Inter-observer and intra-observer agreement with the use of regular arrangement of collecting venules (RAC) in the diagnosis of Helicobacter pylori gastritis

Publication Date

2020

Document Type

Research

Abstract

Inter-observer and intra-observer agreement was evaluated using kappa statistics. Diagnostic yield was computed as positive predictive value using the results of the endoscopic evaluation of the selected cases and were then compared among endoscopists with different levels of expertise using the McNemar's test. All endoscopists were able to determine 28 (75.7%) patients who were positive for RAC. The expert endoscopist remained the one with the highest number of correctly identified patients after the first and second evaluation (81% and 89.2% respectively). The intermediate and expert endoscopists showed moderate intra-observer agreement (K= 0.49 and 0.59 respectively), hence they are more consistent in identifying RAC. For the inter-observer agreement among endoscopists in the determination of Helicobacter pylori infection, there was noted fair agreement between the beginner vs intermediate endoscopists (K= 0.26) and beginner vs expert endoscopists (K = 0.32). Slight inter-observer agreement between intermediate vs expert endoscopists (K= 0.15). For the association of the level of experience of the endoscopists in the diagnosis of Helicobacter Pylori infection with the use of RAC in endoscopy, the beginner endoscopists showed the lowest interobserver agreement (fair agreement, K= 0.29, 0.36) while the expert endoscopist showed the highest interobserver agreement using the RAC (moderate agreement K= 0.57, substantial agreement K= 0.75) in diagnosing H.pylori infection.

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