Interobserver and Intraobserver Variability in pH-Impedance Analysis between 10 Experts and Automated Analysis

Clara M Loots, Michiel P van Wijk, Kathleen Blondeau, Kasper Dalby, Laura Peeters, Rachel Rosen, Silvia Salvatore, Tobias G Wenzl, Yvan Vandenplas, Marc A Benninga, Taher I Omari

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

OBJECTIVE: To determine interobserver and intraobserver variability in pH-impedance interpretation between experts and accuracy of automated analysis (AA). STUDY DESIGN: Ten pediatric 24-hour pH-impedance tracings were analyzed by 10 observers from 7 world groups and with AA. Detection of gastroesophageal reflux (GER) episodes was compared between observers and AA. Intraobserver agreement was assessed in 3 observers after 3 to 5 months. RESULTS: Overall, 1242 liquid and mixed GER events were detected, 490 (42%) were scored by the majority of observers, yielding moderate agreement (Cohen's kappa [κ] = 0.46). Intraclass co-efficient for numbers of GER per study was 0.84 (P <.001). AA has 94% sensitivity rate and 74% specificity rate compared with majority consensus (≥6 observers). Agreement for gas GER was poor (κ = 0.11). Intraobserver agreement was κ = 0.49, κ = 0.71, and κ = 0.85 in 3 observers. CONCLUSION: Interobserver agreement in combined pH-multichannel intraluminal impedance analysis in experts is moderate; only 42% of GER episodes were detected by the majority of observers. Detection of total GER numbers is more consistent. Considering these poor outcomes, AA seems favorable compared with manual analysis because of its reproducibility. However, the lower specificity rate suggests the need for refinement of AA before widespread use can be advocated.
OriginalsprogEngelsk
TidsskriftJournal of Pediatrics
Vol/bind16
Udgave nummer3
Sider (fra-til)441-446
Antal sider6
ISSN0022-3476
DOI
StatusUdgivet - 2011

Fingeraftryk

Observer Variation
Gastroesophageal Reflux
Electric Impedance
Gases
Pediatrics

Citer dette

Loots, C. M., van Wijk, M. P., Blondeau, K., Dalby, K., Peeters, L., Rosen, R., ... Omari, T. I. (2011). Interobserver and Intraobserver Variability in pH-Impedance Analysis between 10 Experts and Automated Analysis. Journal of Pediatrics, 16(3), 441-446. https://doi.org/10.1016/j.jpeds.2011.08.017
Loots, Clara M ; van Wijk, Michiel P ; Blondeau, Kathleen ; Dalby, Kasper ; Peeters, Laura ; Rosen, Rachel ; Salvatore, Silvia ; Wenzl, Tobias G ; Vandenplas, Yvan ; Benninga, Marc A ; Omari, Taher I. / Interobserver and Intraobserver Variability in pH-Impedance Analysis between 10 Experts and Automated Analysis. I: Journal of Pediatrics. 2011 ; Bind 16, Nr. 3. s. 441-446.
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title = "Interobserver and Intraobserver Variability in pH-Impedance Analysis between 10 Experts and Automated Analysis",
abstract = "OBJECTIVE: To determine interobserver and intraobserver variability in pH-impedance interpretation between experts and accuracy of automated analysis (AA). STUDY DESIGN: Ten pediatric 24-hour pH-impedance tracings were analyzed by 10 observers from 7 world groups and with AA. Detection of gastroesophageal reflux (GER) episodes was compared between observers and AA. Intraobserver agreement was assessed in 3 observers after 3 to 5 months. RESULTS: Overall, 1242 liquid and mixed GER events were detected, 490 (42{\%}) were scored by the majority of observers, yielding moderate agreement (Cohen's kappa [κ] = 0.46). Intraclass co-efficient for numbers of GER per study was 0.84 (P <.001). AA has 94{\%} sensitivity rate and 74{\%} specificity rate compared with majority consensus (≥6 observers). Agreement for gas GER was poor (κ = 0.11). Intraobserver agreement was κ = 0.49, κ = 0.71, and κ = 0.85 in 3 observers. CONCLUSION: Interobserver agreement in combined pH-multichannel intraluminal impedance analysis in experts is moderate; only 42{\%} of GER episodes were detected by the majority of observers. Detection of total GER numbers is more consistent. Considering these poor outcomes, AA seems favorable compared with manual analysis because of its reproducibility. However, the lower specificity rate suggests the need for refinement of AA before widespread use can be advocated.",
author = "Loots, {Clara M} and {van Wijk}, {Michiel P} and Kathleen Blondeau and Kasper Dalby and Laura Peeters and Rachel Rosen and Silvia Salvatore and Wenzl, {Tobias G} and Yvan Vandenplas and Benninga, {Marc A} and Omari, {Taher I}",
note = "Copyright {\circledC} 2011 Mosby, Inc. All rights reserved.",
year = "2011",
doi = "10.1016/j.jpeds.2011.08.017",
language = "English",
volume = "16",
pages = "441--446",
journal = "Journal of Pediatrics",
issn = "0022-3476",
publisher = "Mosby, Inc.",
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Loots, CM, van Wijk, MP, Blondeau, K, Dalby, K, Peeters, L, Rosen, R, Salvatore, S, Wenzl, TG, Vandenplas, Y, Benninga, MA & Omari, TI 2011, 'Interobserver and Intraobserver Variability in pH-Impedance Analysis between 10 Experts and Automated Analysis', Journal of Pediatrics, bind 16, nr. 3, s. 441-446. https://doi.org/10.1016/j.jpeds.2011.08.017

