DESCRIPTIVE FEATURES OF GASTRIC-ULCERS - DO ENDOSCOPISTS AGREE ON WHAT THEY SEE

Background: Little is known about the interobserver variation between endoscopists on descriptive morphologic features. Methods: This study describes the agreement among 10 endoscopists on their description of 12 morphologic features, using 10 photographs of gastric ulcers, and o n their eventual interpretation. The endoscopists used a form with pre defined options for description. Results: Kappa value was on average 0 .36 for descriptive features and 0.31 for interpretation. The proporti on of endoscopists agreeing on descriptive features was on average 84% , and 81% on interpretations. The chance of an endoscopist describing all 12 morphologic features of an ulcer on a photograph exactly the sa me as a colleague ranged from 4% to 46% (average 15%). A positive corr elation between agreement in description and interpretation (8.75, p < 0.05) was found. Conclusions: These results indicate a poor agreement between endoscopists in their translation of visual observations into descriptive terms. The positive correlation between agreement in desc ription and interpretation suggests disagreement in description as an important cause for disagreement in interpretation. We believe that th e use of more explicit descriptive terms will improve agreement in des cription and in subsequent interpretation.