Evidence map›Paper›PMID 33783691›Full record

Observational studyDigestive diseases and sciences2022

Digital Cholangioscopic Interpretation: When North Meets the South.

Michel Kahaleh, Isaac Raijman, Monica Gaidhane, Amy Tyberg, Amrita Sethi, Adam Slivka, Douglas G Adler, Divyesh Sejpal, Haroon Shahid, Avik Sarkar and 13 more

2 registry-linked trialsAbstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Digestive diseases and sciences, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
–field-weighted citation impact
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.

NCT02166099 unknown statusnot on this map

Choledochoscopy For Diagnosing Pancreatico-Biliary Disorders: A Multicenter Registry

Typeobservational_patient_registrySponsorWeill Medical College of Cornell UniversityRan2012 to 2018Enrolled250ConditionsPancreatico-biliary DisorderArmsCholedochoscopy using Digital Spyglass
NCT05147389 completednot on this map

Clinical Validation of an Artificial Intelligence Software for Digital Cholangioscopy Diagnosis: an Observational Trial

Typeobservational_patient_registrySponsorInstituto Ecuatoriano de Enfermedades DigestivasRan2020 to 2022Enrolled170ConditionsCommon Bile Duct Neoplasms, Non-Neoplastic Bile Duct DisorderArmsAI model classification, DSOC endoscopist experts' classification
3 · Its place in the literature

Who cites it

11 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
  4. Article
  5. Endoscopic evaluation of indeterminate biliary strictures: Cholangioscopy, endoscopic ultrasound, or both?Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society · 2024
    Review
  6. Article
  7. Review
  8. Article
  9. Article
  10. Article
  11. Review
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

23 authors.

Michel KahalehDepartment of Medicine, Rutgers Robert Wood Johnson Medical School, Robert Wood Johnson University Hospital, Rutgers University, 1 RWJ Place, MEB 464, New Brunswick, NJ, 08901, USA. mkahaleh@gmail.com.ORCID 0000-0003-0836-6114
Isaac RaijmanGastroenterology, Greater Houston Gastroenterology, Houston, USA.
Monica GaidhaneDepartment of Medicine, Rutgers Robert Wood Johnson Medical School, Robert Wood Johnson University Hospital, Rutgers University, 1 RWJ Place, MEB 464, New Brunswick, NJ, 08901, USA.
Amy TybergDepartment of Medicine, Rutgers Robert Wood Johnson Medical School, Robert Wood Johnson University Hospital, Rutgers University, 1 RWJ Place, MEB 464, New Brunswick, NJ, 08901, USA.
Amrita SethiColumbia University Medical Center, New York, USA.
Adam SlivkaGastroenterology, University of Pittsburgh Medical Center, Pittsburgh, USA.
Douglas G AdlerGastroenterology, University of Utah Health, Salt Lake City, USA.
Divyesh SejpalBaylor College of Medicine Houston, Long Island, USA.
Haroon ShahidDepartment of Medicine, Rutgers Robert Wood Johnson Medical School, Robert Wood Johnson University Hospital, Rutgers University, 1 RWJ Place, MEB 464, New Brunswick, NJ, 08901, USA.
Avik SarkarDepartment of Medicine, Rutgers Robert Wood Johnson Medical School, Robert Wood Johnson University Hospital, Rutgers University, 1 RWJ Place, MEB 464, New Brunswick, NJ, 08901, USA.
Fernanda MartinsHospital Israelita Albert Einstein, São Paulo, Brazil.
Christine BoumitriSaint Louis University School of Medicine, St. Louis, MO, USA.
Samuel BurtonSaint Louis University School of Medicine, St. Louis, MO, USA.
Helga BertaniNuovoOspedale Civile S. Agostino Endoscopy Unit, Dr., Baggiovara, Italy.
Paul TarnaskyDigestive Health Associates of Texas, Dallas, USA.
Frank GressDivision of Digestive and Liver Diseases, Columbia University, New York, USA.
Ian GanVancouver General Hospital, GI, Vancouver, Canada.
Jose C ArdenghHCFMRP-USP Department of Surgery and Anatomy, Surgery and Anatomy of HCFMRP-USP, São Paulo, Brazil.
Prashant KediaDigestive Health Associates of Texas, Dallas, USA.
Urban ArneloDepartment of Upper Gastrointestinal Diseases, Division of Surgery, CLINTEC, Karolinska Institutet, Stockholm, Sweden.
Priya JamidarGastroenterology/Medicine, Yale University, Guilford, USA.
Raj J ShahGastroenterology, University of Colorado, Aurora, USA.
Carlos Robles-MedrandaInstituto Ecuatoriano De Enfermedades Digestivas (IECED)-University Hospital Omni, Espiritu Santo University, Guayaquil, Ecuador.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDigital single-operator cholangioscopy (DSOC) (SpyGlass DS™, Boston Scientific, MA, USA) allows for high-definition imaging of the biliary tree. The superior visualization has led to the development of two different sets of criteria to evaluate and classify indeterminate biliary strictures: the Monaco criteria and the criteria in Carlos Robles-Medranda's publication (CRM). Our objective was to assess the interrater agreement (IA) of DSOC interpretation for indeterminate biliary strictures using the two newly published criteria.

methodsForty de-identified DSOC video recordings were sent to 15 interventional endoscopists with experience in cholangioscopy. They were asked to score the videos based on the presence of Monaco Classification criteria: stricture, lesion, mucosal changes, papillary projections, ulceration, white linear bands or rings, and vessels. Next, they scored the videos using CRM criteria: villous pattern, polypoid pattern, inflammatory pattern, flat pattern, ulcerate pattern and honeycomb pattern. The endoscopists then diagnosed the recordings as neoplastic or non-neoplastic based on the criteria. Intraclass correlation (ICC) analysis was done to evaluate interrater agreement for both criteria set and final diagnosis.

resultsRecordings of 26 malignant lesions and 14 benign lesions were scored. The IA using both the Monaco criteria and CRM criteria ranged from poor to excellent (range 0.1-0.76) and (range 0.1-0.62), respectively. Within the Monaco criteria, IA was excellent for lesion (0.75) and fingerlike papillary projections (0.74); good for tortuous vessels (0.7), mucosal features (0.62), uniform papillary projections (0.53), and ulceration (0.58); and fair for white linear bands (0.4). Within the CRM criteria, the IA was good for villous pattern (0.62), flat pattern (0.62), and honeycomb pattern; fair for ulcerated pattern (0.56), polypoid pattern (0.52) and inflammatory pattern (0.54). The diagnostic IA using Monaco criteria was good (0.65), while the diagnostic IA using CRM was fair (0.58). The overall diagnostic accuracy using the Monaco classification was 61% and CRM criteria were 57%.

conclusionThe IOA and accuracy rate of DSOC using visual criteria from both Monaco Criteria and CRM are similar. However, some criteria from both sets suffer from poor IA, thus affecting the overall diagnostic accuracy. More formal training and refinements in visual criteria with additional validation are needed to improve diagnostic accuracy.

trial registrationClinicalTrials.gov Identifier: NCT02166099.

Indexed as

Biliary Tract Surgical ProceduresCholestasisLaparoscopyConstriction, PathologicEndoscopy, Digestive SystemHumansCholangioscopyIndeterminate biliary strictureMonaco criteriaSingle-operator digital cholangioscopyVideo cholangioscopy

Identifiers

PMID33783691

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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.