Accuracy and reliability of the endoscopic classification of portal hypertensive gastropathy

Hwan Y. Yoo, Joseph A. Eustace, Sumita Verma, Lin Zhang, Mary Harris, Sergey Kantsevoy, Linda A. Lee, Anthony N. Kalloo, William J. Ravich, Paul J. Thuluvath

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


Background: There is no consensus regarding the endoscopic classification of the severity of portal hypertensive gastropathy. This study compared the accuracy and reproducibility of the 2-category classification system (2-CCS) with the 3-category classification system (3-CCS). Methods: Ninety-eight endoscopic pictures of portal hypertensive gastropathy and 22 of nonspecific gastritis were selected. Eight duplicate sets were generated, each in a different random order. These were shown to 6 experienced endoscopists during 2 sessions 1 week apart with 4 slide sets at each session. Each picture was scored by using either the 2-CCS or 3-CCS. Kappa statistics and percent agreement were used to estimate the reproducibility and agreement. Results: The mean percentage agreement among the 4 separate readings for each observer was significantly lower for the 3-CCS compared with the 2-CCS (mean [standard deviation] = 33,5% [8.9%] vs. 64.9% [9.1%]; p = 0.0001). The mean (SD) interobserver kappa values were 0.44 (0.03) for the 3-CCS and 0.52 (0.04) for the 2-CCS (p = 0.02), and the respective intraobserver kappa values were 0.43 (0.1) and 0.63 (0.06) (p = 0.002). Conclusions: Even though both the 2-CCS and 3-CCS have substantial limitations with regard to specificity and reliability, there were better agreement and reproducibility with the simpler classification system for portal hypertensive gastropathy.

Original languageEnglish (US)
Pages (from-to)675-680
Number of pages6
JournalGastrointestinal endoscopy
Issue number5
StatePublished - Nov 1 2002

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology


Dive into the research topics of 'Accuracy and reliability of the endoscopic classification of portal hypertensive gastropathy'. Together they form a unique fingerprint.

Cite this