Accuracy of endoscopic diagnosis of Helicobacter pyloriinfection according to level of endoscopic experience and the effect of training

BMC Gastroenterology

Research Article

Takuro Shimbo¹  Chizu Yokoi²  Toshiyuki Sakurai²  Junichi Akiyama²  Kazuhiro Watanabe²  Naoyoshi Nagata²  Ryo Nakashima²  Etsuko Furuhata²  Masao Kobayakawa²  Naoki Akazawa²  Naomi Uemura³  Masashi Mizokami⁴ 

[1] Department of Clinical Research and Informatics, National Center for Global Health and Medicine, 1-21-1 Toyama, 162-8655, Shinjuku-ku, Tokyo, Japan;Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, 1-21-1 Toyama, 162-8655, Shinjuku-ku, Tokyo, Japan;Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Kohnodai Hospital, 1-7-1 Kohnodai, 272-8516, Ichikawa City, Chiba, Japan;Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, Kohnodai Hospital, 1-7-1 Kohnodai, 272-8516, Ichikawa City, Chiba, Japan;

关键词: Helicobacter pylori;    Endoscopic training;    Diagnostic yield;    Endoscopic career level;    Inter-observer agreement;    Intra-observer agreement;   

DOI  :  10.1186/1471-230X-13-128

 received in 2013-03-07, accepted in 2013-08-08,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundAccurate prediction of Helicobacter pylori infection status on endoscopic images can contribute to early detection of gastric cancer, especially in Asia. We identified the diagnostic yield of endoscopy for H. pylori infection at various endoscopist career levels and the effect of two years of training on diagnostic yield.MethodsA total of 77 consecutive patients who underwent endoscopy were analyzed. H. pylori infection status was determined by histology, serology, and the urea breast test and categorized as H. pylori-uninfected, -infected, or -eradicated. Distinctive endoscopic findings were judged by six physicians at different career levels: beginner (<500 endoscopies), intermediate (1500–5000), and advanced (>5000). Diagnostic yield and inter- and intra-observer agreement on H. pylori infection status were evaluated. Values were compared between the two beginners after two years of training. The kappa (K) statistic was used to calculate agreement.ResultsFor all physicians, the diagnostic yield was 88.9% for H. pylori-uninfected, 62.1% for H. pylori-infected, and 55.8% for H. pylori-eradicated. Intra-observer agreement for H. pylori infection status was good (K > 0.6) for all physicians, while inter-observer agreement was lower (K = 0.46) for beginners than for intermediate and advanced (K > 0.6). For all physicians, good inter-observer agreement in endoscopic findings was seen for atrophic change (K = 0.69), regular arrangement of collecting venules (K = 0.63), and hemorrhage (K = 0.62). For beginners, the diagnostic yield of H. pylori-infected/eradicated status and inter-observer agreement of endoscopic findings were improved after two years of training.ConclusionsThe diagnostic yield of endoscopic diagnosis was high for H. pylori-uninfected cases, but was low for H. pylori-eradicated cases. In beginners, daily training on endoscopic findings improved the low diagnostic yield.

【 授权许可】

Unknown   
© Watanabe et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.