INTEROBSERVER VARIATION OF COLONOILEOSCOPIC FINDINGS IN CROHNS-DISEASE

Background: Colonoileoscopy is increasingly used to evaluate Crohn's d isease, but the reproducibility of endoscopic findings is not clear. M ethods: The interobserver variation of endoscopic findings and the inf luence of experience on assessments were investigated in 82 colonoileo scopies in Crohn's disease. Results: In colonic assessment there was e xcellent agreement for most endoscopic features (kappa values >0.75; p < 0.001). In ileal assessment agreement was excellent with regard to detection of large ulcers and strictures and endoscopic staging on the basis of ulcer size and stricture (kappa >0.76; p < 0.001). Observer experience was an important factor in ileal assessments: agreement was excellent for 13 features within experienced pairs, compared with 3 w hen only 1 of a pair was experienced. In colonic assessment experience was less important. Conclusion: The study showed that acceptable agre ement can be obtained on some well-defined inflammatory lesions in Cro hn's disease even when investigator experience is limited. Endoscopic staging on the basis of ulcer size and stricture, being excellently re producible, can serve as a simple summarizing assessment.