Evidence map›Paper›PMID 28283726›Full record

ArticlePediatric radiology2017

Magnetic resonance enterography has good inter-rater agreement and diagnostic accuracy for detecting inflammation in pediatric Crohn disease.

Peter C Church, Mary-Louise C Greer, Ruth Cytter-Kuint, Andrea S Doria, Anne M Griffiths, Dan Turner, Thomas D Walters, Brian M Feldman

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In one paragraph

Article in Pediatric radiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 2 pooled it
3.1field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 35 citations in OpenAlex.

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  14. Magnetic resonance enterography and bowel ultrasonography in Saudi Arabian patients with Crohn's disease: A correlation study.Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 2 countries.

Peter C ChurchDivision of Gastroenterology, Hepatology & Nutrition, The Hospital for Sick Children, Department of Pediatrics, University of Toronto, 555 University Ave., Toronto, ON, Canada, M5G 1X8. peterchurch@gmail.com.
Mary-Louise C GreerDepartment of Diagnostic Imaging, The Hospital for Sick Children, Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.
Ruth Cytter-KuintDepartment of Diagnostic Imaging, The Hospital for Sick Children, Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.
Andrea S DoriaInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Anne M GriffithsDivision of Gastroenterology, Hepatology & Nutrition, The Hospital for Sick Children, Department of Pediatrics, University of Toronto, 555 University Ave., Toronto, ON, Canada, M5G 1X8.
Dan TurnerShaare Zedek Medical Center, Jerusalem, Israel.
Thomas D WaltersDivision of Gastroenterology, Hepatology & Nutrition, The Hospital for Sick Children, Department of Pediatrics, University of Toronto, 555 University Ave., Toronto, ON, Canada, M5G 1X8.
Brian M FeldmanInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Hospital for Sick Children · CAUniversity of Toronto · CAShaare Zedek Medical Center · ILSickKids Foundation · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMagnetic resonance enterography (MRE) is increasingly relied upon for noninvasive assessment of intestinal inflammation in Crohn disease. However very few studies have examined the diagnostic accuracy of individual MRE signs in children.

objectiveWe have created an MR-based multi-item measure of intestinal inflammation in children with Crohn disease - the Pediatric Inflammatory Crohn's MRE Index (PICMI). To inform item selection for this instrument, we explored the inter-rater agreement and diagnostic accuracy of individual MRE signs of inflammation in pediatric Crohn disease and compared our findings with the reference standards of the weighted Pediatric Crohn's Disease Activity Index (wPCDAI) and C-reactive protein (CRP). MATERIALS AND

methodsIn this cross-sectional single-center study, MRE studies in 48 children with diagnosed Crohn disease (66% male, median age 15.5 years) were reviewed by two independent radiologists for the presence of 15 MRE signs of inflammation. Using kappa statistics we explored inter-rater agreement for each MRE sign across 10 anatomical segments of the gastrointestinal tract. We correlated MRE signs with the reference standards using correlation coefficients. Radiologists measured the length of inflamed bowel in each segment of the gastrointestinal tract. In each segment, MRE signs were scored as either binary (0-absent, 1-present), or ordinal (0-absent, 1-mild, 2-marked). These segmental scores were weighted by the length of involved bowel and were summed to produce a weighted score per patient for each MRE sign. Using a combination of wPCDAI≥12.5 and CRP≥5 to define active inflammation, we calculated area under the receiver operating characteristic curve (AUC) for each weighted MRE sign.

resultsBowel wall enhancement, wall T2 hyperintensity, wall thickening and wall diffusion-weighted imaging (DWI) hyperintensity were most commonly identified. Inter-rater agreement was best for decreased motility and wall DWI hyperintensity (kappa≥0.64). Correlation between MRE signs and wPCDAI was higher than with CRP. AUC was highest (≥0.75) for ulcers, wall enhancement, wall thickening, wall T2 hyperintensity and wall DWI hyperintensity.

conclusionSome MRE signs had good inter-rater agreement and AUC for detection of inflammation in children with Crohn disease.

Indexed as

AdolescentCrohn DiseaseCross-Sectional StudiesFemaleHumansInflammationIntestinesMagnetic Resonance ImagingMaleObserver VariationReproducibility of ResultsRetrospective StudiesChildrenCrohn diseaseDiagnostic accuracyInflammationMagnetic resonance enterographyMagnetic resonance imaging

Identifiers

PMID28283726
OpenAlexW2591767537

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.