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P136 Validation of ulcerative colitis endoscopic index of severity (UCEIS) in Korea

Y. J. Lee*1, E. S. Kim1, K. B. Cho1, S. Han1, S. K. Kim2, H. S. Lee2, E. Y. Kim3, J. T. Jung3, J. G. Kwon3, S. G. Kwak3, B. I. Jang4, K. O. Kim4, S. H. Lee4, W. J. Kim5, Y. G. Kim5, C. H. Yang6, Y. J. Jung7

1Keimyung University School of Medicine, Daegu, South Korea, 2Kyungpook National University School of Medicine, Daegu, South Korea, 3Catholic University of Daegu School of Medicine, Daegu, South Korea, 4Yeungnam University College of Medicine, Daegu, South Korea, 5Soonchunhyang University College of Medicine, Gumi, South Korea, 6Dongguk University School of Medicine, Gyeongju, South Korea, 7Fatima Hospital of Daegu, Daegu, South Korea

Background

The Ulcerative Colitis Endoscopic Index of Severity (UCEIS) was developed and validated in Western countries to measure endoscopic severity of ulcerative colitis (UC). We aimed to evaluate its validity and reliability in Korean clinical setting.

Methods

We selected 36 videos of sigmoidoscopy in patients with UC and stratified them according to disease activity using Mayo score. Further, 12 inflammatory bowel disease experienced gastroenterologists trained for the Korean version of UCEIS and independently assessed the videos. Investigators scored in 3 descriptors comprising the UCEIS and measured visual analogue scale (VAS) of overall severity. Using 6 repeated videos (3 with clinical details and the other 3 without clinical details), the effect of clinical information on assessment of UCEIS and intra-investigator agreement were measured. Kappa (k) statistics was used to measure agreements.

Results

The UCEIS was highly correlated with overall severity assessed by VAS (correlation coefficient, 0.898). Correlation between the 3 individual descriptors and overall severity on the VAS was 0.716 for vascular pattern, 0.757 for bleeding, and 0.864 for erosions and ulcers. The Cronbach coefficient α indicating internal consistency was 0.989 for the UCEIS overall (vascular pattern, 0.970; bleeding, 0.969; erosions and ulcers, 0.986). Intra-investigator agreement for UCEIS overall showed fair (k = 0.601), with moderate to good agreement in each descriptors (vascular, 0.862; bleeding, 0.748; erosion and ulcers, 0.809). Inter-investigator agreement for UCEIS overall was also fair (k = 0.593), with fair to moderate agreement in each descriptor (vascular, 0.516; bleeding, 0.442; erosion and ulcers, 0.670). Clinical information seems to affect minimally on the assessment of UCEIS score.

Conclusion

The UCEIS demonstrated acceptable validity and reliability for assessing endoscopic severity of UC in Korean independent cohort of investigators.