Intra- and interobserver variation in capsule endoscopy reviews
Laursen, E.L.; Ersbøll, A.K.; Rasmussen, A.M.O.; Christensen, E.H.; Holm, J.; Hansen, M.B.
Ugeskrift for Laeger 171(23): 1929-1934
2009
ISSN/ISBN: 1603-6824 PMID: 19500517 Document Number: 633016
It is unclear which professional groups can and should perform reviews of capsule endoscopy (CE) exams of the GI tract. We investigate whether a junior doctor or an endoscopy nurse can review CE films with the same diagnostic results as a specialist. An endoscopy nurse and a junior doctor, both with no CE experience, reviewed 30 CE films twice and noted their findings. A distinction was made between clinically important and non-important findings. An endoscopy specialist and the Given Imaging Review Service reviewed the films once each, and their findings were used as the study's gold standard. Time consumption, intra- and interobserver agreement, sensitivity and specificity were assessed. The junior doctor improved in speed from 1st to 2nd review, but the nurse did not. Both performed poorly compared with Given Imaging Review Service regarding diagnostic accuracy. The junior doctor improved in diagnostic accuracy from 1st to 2nd review, while the nurse did not. The nurse showed a decrease in sensitivity from 1st to 2nd review from 89% to 62%, whereas the junior doctor's sensitivity increased from 48% to 62%. Both missed many pathological findings and their results were not reproducible. The nurse and junior doctor did not obtain the same diagnostic results as the gold standard. The results raise questions of whether nurses or junior doctors should perform capsule endoscopy reviews.