Endoscopic Assessment of the Duodenum in Dogs with Inflammatory Bowel Disease

J. E. Slovak, C. Wang, J. A. Morrison, K. L. Deitz, D. N. Levine, C. Otoni, R. R. King, L. E. Gerber, K. R. Hanson, A. P. Lundberg, A. E. Jergens

Research output: Contribution to journalArticle

Abstract

Background: Endoscopy is performed for direct inspection of the mucosa and acquisition of biopsies in dogs with inflammatory bowel disease (IBD). Aim: To evaluate the interobserver agreement in the endoscopic assessment of duodenal mucosa in dogs with IBD. Methods: Thirty-five archived endoscopic images of grossly normal (n = 6) and inflamed (n = 29) duodenal mucosa were displayed to 3 expert and 5 trainee endoscopists. Each image was assessed independently by endoscopists for mucosal abnormalities using established indices (of hyperemia, granularity, friability, lymphatic dilatation, and erosions) or interpreted as normal mucosa (trial 1). A repeated trial (trial 2) was performed with the same images presented in random order 1 month later, and accompanied by a visual template. Results: There was slight interobserver agreement in initial mucosal assessment for expert and trainee endoscopists in trial 1 (kappa ≤ 0.02, P > .05). Interobserver agreement improved in trial 2 for both expert and trainee endoscopists (kappa = 0.2, P > .05) for experts and (P < .05) for trainees. There was a significant (P < .01) improvement in trainee endoscopy scores of lesions from trial 1 to trial 2. Regression analysis showed a significant (P < .01) difference between expert versus trainee endoscopy scores in trial 1. Repeat lesion assessment aided by use of a visual template (trial 2) improved the overall scores of trainee endoscopists to near that of expert endoscopists (P = .06). Conclusions and Clinical Importance: Interobserver agreement of IBD mucosal appearance from endoscopic findings benefitted from operator experience.

Original languageEnglish (US)
Pages (from-to)1442-1446
Number of pages5
JournalJournal of veterinary internal medicine
Volume28
Issue number5
DOIs
StatePublished - Sep 1 2014
Externally publishedYes

Fingerprint

inflammatory bowel disease
duodenum
Inflammatory Bowel Diseases
Duodenum
Mucous Membrane
Dogs
Endoscopy
mucosa
dogs
endoscopy
lesions (animal)
Hyperemia
Dilatation
Regression Analysis
Biopsy
biopsy
regression analysis

Keywords

  • Endoscopy
  • Inflammatory bowel disease
  • Mucosal assessment

ASJC Scopus subject areas

  • veterinary(all)

Cite this

Slovak, J. E., Wang, C., Morrison, J. A., Deitz, K. L., Levine, D. N., Otoni, C., ... Jergens, A. E. (2014). Endoscopic Assessment of the Duodenum in Dogs with Inflammatory Bowel Disease. Journal of veterinary internal medicine, 28(5), 1442-1446. https://doi.org/10.1111/jvim.12424

Endoscopic Assessment of the Duodenum in Dogs with Inflammatory Bowel Disease. / Slovak, J. E.; Wang, C.; Morrison, J. A.; Deitz, K. L.; Levine, D. N.; Otoni, C.; King, R. R.; Gerber, L. E.; Hanson, K. R.; Lundberg, A. P.; Jergens, A. E.

In: Journal of veterinary internal medicine, Vol. 28, No. 5, 01.09.2014, p. 1442-1446.

Research output: Contribution to journalArticle

Slovak, JE, Wang, C, Morrison, JA, Deitz, KL, Levine, DN, Otoni, C, King, RR, Gerber, LE, Hanson, KR, Lundberg, AP & Jergens, AE 2014, 'Endoscopic Assessment of the Duodenum in Dogs with Inflammatory Bowel Disease', Journal of veterinary internal medicine, vol. 28, no. 5, pp. 1442-1446. https://doi.org/10.1111/jvim.12424
Slovak JE, Wang C, Morrison JA, Deitz KL, Levine DN, Otoni C et al. Endoscopic Assessment of the Duodenum in Dogs with Inflammatory Bowel Disease. Journal of veterinary internal medicine. 2014 Sep 1;28(5):1442-1446. https://doi.org/10.1111/jvim.12424
Slovak, J. E. ; Wang, C. ; Morrison, J. A. ; Deitz, K. L. ; Levine, D. N. ; Otoni, C. ; King, R. R. ; Gerber, L. E. ; Hanson, K. R. ; Lundberg, A. P. ; Jergens, A. E. / Endoscopic Assessment of the Duodenum in Dogs with Inflammatory Bowel Disease. In: Journal of veterinary internal medicine. 2014 ; Vol. 28, No. 5. pp. 1442-1446.
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abstract = "Background: Endoscopy is performed for direct inspection of the mucosa and acquisition of biopsies in dogs with inflammatory bowel disease (IBD). Aim: To evaluate the interobserver agreement in the endoscopic assessment of duodenal mucosa in dogs with IBD. Methods: Thirty-five archived endoscopic images of grossly normal (n = 6) and inflamed (n = 29) duodenal mucosa were displayed to 3 expert and 5 trainee endoscopists. Each image was assessed independently by endoscopists for mucosal abnormalities using established indices (of hyperemia, granularity, friability, lymphatic dilatation, and erosions) or interpreted as normal mucosa (trial 1). A repeated trial (trial 2) was performed with the same images presented in random order 1 month later, and accompanied by a visual template. Results: There was slight interobserver agreement in initial mucosal assessment for expert and trainee endoscopists in trial 1 (kappa ≤ 0.02, P > .05). Interobserver agreement improved in trial 2 for both expert and trainee endoscopists (kappa = 0.2, P > .05) for experts and (P < .05) for trainees. There was a significant (P < .01) improvement in trainee endoscopy scores of lesions from trial 1 to trial 2. Regression analysis showed a significant (P < .01) difference between expert versus trainee endoscopy scores in trial 1. Repeat lesion assessment aided by use of a visual template (trial 2) improved the overall scores of trainee endoscopists to near that of expert endoscopists (P = .06). Conclusions and Clinical Importance: Interobserver agreement of IBD mucosal appearance from endoscopic findings benefitted from operator experience.",
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AU - King, R. R.

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