Validatie van de Montreal, een classificatie systeem voor sub fenotypen in inflammatoire darmziekten.

Spekhorst, L.M. (2013) Validatie van de Montreal, een classificatie systeem voor sub fenotypen in inflammatoire darmziekten. thesis, Medicine.

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Abstract

Background: Inflammatory Bowel Disease (IBD), consisting of ulcerative colitis (UC) and Crohn’s disease (CD), is a chronic disease with an unpredictable disease behavior and clinical heterogeneity. To ensure high-quality data, validation of the Montreal classification is mandatory for multicentre prospective data collections. Until now only limited data on the reliability of the Montreal classification is available. The aim of this study was to validate the Montreal IBD sub phenotype classification system for CD and UC within the Netherlands. Methods: 20 de-identified medical records were scored by 30 observers with different professions and experience level in both university and non-university hospitals. The inter-observer agreement was calculated by percentages correct answers and Fleiss-kappa (k) using R statistical software. Kappa cut-offs: <0.4 poor, 0.41-0.6 moderate, 0.61-0.8 good, >0.8 excellent. Results: The inter-observer agreement was excellent for diagnosis (k=0.96), perianal disease (k=0.92) and disease location in CD (k=0.82) and good for age of onset (k=0.67), upper gastrointestinal disease (k=0.62), disease behavior in CD (k=0.79), disease extent in UC (k=0.65) and EIM (k=0.68). Disease severity in CD was scored moderate (k=0.44) and in UC poor (k=0.23). Percentages of correct answers over all Montreal items gives a good reflection of inter-observer agreement (>80%), except for disease severity (48-74%). Experience level did not affect the results. Conclusions: We found a good to excellent inter-observer agreement for all Montreal items except for disease severity in CD (moderate) and UC (poor). This study highlights the importance of accurate medical reporting and a clear definition of disease severity.

Item Type:	Thesis (Thesis)
Supervisor name:	Weersma, Prof. dr. R.K. and Visschedijk, Drs. M.C.
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:46
Last Modified:	25 Jun 2020 10:46
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/700

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