Original Article: Clinical EndoscopyIntraobserver and interobserver consistency for grading esophagitis with narrow-band imaging
Section snippets
Patients and design
Between October 2005 and March 2006, we prospectively recruited 230 consecutive subjects with symptoms suggestive of GERD. Participants provided informed consent, and the ethics committee of National Taiwan University Hospital approved the study protocol.
All subjects received conventional endoscopic imaging, as well as imaging with the NBI system by using video endoscopes (GIF-H260; Olympus Optical Co, Ltd, Tokyo, Japan). Four experienced endoscopists performed the examinations (Y.C.L., H.M.C.,
Intraobserver variability
The percentages of photographs graded to each grade of esophagitis, as determined by using the conventional system with or without NBI, are shown in Table 1. The most frequent category was ENRD, followed by esophagitis of classes A, B, C, and D. A significant difference was noted in the distribution of grades between the rating approaches (χ2[4] = 40.63, P < .0001).
Intraobserver κ values for evaluations done without and with NBI are shown in Table 2, Table 3, respectively. With only
Discussion
Videoendoscopy is based on the different abilities of various wavelengths of light to penetrate tissues. The blue band is used for evaluating superficial layers; the green band, for intermediate layers; and the red band, for deep layers. In NBI, the central wavelengths of the dichromatic optical filters are 415 and 540 nm, and each has 30-nm bandwidths. These properties allow enhanced and real-time observation of the microvascular architecture of the superficial mucosa.10 Performed in the usual
Acknowledgments
We thank Jiann-Hwa Chen, MD, Wei-Chih Su, MD, Buddhist Tzu Chi General Hospital, Taipei Branch; Fu-Jen Lee, MD, Taiwan Adventist Hospital; and Chi-Huang Yeh, MD, Xiang-An Clinics, for participating in the assessment of GERD.
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