The Toronto Upper Gastrointestinal Cleaning Score: a prospective validation study.

Autor:	Khan R; Department of Medicine, University of Toronto, Toronto, Canada., Gimpaya N; Division of Gastroenterology, St. Michael's Hospital, Toronto, Canada., Vargas JI; Faculty of Medicine, Pontifical Catholic University of Chile, Santiago, Chile., Ramkissoon A; Division of Gastroenterology, St. Michael's Hospital, Toronto, Canada., Seleq S; Division of Gastroenterology, St. Michael's Hospital, Toronto, Canada., Gholami R; Division of Gastroenterology, St. Michael's Hospital, Toronto, Canada., Akhtar HJ; Division of Gastroenterology, St. Michael's Hospital, Toronto, Canada., Bansal R; Division of Gastroenterology, St. Michael's Hospital, Toronto, Canada., Scaffidi MA; Division of Gastroenterology, St. Michael's Hospital, Toronto, Canada., Amin S; Division of Digestive Health and Liver Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, United States., Bollipo S; Gastroenterology Department, John Hunter Hospital, University of Newcastle, Newcastle, New South Wales, Australia., Kral J; Institute for Clinical and Experimental Medicine, Hepatogastroenterology Department, Prague, Czech Republic., Lui R; Division of Gastroenterology and Hepatology, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China., Pawlak KM; Hospital of the Ministry of Interior and Administration, Szczecin, Poland., Sandhu DS; Division of Gastroenterology, Hepatology and Nutrition, Cleveland Clinic, Cleveland, Ohio, United States., Bilal M; Minneapolis VA Health Care Centre, University of Minnesota, Minneapolis, Minnesota, United States., de-Madaria E; Gastroenterology Department, Alicante University General Hospital, ISABIAL, Alicante, Spain., Siau K; Medical and Dental Sciences, Institute of Translational Medicine, University of Birmingham, Birmingham, United Kingdom., Charabaty A; Division of Gastroenterology, Johns Hopkins-Sibley Memorial Hospital, Washington DC, United States., Hashim A; Department of Medicine, University of Jeddah, Jeddah, Saudi Arabia., Sánchez-Luna SA; Basil I. Hirschowitz Endoscopic Center of Excellence, Division of Gastroenterology and Hepatology, The University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, United States., Teshima CW; Department of Medicine, University of Toronto, Toronto, Canada.; Division of Gastroenterology, St. Michael's Hospital, Toronto, Canada.; The Centre for Therapeutic Endoscopy and Endoscopic Oncology, St. Michael's Hospital, Toronto, Canada., May GR; Department of Medicine, University of Toronto, Toronto, Canada.; Division of Gastroenterology, St. Michael's Hospital, Toronto, Canada.; The Centre for Therapeutic Endoscopy and Endoscopic Oncology, St. Michael's Hospital, Toronto, Canada., Mosko JD; Department of Medicine, University of Toronto, Toronto, Canada.; Division of Gastroenterology, St. Michael's Hospital, Toronto, Canada.; The Centre for Therapeutic Endoscopy and Endoscopic Oncology, St. Michael's Hospital, Toronto, Canada.; Li Ka Shing Knowledge Institute, Toronto, Canada., Walsh CM; Division of Gastroenterology, Hepatology and Nutrition and the Research and Learning Institutes, Hospital for Sick Children, Toronto, Canada.; The Wilson Centre, University of Toronto, Toronto, Canada., Grover SC; Department of Medicine, University of Toronto, Toronto, Canada.; Division of Gastroenterology, St. Michael's Hospital, Toronto, Canada.; The Centre for Therapeutic Endoscopy and Endoscopic Oncology, St. Michael's Hospital, Toronto, Canada.; Li Ka Shing Knowledge Institute, Toronto, Canada.
Jazyk:	angličtina
Zdroj:	Endoscopy [Endoscopy] 2023 Feb; Vol. 55 (2), pp. 121-128. Date of Electronic Publication: 2022 May 31.
DOI:	10.1055/a-1865-4180
Abstrakt:	BACKGROUND : Assessment of mucosal visualization during esophagogastroduodenoscopy (EGD) can be improved with a standardized scoring system. To address this need, we created the Toronto Upper Gastrointestinal Cleaning Score (TUGCS). METHODS : We developed the TUGCS using Delphi methodology, whereby an international group of endoscopy experts iteratively rated their agreement with proposed TUGCS items and anchors on a 5-point Likert scale. After each Delphi round, we analyzed responses and refined the TUGCS using an 80 % agreement threshold for consensus. We used the intraclass correlation coefficient (ICC) to assess inter-rater and test-retest reliability. We assessed internal consistency with Cronbach's alpha and item-total and inter-item correlations with Pearson's correlation coefficient. We compared TUGCS ratings with an independent endoscopist's global rating of mucosal visualization using Spearman's ρ. RESULTS : We achieved consensus with 14 invited participants after three Delphi rounds. Inter-rater reliability was high at 0.79 (95 %CI 0.64-0.88). Test-retest reliability was excellent at 0.83 (95 %CI 0.77-0.87). Cronbach's α was 0.81, item-total correlation range was 0.52-0.70, and inter-item correlation range was 0.38-0.74. There was a positive correlation between TUGCS ratings and a global rating of visualization (r = 0.41, P  = 0.002). TUGCS ratings for EGDs with global ratings of excellent were significantly higher than those for EGDs with global ratings of fair ( P  = 0.01). CONCLUSION : The TUGCS had strong evidence of validity in the clinical setting. The international group of assessors, broad variety of EGD indications, and minimal assessor training improves the potential for dissemination. Competing Interests: R. Khan has received research grants from AbbVie (2018) and Ferring Pharmaceuticals (2019), and research funding from Pendopharm (2019). S.C. Grover has received research grants and personal fees from AbbVie and Ferring Pharmaceuticals, personal fees from Takeda, education grants from Janssen, and has equity in Volo Healthcare. N. Gimpaya, J.I. Vargas, A. Ramkissoon, S. Seleq, R. Gholami, H.J. Akhtar, R. Bansal, M.A. Scaffidi, S. Amin, S. Bollipo, J. Kral, R. Lui, K.M. Pawlak, D. Sandhu, M. Bilal, E. de-Madaria, K. Siau, A. Charabaty, A. Hashim, S.A. Sánchez-Luna, C.W. Teshima, G.R. May, J.D. Mosko, and C.M. Walsh declare that they have no conflict of interest. (Thieme. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu