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E-pub ahead of print

Expert consensus on optimal acquisition and development of the International Bowel Ultrasound Segmental Activity Score (IBUS-SAS): a reliability and inter-rater variability study on intestinal ultrasonography in Crohn's Disease

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

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    Publikation: Bidrag til tidsskriftLetterForskningpeer review

  • Kerri L Novak
  • Kim Nylund
  • Christian Maaser
  • Frauke Petersen
  • Torsten Kucharzik
  • Cathy Lu
  • Mariangela Allocca
  • Giovanni Maconi
  • Floris de Voogd
  • Britt Christensen
  • Rose Vaughan
  • Carolina Palmela
  • Dan Carter
  • Rune Wilkens
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BACKGROUND AND AIMS: Intestinal ultrasound (IUS) is an accurate, patient-centered monitoring tool that objectively evaluates Crohn's disease (CD) activity. However, no current, widely accepted, reproducible activity index exists to facilitate consistent IUS identification of inflammatory activity. The aim of this study is to identify key parameters of CD inflammation on IUS, evaluate their reliability and develop an IUS index reflecting segmental activity.

METHODS: There were 3 phases: 1) expert consensus Delphi method to derive measures of IUS activity; 2) an initial, multi-expert case acquisition and expert-interpretation of 20 blinded cases to measure inter-rater reliability for individual measures; 3) refinement of case acquisition and interpretation by 12 international experts, with 30 blinded case reads with reliability assessment and development of a segmental activity score.

RESULTS: Delphi Consensus: Eleven experts representing 7 countries identified four key parameters including (1) bowel wall thickness (BWT) (2) bowel wall stratification (3) hyperemia of the wall [color Doppler imaging] and (4) inflammatory mesenteric fat. Blind Read: Each variable exhibited moderate to substantial reliability. Optimal, standardized image and cineloop acquisition were established. Second Blind Read and score development: intra-class correlation coefficient (ICC) for BWT was almost perfect 0.96 (0.94-0.98). All 4 parameters correlated with the global disease activity assessment and were included in the final International Bowel Ultrasound Segmental Activity Score with almost perfect ICC [0.97 (0.95-0.99, p<0.001)].

CONCLUSIONS: Using expert consensus and standardized approaches, identification of key activity measurements on IUS has been achieved and a segmental activity score has been proposed, demonstrating excellent reliability.

OriginalsprogEngelsk
TidsskriftJournal of Crohn's & colitis
ISSN1873-9946
DOI
StatusE-pub ahead of print - 24 okt. 2020

Bibliografisk note

© The Author(s) 2020. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For permissions, please email: journals.permissions@oup.com.

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