Nomenclature and semantic descriptions of ulcerative and inflammatory lesions seen in Crohn’s disease in small bowel capsule endoscopy: An international Delphi consensus statement

Romain Leenhardt, Anthony Buisson, Arnaud Bourreille, Philippe Marteau, Anastasios Koulaouzidis, Cynthia Li, Martin Keuchel, Emmanuele Rondonotti, Ervin Toth, John N. Plevris, Rami Eliakim, Bruno Rosa, Konstantinos Triantafyllou, Luca Elli, Gabriele Wurm Johansson, Simon Panter, Pierre Ellul, Enrique Pérez-Cuadrado Robles, Deirdre McNamara, Hanneke BeaumontCristiano Spada, Flaminia Cavallaro, Franck Cholet, Ignacio Fernandez-Urien Sainz, Uri Kopylov, Mark E. McAlindon, Artur Németh, Gian Eugenio Tontini, Diana E. Yung, Yaron Niv, Gabriel Rahmi, Jean Christophe Saurin, Xavier Dray

Research output: Contribution to journalArticle

Abstract

Background: In the medical literature, the nomenclature and descriptions (ND) of small bowel (SB) ulcerative and inflammatory (U-I) lesions in capsule endoscopy (CE) are scarce and inconsistent. Inter-observer variability in interpreting these findings remains a major limitation in the assessment of the severity of mucosal lesions, which can impact negatively on clinical care, training and research on SB-CE. Objective: Focusing on SB-CE in Crohn’s disease (CD), our aim is to establish a consensus on the ND of U-I lesions. Methods: An international panel of experienced SB-CE readers was formed during the 2016 United European Gastroenterology Week meeting. A core group of five CE and inflammatory bowel disease (IBD) experts established an Internet-based, three-round Delphi consensus but did not participate in the voting process. The core group built illustrated questionnaires, including SB-CE still frames of U-I lesions from patients with documented CD. Twenty-seven other experts were asked to rate and comment on the different proposals for the ND of the most frequent SB U-I lesions. For each round, we used a 6-point rating scale (varying from ‘strongly disagree’ to ‘strongly agree’). The consensus was reached when at least 80 % of the voting members scored the statement within the ‘agree’ or ‘strongly agree’ categories. Results: A 100% participation rate was obtained for all the rounds. Consensual ND were reached for the following seven U-I lesions: aphthoid erosion, deep ulceration, superficial ulceration, stenosis, edema, hyperemia and denudation. Conclusion: Considering the most frequent SB U-I lesions seen in CE in CD, a consensual ND was reached by the international group of experts. These descriptions and names are useful not only for daily practice and medical education, but also for medical research.

Original languageEnglish
Pages (from-to)99-107
JournalUnited European Gastroenterology Journal
Volume8
Issue number1
DOIs
Publication statusPublished - 2020

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Capsule Endoscopy
Semantics
Terminology
Crohn Disease
Politics
Observer Variation
Hyperemia
Gastroenterology
Medical Education
Inflammatory Bowel Diseases
Internet
Names
Biomedical Research
Edema
Pathologic Constriction
Research

Keywords

  • Capsule endoscopy
  • Crohn’s disease
  • Delphi consensus
  • inflammatory bowel diseases
  • nomenclature
  • small-bowel

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology

Cite this

Nomenclature and semantic descriptions of ulcerative and inflammatory lesions seen in Crohn’s disease in small bowel capsule endoscopy : An international Delphi consensus statement. / Leenhardt, Romain; Buisson, Anthony; Bourreille, Arnaud; Marteau, Philippe; Koulaouzidis, Anastasios; Li, Cynthia; Keuchel, Martin; Rondonotti, Emmanuele; Toth, Ervin; Plevris, John N.; Eliakim, Rami; Rosa, Bruno; Triantafyllou, Konstantinos; Elli, Luca; Wurm Johansson, Gabriele; Panter, Simon; Ellul, Pierre; Pérez-Cuadrado Robles, Enrique; McNamara, Deirdre; Beaumont, Hanneke; Spada, Cristiano; Cavallaro, Flaminia; Cholet, Franck; Fernandez-Urien Sainz, Ignacio; Kopylov, Uri; McAlindon, Mark E.; Németh, Artur; Tontini, Gian Eugenio; Yung, Diana E.; Niv, Yaron; Rahmi, Gabriel; Saurin, Jean Christophe; Dray, Xavier.

In: United European Gastroenterology Journal, Vol. 8, No. 1, 2020, p. 99-107.

