TY - JOUR
T1 - Global quantitative assessment of the colorectal polyp burden in familial adenomatous polyposis by using a Web-based tool
AU - Lynch, Patrick M.
AU - Morris, Jeffrey S.
AU - Ross, William A.
AU - Rodriguez-Bigas, Miguel A.
AU - Posadas, Juan
AU - Khalaf, Rossa
AU - Weber, Diane M.
AU - Sepeda, Valerie O.
AU - Levin, Bernard
AU - Shureiqi, Imad
PY - 2013/3
Y1 - 2013/3
N2 - Background: Accurate measures of the total polyp burden in familial adenomatous polyposis (FAP) are lacking. Current assessment tools include polyp quantitation in limited-field photographs and qualitative total colorectal polyp burden by video. Objective: To develop global quantitative tools of the FAP colorectal adenoma burden. Design: A single-arm, phase II trial. Patients: Twenty-seven patients with FAP. Intervention: Treatment with celecoxib for 6 months, with before-treatment and after-treatment videos posted to an intranet with an interactive site for scoring. Main Outcome Measurements: Global adenoma counts and sizes (grouped into categories: <2 mm, 2-4 mm, and >4 mm) were scored from videos by using a novel Web-based tool. Baseline and end-of-study adenoma burden results were summarized by using 5 models. Correlations between pairs of reviewers were analyzed for each model. Results: Interobserver agreement was high for all 5 measures of polyp burden. Measures that used both polyp count and polyp size had better interobserver agreement than measures based only on polyp count. The measure in which polyp counts were weighted according to diameter, calculated as (1) × (no. of polyps <2 mm) + (3) × (no. of polyps 2-4 mm) + (5) × (no. of polyps >4 mm) had the highest interobserver agreement (Pearson r = 0.978 for two gastroenterologists, 0.786 and 0.846 for the surgeon vs each gastroenterologist). Treatment reduced the polyp burden by these measurements in 70% to 89% of patients (P <.001). Limitations: Phase II study. Conclusion: This novel, Web-based polyp scoring method provides a convenient and reproducible way to quantify the global colorectal adenoma burden in FAP patients and a framework for developing a clinical staging system for FAP.
AB - Background: Accurate measures of the total polyp burden in familial adenomatous polyposis (FAP) are lacking. Current assessment tools include polyp quantitation in limited-field photographs and qualitative total colorectal polyp burden by video. Objective: To develop global quantitative tools of the FAP colorectal adenoma burden. Design: A single-arm, phase II trial. Patients: Twenty-seven patients with FAP. Intervention: Treatment with celecoxib for 6 months, with before-treatment and after-treatment videos posted to an intranet with an interactive site for scoring. Main Outcome Measurements: Global adenoma counts and sizes (grouped into categories: <2 mm, 2-4 mm, and >4 mm) were scored from videos by using a novel Web-based tool. Baseline and end-of-study adenoma burden results were summarized by using 5 models. Correlations between pairs of reviewers were analyzed for each model. Results: Interobserver agreement was high for all 5 measures of polyp burden. Measures that used both polyp count and polyp size had better interobserver agreement than measures based only on polyp count. The measure in which polyp counts were weighted according to diameter, calculated as (1) × (no. of polyps <2 mm) + (3) × (no. of polyps 2-4 mm) + (5) × (no. of polyps >4 mm) had the highest interobserver agreement (Pearson r = 0.978 for two gastroenterologists, 0.786 and 0.846 for the surgeon vs each gastroenterologist). Treatment reduced the polyp burden by these measurements in 70% to 89% of patients (P <.001). Limitations: Phase II study. Conclusion: This novel, Web-based polyp scoring method provides a convenient and reproducible way to quantify the global colorectal adenoma burden in FAP patients and a framework for developing a clinical staging system for FAP.
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U2 - 10.1016/j.gie.2012.11.038
DO - 10.1016/j.gie.2012.11.038
M3 - Article
C2 - 23332604
AN - SCOPUS:84873701533
SN - 0016-5107
VL - 77
SP - 455
EP - 463
JO - Gastrointestinal endoscopy
JF - Gastrointestinal endoscopy
IS - 3
ER -