P0549 Colombian Observer Inter-agreement in intestinal Ultrasound for ulcerative Colitis (COI-UC)
The results show a good to excellent IOA in this first Colombian initiative to implement IUS in UC, which is important to expand the use of IUS in developing countries where this tool may be more cost-effective.
Abstract
Intestinal ultrasound (IUS) is a non-invasive and effective tool for assessing intestinal inflammation in ulcerative colitis (UC) patients. Inter-observer agreement (IOA) in IUS for UC is crucial for accurate disease monitoring, particularly in countries and centers just implementing and educating on IUS, such as Colombia. Therefore, we conducted a study to assess the reliability of IUS in UC by comparing two Colombian gastroenterologists who performed prior at least 40 intestinal ultrasounds. Thirty-seven patients with both clinically (in)active UC were included. Two gastroenterologists scanned all patients, assessing key IUS parameters, including bowel wall thickness (BWT), colour Doppler signal (CDS), loss of bowel wall stratification (BWS), presence or absence of mesenteric fat proliferation (i-fat) and lymph nodes. Statistical methods such as Cohen’s kappa or intraclass correlation coefficients (ICCs) were used to quantify agreement levels between both observers. Inter-observer agreement in BWT was analyzed per colonic segment and a moderate ICC average was found (0.746). However, for the most affected segment, the ICC was excellent (k=0.967), as was the agreement in calculating the Milan ultrasound score (MUC) score (k=0.981), the modified Limberg score (k=0.94) and CDS (k=0.94). Loss of BWS had a good agreement (k=0.83), while the agreement on the presence of lymph nodes and i-fat was moderate (k=0.53) and low (k=0.31), respectively. Establishing a solid IOA with IUS for UC patients is vital for enhancing diagnostic accuracy and disease monitoring. Standardized acquisition and assessment of UC utilizing IUS with established reliability is important to expand the use of IUS in developing countries where this tool may be more cost-effective. Our results show a good to excellent IOA in this first Colombian initiative to implement IUS in UC. Further educational initiatives and improved standardization could further improve agreement among practitioners.