Research output: Contribution to journalArticle

Leenhardt, R, Buisson, A, Bourreille, A, Marteau, P, Koulaouzidis, A, Li, C, Keuchel, M, Rondonotti, E, Toth, E, Plevris, JN, Eliakim, R, Rosa, B, Triantafyllou, K, Elli, L, Wurm Johansson, G, Panter, S, Ellul, P, Pérez-Cuadrado Robles, E, McNamara, D, Beaumont, H, Spada, C, Cavallaro, F, Cholet, F, Fernandez-Urien Sainz, I, Kopylov, U, McAlindon, ME, Németh, A, Tontini, GE, Yung, DE, Niv, Y, Rahmi, G, Saurin, JC & Dray, X 2020, 'Nomenclature and semantic descriptions of ulcerative and inflammatory lesions seen in Crohn’s disease in small bowel capsule endoscopy: An international Delphi consensus statement', United European Gastroenterology Journal, vol. 8, no. 1, pp. 99-107. https://doi.org/10.1177/2050640619895864
Leenhardt, Romain ; Buisson, Anthony ; Bourreille, Arnaud ; Marteau, Philippe ; Koulaouzidis, Anastasios ; Li, Cynthia ; Keuchel, Martin ; Rondonotti, Emmanuele ; Toth, Ervin ; Plevris, John N. ; Eliakim, Rami ; Rosa, Bruno ; Triantafyllou, Konstantinos ; Elli, Luca ; Wurm Johansson, Gabriele ; Panter, Simon ; Ellul, Pierre ; Pérez-Cuadrado Robles, Enrique ; McNamara, Deirdre ; Beaumont, Hanneke ; Spada, Cristiano ; Cavallaro, Flaminia ; Cholet, Franck ; Fernandez-Urien Sainz, Ignacio ; Kopylov, Uri ; McAlindon, Mark E. ; Németh, Artur ; Tontini, Gian Eugenio ; Yung, Diana E. ; Niv, Yaron ; Rahmi, Gabriel ; Saurin, Jean Christophe ; Dray, Xavier. / Nomenclature and semantic descriptions of ulcerative and inflammatory lesions seen in Crohn’s disease in small bowel capsule endoscopy : An international Delphi consensus statement. In: United European Gastroenterology Journal. 2020 ; Vol. 8, No. 1. pp. 99-107.
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abstract = "Background: In the medical literature, the nomenclature and descriptions (ND) of small bowel (SB) ulcerative and inflammatory (U-I) lesions in capsule endoscopy (CE) are scarce and inconsistent. Inter-observer variability in interpreting these findings remains a major limitation in the assessment of the severity of mucosal lesions, which can impact negatively on clinical care, training and research on SB-CE. Objective: Focusing on SB-CE in Crohn’s disease (CD), our aim is to establish a consensus on the ND of U-I lesions. Methods: An international panel of experienced SB-CE readers was formed during the 2016 United European Gastroenterology Week meeting. A core group of five CE and inflammatory bowel disease (IBD) experts established an Internet-based, three-round Delphi consensus but did not participate in the voting process. The core group built illustrated questionnaires, including SB-CE still frames of U-I lesions from patients with documented CD. Twenty-seven other experts were asked to rate and comment on the different proposals for the ND of the most frequent SB U-I lesions. For each round, we used a 6-point rating scale (varying from ‘strongly disagree’ to ‘strongly agree’). The consensus was reached when at least 80 {\%} of the voting members scored the statement within the ‘agree’ or ‘strongly agree’ categories. Results: A 100{\%} participation rate was obtained for all the rounds. Consensual ND were reached for the following seven U-I lesions: aphthoid erosion, deep ulceration, superficial ulceration, stenosis, edema, hyperemia and denudation. Conclusion: Considering the most frequent SB U-I lesions seen in CE in CD, a consensual ND was reached by the international group of experts. These descriptions and names are useful not only for daily practice and medical education, but also for medical research.",
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author = "Romain Leenhardt and Anthony Buisson and Arnaud Bourreille and Philippe Marteau and Anastasios Koulaouzidis and Cynthia Li and Martin Keuchel and Emmanuele Rondonotti and Ervin Toth and Plevris, {John N.} and Rami Eliakim and Bruno Rosa and Konstantinos Triantafyllou and Luca Elli and {Wurm Johansson}, Gabriele and Simon Panter and Pierre Ellul and {P{\'e}rez-Cuadrado Robles}, Enrique and Deirdre McNamara and Hanneke Beaumont and Cristiano Spada and Flaminia Cavallaro and Franck Cholet and {Fernandez-Urien Sainz}, Ignacio and Uri Kopylov and McAlindon, {Mark E.} and Artur N{\'e}meth and Tontini, {Gian Eugenio} and Yung, {Diana E.} and Yaron Niv and Gabriel Rahmi and Saurin, {Jean Christophe} and Xavier Dray",
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T1 - Nomenclature and semantic descriptions of ulcerative and inflammatory lesions seen in Crohn’s disease in small bowel capsule endoscopy

T2 - An international Delphi consensus statement

AU - Leenhardt, Romain

AU - Buisson, Anthony

AU - Bourreille, Arnaud

AU - Marteau, Philippe

AU - Koulaouzidis, Anastasios

AU - Li, Cynthia

AU - Keuchel, Martin

AU - Rondonotti, Emmanuele

AU - Toth, Ervin

AU - Plevris, John N.

