Evidence map›Paper›PMID 40707749›Full record

ArticleDigestive diseases and sciences2025

Interobserver Agreement for the Paris Classification of Colorectal Lesions Amongst Surgeons, Gastroenterologists, Trainees and Experts: A Video-Based Study.

Roupen Djinbachian, Abla Alj, Edgard Medawar, Mathieu Pioche, Yutaka Saito, Amrita Sethi, Philip Chiu, Jeffrey Marks, Herawaty Sebajang, Katarzyna Pawlak and 5 more

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Article in Digestive diseases and sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

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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

4 citing papers in PubMed.

  1. Review
  2. Article
  3. Reply to Koulaouzidis and Marlicz.Endoscopy international open · 2026
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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

15 authors.

Roupen Djinbachian *Montreal University Hospital Research Center, Montreal, QC, Canada.
Abla Alj *Montreal University Hospital Research Center, Montreal, QC, Canada.
Edgard MedawarMontreal University Hospital Research Center, Montreal, QC, Canada.
Mathieu PiocheGastroenterology and Endoscopy Division, Edouard Herriot University Hospital, Hospices Civils de Lyon, Lyon, France.
Yutaka SaitoEndoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
Amrita SethiDivision of Digestive and Liver Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, USA.
Philip ChiuDepartment of Surgery, Faculty of Medicine, Institute of Digestive Disease, The Chinese University of Hong Kong, Ma Liu Shui, Hong Kong.
Jeffrey MarksDepartment of Surgery, University Hospitals Cleveland Medical Center, Cleveland, USA.
Herawaty SebajangDivision of Surgery, Montreal University Hospital Center (CHUM), Montreal, QC, Canada.
Katarzyna PawlakDivision of Gastroenterology and Hepatology, University of Toronto, Toronto, ON, Canada.
Anas ChennoufDivision of Gastroenterology, Montreal University Hospital Center (CHUM), Montreal, QC, Canada.
Florence BenardDivision of Surgery, Montreal University Hospital Center (CHUM), Montreal, QC, Canada.
Yutaro IdeDigestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
Frances DangDivision of Gastroenterology and Hepatology, University of Toronto, Toronto, ON, Canada.
Daniel von RentelnMontreal University Hospital Research Center, Montreal, QC, Canada. danielrenteln@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundColonic polyps are described based on their macroscopic shape, according to the Paris classification. This represents a useful tool to communicate polyp and lesion morphology between endoscopists, however, the agreement between endoscopists on polyp morphology evaluation has not been demonstrated in the literature. We were interested in evaluating endoscopist agreement using the Paris classification.

methodsWe conducted a prospective video-based study evaluating endoscopist assessment of lesion morphology. An international group of endoscopists including surgeons, gastroenterologists, experts and trainees were included. Primary outcome was overall inter-observer agreement for the Paris classification. Secondary outcomes were inter-observer agreement stratified by endoscopist characteristics.

results11 endoscopists were included in the analysis with 1320 morphologic assessments of 120 individual polyps. There was low overall inter-observer agreement for the Paris classification with an overall Light's Kappa of 0.19 (95%CI 0.14-0.24). Agreement remained low for men (K = 0.25; 95%CI 0.20-0.30), women (K = 0.25; 95%CI 0.18-0.35), gastroenterologists (K = 0.23; 95%CI 0.19-0.29), surgeons (K = 0.11; 95%CI 0.05-0.18), trainees (K = 0.19; 95%CI 0.13-0.25), and experts (K = 0.16; 95%CI 0.11-0.22). Endoscopists who have received training on lesion evaluation in Asia had higher inter-observer agreement when using the Paris classification compared to endoscopists in the west (K = 0.50; 95%CI 0.42-0.59 vs 0.26; 95%CI 0.18-0.34).

conclusionsAgreement when using the Paris classification was low amongst a varied international group of surgeons, gastroenterologists, trainees and experts. Training in the east, where higher emphasis is placed on lesion characterization was associated with the highest inter-observer agreement.

Indexed as

Colonic PolypsColonoscopyColorectal NeoplasmsGastroenterologistsSurgeonsFemaleGastroenterologyHumansMaleMiddle AgedObserver VariationProspective StudiesVideo RecordingColonic PolypsColonoscopyColorectal CancerParis Classification

Identifiers

PMID40707749

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Registered trials

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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.