好和53.4％（n = 31）不足。CC-CLEAR观察者间协议优于Leighton-Rex量表（Kendall的W .911和.806分别；P <.01）。对于两个读者来说，CC-CLEAR的观察者内部协议都非常出色（P > .01）。