AU - Eliakim, Rami

AU - Rosa, Bruno

AU - Triantafyllou, Konstantinos

AU - Elli, Luca

AU - Wurm Johansson, Gabriele

AU - Panter, Simon

AU - Ellul, Pierre

AU - Pérez-Cuadrado Robles, Enrique

AU - McNamara, Deirdre

AU - Beaumont, Hanneke

AU - Spada, Cristiano

AU - Cavallaro, Flaminia

AU - Cholet, Franck

AU - Fernandez-Urien Sainz, Ignacio

AU - Kopylov, Uri

AU - McAlindon, Mark E.

AU - Németh, Artur

AU - Tontini, Gian Eugenio

AU - Yung, Diana E.

AU - Niv, Yaron

AU - Rahmi, Gabriel

AU - Saurin, Jean Christophe

AU - Dray, Xavier

PY - 2020

Y1 - 2020

N2 - Background: In the medical literature, the nomenclature and descriptions (ND) of small bowel (SB) ulcerative and inflammatory (U-I) lesions in capsule endoscopy (CE) are scarce and inconsistent. Inter-observer variability in interpreting these findings remains a major limitation in the assessment of the severity of mucosal lesions, which can impact negatively on clinical care, training and research on SB-CE. Objective: Focusing on SB-CE in Crohn’s disease (CD), our aim is to establish a consensus on the ND of U-I lesions. Methods: An international panel of experienced SB-CE readers was formed during the 2016 United European Gastroenterology Week meeting. A core group of five CE and inflammatory bowel disease (IBD) experts established an Internet-based, three-round Delphi consensus but did not participate in the voting process. The core group built illustrated questionnaires, including SB-CE still frames of U-I lesions from patients with documented CD. Twenty-seven other experts were asked to rate and comment on the different proposals for the ND of the most frequent SB U-I lesions. For each round, we used a 6-point rating scale (varying from ‘strongly disagree’ to ‘strongly agree’). The consensus was reached when at least 80 % of the voting members scored the statement within the ‘agree’ or ‘strongly agree’ categories. Results: A 100% participation rate was obtained for all the rounds. Consensual ND were reached for the following seven U-I lesions: aphthoid erosion, deep ulceration, superficial ulceration, stenosis, edema, hyperemia and denudation. Conclusion: Considering the most frequent SB U-I lesions seen in CE in CD, a consensual ND was reached by the international group of experts. These descriptions and names are useful not only for daily practice and medical education, but also for medical research.

AB - Background: In the medical literature, the nomenclature and descriptions (ND) of small bowel (SB) ulcerative and inflammatory (U-I) lesions in capsule endoscopy (CE) are scarce and inconsistent. Inter-observer variability in interpreting these findings remains a major limitation in the assessment of the severity of mucosal lesions, which can impact negatively on clinical care, training and research on SB-CE. Objective: Focusing on SB-CE in Crohn’s disease (CD), our aim is to establish a consensus on the ND of U-I lesions. Methods: An international panel of experienced SB-CE readers was formed during the 2016 United European Gastroenterology Week meeting. A core group of five CE and inflammatory bowel disease (IBD) experts established an Internet-based, three-round Delphi consensus but did not participate in the voting process. The core group built illustrated questionnaires, including SB-CE still frames of U-I lesions from patients with documented CD. Twenty-seven other experts were asked to rate and comment on the different proposals for the ND of the most frequent SB U-I lesions. For each round, we used a 6-point rating scale (varying from ‘strongly disagree’ to ‘strongly agree’). The consensus was reached when at least 80 % of the voting members scored the statement within the ‘agree’ or ‘strongly agree’ categories. Results: A 100% participation rate was obtained for all the rounds. Consensual ND were reached for the following seven U-I lesions: aphthoid erosion, deep ulceration, superficial ulceration, stenosis, edema, hyperemia and denudation. Conclusion: Considering the most frequent SB U-I lesions seen in CE in CD, a consensual ND was reached by the international group of experts. These descriptions and names are useful not only for daily practice and medical education, but also for medical research.

KW - Capsule endoscopy

KW - Crohn’s disease

KW - Delphi consensus

KW - inflammatory bowel diseases

KW - nomenclature

KW - small-bowel

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