Interobserver and Intraobserver Variability in pH-Impedance Analysis between 10 Experts and Automated Analysis. / Loots, Clara M; van Wijk, Michiel P; Blondeau, Kathleen; Dalby, Kasper; Peeters, Laura; Rosen, Rachel; Salvatore, Silvia; Wenzl, Tobias G; Vandenplas, Yvan; Benninga, Marc A; Omari, Taher I.

I: Journal of Pediatrics, Bind 16, Nr. 3, 2011, s. 441-446.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Interobserver and Intraobserver Variability in pH-Impedance Analysis between 10 Experts and Automated Analysis

AU - Loots, Clara M

AU - van Wijk, Michiel P

AU - Blondeau, Kathleen

AU - Dalby, Kasper

AU - Peeters, Laura

AU - Rosen, Rachel

AU - Salvatore, Silvia

AU - Wenzl, Tobias G

AU - Vandenplas, Yvan

AU - Benninga, Marc A

AU - Omari, Taher I

N1 - Copyright © 2011 Mosby, Inc. All rights reserved.

PY - 2011

Y1 - 2011

N2 - OBJECTIVE: To determine interobserver and intraobserver variability in pH-impedance interpretation between experts and accuracy of automated analysis (AA). STUDY DESIGN: Ten pediatric 24-hour pH-impedance tracings were analyzed by 10 observers from 7 world groups and with AA. Detection of gastroesophageal reflux (GER) episodes was compared between observers and AA. Intraobserver agreement was assessed in 3 observers after 3 to 5 months. RESULTS: Overall, 1242 liquid and mixed GER events were detected, 490 (42%) were scored by the majority of observers, yielding moderate agreement (Cohen's kappa [κ] = 0.46). Intraclass co-efficient for numbers of GER per study was 0.84 (P <.001). AA has 94% sensitivity rate and 74% specificity rate compared with majority consensus (≥6 observers). Agreement for gas GER was poor (κ = 0.11). Intraobserver agreement was κ = 0.49, κ = 0.71, and κ = 0.85 in 3 observers. CONCLUSION: Interobserver agreement in combined pH-multichannel intraluminal impedance analysis in experts is moderate; only 42% of GER episodes were detected by the majority of observers. Detection of total GER numbers is more consistent. Considering these poor outcomes, AA seems favorable compared with manual analysis because of its reproducibility. However, the lower specificity rate suggests the need for refinement of AA before widespread use can be advocated.

AB - OBJECTIVE: To determine interobserver and intraobserver variability in pH-impedance interpretation between experts and accuracy of automated analysis (AA). STUDY DESIGN: Ten pediatric 24-hour pH-impedance tracings were analyzed by 10 observers from 7 world groups and with AA. Detection of gastroesophageal reflux (GER) episodes was compared between observers and AA. Intraobserver agreement was assessed in 3 observers after 3 to 5 months. RESULTS: Overall, 1242 liquid and mixed GER events were detected, 490 (42%) were scored by the majority of observers, yielding moderate agreement (Cohen's kappa [κ] = 0.46). Intraclass co-efficient for numbers of GER per study was 0.84 (P <.001). AA has 94% sensitivity rate and 74% specificity rate compared with majority consensus (≥6 observers). Agreement for gas GER was poor (κ = 0.11). Intraobserver agreement was κ = 0.49, κ = 0.71, and κ = 0.85 in 3 observers. CONCLUSION: Interobserver agreement in combined pH-multichannel intraluminal impedance analysis in experts is moderate; only 42% of GER episodes were detected by the majority of observers. Detection of total GER numbers is more consistent. Considering these poor outcomes, AA seems favorable compared with manual analysis because of its reproducibility. However, the lower specificity rate suggests the need for refinement of AA before widespread use can be advocated.

U2 - 10.1016/j.jpeds.2011.08.017

DO - 10.1016/j.jpeds.2011.08.017

M3 - Journal article

VL - 16

SP - 441

EP - 446

JO - Journal of Pediatrics

JF - Journal of Pediatrics

SN - 0022-3476

IS - 3

ER -