Improving Endoscopic Scoring Accuracy in Pediatric Inflammatory Bowel Disease: Impact of a Focused Training Intervention

Abstract Background High variability has been reported in assessing endoscopic scoring systems for pediatric inflammatory bowel disease (IBD). This study assessed whether a structured training could improve interobserver agreement when scoring IBD endoscopy findings. Methods Ten ileocolonoscopic videos were scored using the Mayo Endoscopic Score (MES) and Ulcerative Colitis Endoscopic Index of Severity (UCEIS) for ulcerative colitis, and the Simple Endoscopic Score for Crohn’s Disease (SES-CD). Ten expert endoscopists and ten trainees evaluated the videos before and after a focused training session. Agreement was measured using intraclass correlation coefficient (ICC) and Fleiss kappa (κ), and perceived benefit was surveyed. Results For MES, κ slightly improved among experts, but ICC declined; trainees showed stable κ and improved ICC. The UCEIS agreement was stable in experts and slightly improved in trainees. The SES-CD scores showed improved agreement for both groups, with trainee accuracy improving from 74% to 86% (Δ = 12%, p = 0.051). Both groups reported subjective improvement, although not statistically significant. Conclusions Interobserver agreement ranged from moderate to good. Structured training produced only modest improvements, especially in SES-CD scoring, with limited overall effect on scoring consistency.

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Publication Details

Journal
Endoscopy International Open
Published
2026-09-25
DOI
https://doi.org/10.1055/a-2955-0298
Primary Topic
Inflammatory Bowel Disease
Type
article
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article

Improving Endoscopic Scoring Accuracy in Pediatric Inflammatory Bowel Disease: Impact of a Focused Training Intervention

Elena Sofia Pieri, Francesca Bravin, Sara Lega, Sara Renzo et al.
Endoscopy International Open
Inflammatory Bowel Disease
article

Improving Endoscopic Scoring Accuracy in Pediatric Inflammatory Bowel Disease: Impact of a Focused Training Intervention

Elena Sofia Pieri, Francesca Bravin, Sara Lega, Sara Renzo, Matteo Bramuzzo, Fabiola Giudici, Giacomo Mulinacci, Marco Deganello Saccomani, Cecilia Mantegazza, Martina Di Benedetto, Erasmo Miele, Lorenzo Norsa, Marta Maino, Salvatore Oliva, Serena Arrigo, Sara Curto, Flavio Labriola, Claudio Romano, Paola De Angelis, Antonio Pizzol, Elvira Difrancisca
article en

Abstract

Abstract Background High variability has been reported in assessing endoscopic scoring systems for pediatric inflammatory bowel disease (IBD). This study assessed whether a structured training could improve interobserver agreement when scoring IBD endoscopy findings. Methods Ten ileocolonoscopic videos were scored using the Mayo Endoscopic Score (MES) and Ulcerative Colitis Endoscopic Index of Severity (UCEIS) for ulcerative colitis, and the Simple Endoscopic Score for Crohn’s Disease (SES-CD). Ten expert endoscopists and ten trainees evaluated the videos before and after a focused training session. Agreement was measured using intraclass correlation coefficient (ICC) and Fleiss kappa (κ), and perceived benefit was surveyed. Results For MES, κ slightly improved among experts, but ICC declined; trainees showed stable κ and improved ICC. The UCEIS agreement was stable in experts and slightly improved in trainees. The SES-CD scores showed improved agreement for both groups, with trainee accuracy improving from 74% to 86% (Δ = 12%, p = 0.051). Both groups reported subjective improvement, although not statistically significant. Conclusions Interobserver agreement ranged from moderate to good. Structured training produced only modest improvements, especially in SES-CD scoring, with limited overall effect on scoring consistency.

Endoscopy International OpenVol. 14(CP)
University of Messina (IT), University of Verona (IT), IRCCS Materno Infantile Burlo Garofolo (IT), Istituto Giannina Gaslini (IT), Azienda Ospedaliera Citta' della Salute e della Scienza di Torino (IT), Ospedale Santa Chiara (IT), Ospedale Maggiore Carlo Alberto Pizzardi (IT), Azienda Ospedaliera San Gerardo (IT), Meyer Children's Hospital (IT), Regione Siciliana (IT), Federico II University Hospital (IT), Bambino Gesù Children's Hospital (IT), Centro di Riferimento Oncologico (IT), Ospedale Regina Margherita (IT), Ospedale dei Bambini Vittore Buzzi (IT), Ospedale San Donato (IT), Azienda di Rilievo Nazionale ed Alta Specializzazione (IT), Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo (IT), Sapienza University of Rome (IT)
Good health and well-being
Openalex Percentile: Top 12%
Inflammatory Bowel Disease
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