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The Gastroscopy RAte of Cleanliness Evaluation (GRACE) Scale: an international reliability and validation study

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Autores da FMUP

  • Cristina Maria Nogueira Da Costa Santos

    Autor

Participantes de fora da FMUP

  • Esposito, Gianluca
  • Dilaghi, Emanuele
  • Ligato, Irene
  • Annibale, Bruno
  • Dinis-Ribeiro, Mario
  • Areia, Miguel
  • Arantes, Vitor N.
  • Bergman, Jacques
  • Bisschops, Raf
  • de Jonge, Pieter J. . F.
  • Di Matteo, Francesco
  • Ebigbo, Alanna
  • Ferlitsch, Monika
  • Giljaca, Vanja
  • Hassan, Cesare
  • Hucl, Tomas
  • Kuvaev, Roman
  • Leclercq, Philippe
  • Matysiak-Budnik, Tamara
  • Mori, Yuichi
  • Moss, Alan
  • Perez-Cuadrado-Robles, Enrique
  • Pouw, Roos E.
  • Rex, Douglas K.
  • de Santiago, Enrique Rodriguez
  • Siersema, Peter D.
  • Tham, Tony C.
  • Triantafyllou, Konstantinos
  • Voiosu, Andrei
  • Weusten, Bas
  • Andrisani, Gianluca
  • Angeletti, Stefano
  • Ayoub, Mousa
  • Bac, Simon
  • Boonstra, Kirsten
  • Borren, Nienke
  • Capogreco, Antonio
  • Falquina, Irene Chivato Martin
  • Chaves, Jessica
  • Citterio, Nicolo
  • Dal Buono, Arianna
  • Dell'Unto, Elisabetta
  • Dragan, Victor
  • Elvas, Luis
  • Filimendikova, Ksenia
  • Frick, Adrian
  • Guardiola, John
  • Halvorsen, Natalie
  • Le Rhun, Marc
  • Libanio, Diogo
  • Macinga, Peter
  • Marini, Marco
  • Meijer, Berrie
  • de Oliveira, Rubia Moresi Vianna
  • Nicolaides, Steven
  • Plomteux, Olivier
  • Prouvost, Victor
  • Samarentsis, Nikos
  • Sinonquel, Pieter
  • Tahir, Imran
  • Tang, Ken
  • Gonzalez, Elena Tenorio
  • van de Ven, Steffi
  • Viegas, Maria Ines
  • GRACE Investigators

Unidades de investigação

Abstract

Background Muco sal visualization during upper gastrointestinal (UGI) endoscopy can be impaired by the presence of foam, bubbles, and mucus. Some UGI endoscopy visibility scales have been proposed but have not undergone multicenter validation. This study aimed to develop and validate the Gastroscopy RAte of Cleanliness Evaluation (GRACE) scale. Methods A multicenter, international, cross-sectional study was conducted. The GRACE scale is based on a score from 0 (worst) to 3 (excellent) for esophagus, stomach, and duodenum, for a total ranging from 0 to 9. In phase 1, four expert endoscopists evaluated 60 images twice, with a 2week interval between rounds; in phase 2, the same 60 images were scored twice by one expert and one nonexpert endoscopist from 27 endoscopy departments worldwide. For reproducibility assessment and real-time validation, the scale was applied to consecutive patients undergoing gastroscopy at each center. Results On internal validation, interobserver agreement was 0.81 (95 %CI 0.73-0.87) and 0.80 (95 %CI 0.72-0.86), with reliability of 0.73 (95 %CI 0.63-0.82) and 0.72 (95 %CI 0.63-0.81), in the two rounds, respectively. On external validation, overall interobserver agreement was 0.85 (95 %CI 0.82-0.88) and reliability was 0.79 (95 %CI 0.73-0.84). In real-time evaluation, the overall proportion of correct classifications was 0.80 (95 %CI 0.77-0.82). Conclusions The GRACE scale showed good interobserver agreement, reliability, and validity. The widespread use of this scale could enhance quality and standardize the assessment of muco sal cleanliness during UGI endoscopy, pushing endoscopists to strive for excellent visibility and reducing the risk of missed lesions.

Thieme. All rights reserved.

Dados da publicação

ISSN/ISSNe:
1438-8812, 0013-726X

Endoscopy  Georg Thieme Verlag

Tipo:
Article
Páginas:
-
Link para outro recurso:
www.scopus.com

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Keywords

  • UPPER GASTROINTESTINAL ENDOSCOPY; N-ACETYLCYSTEINE; IMPROVING VISIBILITY; DOUBLE-BLIND; MUCOSAL VISIBILITY; CONTROLLED-TRIAL; GASTRIC-CANCER; PREMEDICATION; SIMETHICONE; AGREEMENT

Campos de estudo

Proyectos asociados

COVID-19: Monitorizar e planear com base no risco.

Investigador Principal: Cristina Maria Nogueira da Costa Santos

Estudo Observacional Académico (COVID-19) . 2020

Complexity Sciences applied to Cardiotocography

Investigador Principal: Cristina Maria Nogueira da Costa Santos

Estudo Clínico Académico . 2022

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