Spekhorst LM, Visschedijk MC, Alberts R, Festen EA, van der Wouden EJ, Dijkstra G, (ICC) RKWDIOCAC. Performance of the Montreal classification for inflammatory bowel diseases. World J Gastroenterol 2014; 20(41): 15374-15381 [PMID: 25386087 DOI: 10.3748/wjg.v20.i41.15374]
Corresponding Author of This Article
Rinse K Weersma, MD, PhD, Professor, Department of Gastroenterology and Hepatology, University of Groningen and University Medical Centre Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands. r.k.weersma@umcg.nl
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
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S0: Remission, no symptoms S1: Mild, ≤ 4 ×/d stools, no systemic signs of toxicity, normal ESR S2: Moderate, > 4 ×/d stools, minimal systemic signs of toxicity S3: Severe, ≥ 6 ×/d stools, pulse > 90 beats/min, temperature > 37.5, Hemoglobin < 6.5 mmol/L, ESR > 30 mm
Table 2 Characteristics of 30 observers n (%)
< 10 yr of experience with IBD patients
10-20 yr of experience with IBD patients
> 20 yr of experience with IBD patients
Non-university center
University medical center
Total
Gastroenterologist
7 (23%)
5 (17%)
4 (13%)
5 (17%)
11 (37%)
16 (54%)
Gastroenterologist in training
10 (33%)
3 (10%)
7 (23%)
10 (33%)
IBD-nurse
3 (10%)
1 (3%)
1 (3%)
3 (10%)
4 (13%)
Total
20 (67%)
6 (20%)
4 (13%)
100%
Table 3 Percentages of correct answers according to the “expert evaluation” for overall and divided for different professions
Overall correct answers
Gastroenterologist
Gastroenterologist in training
IBD-nurse
Age of onset
94.0%
94.2%
96.8%
86.0%
Diagnosis
96.9%
96.0%
96.0%
98.8%
CD disease Localization
94.0%
90.6%
93.8%
97.5%
CD upper gastrointestinal
91.3%
95.6%
94.0%
84.2%
CD perianal disease
98.0%
99.4%
98.0%
96.7%
CD Disease behavior
92.4%
92.4%
94.8%
90.0%
CD severity (mild, moderate, severe)
73.9%
68.7%
72.9%
80.0%
UC disease extent
84.0%
89.3%
85.2%
77.5%
UC disease severity colitis
50.7%
53.9%
50.7%
47.5%
EIM
82.1%
82.1%
85.8%
78.5%
Table 4 Percentages of correct answers compared to the “expert evaluation” overall and divided for different years of experience with inflammatory bowel disease patients
Overall correct answers
< 10 yr of experience
10-20 yr of experience
> 20 yr of experience
Age of onset
92.3%
95.2%
93.0%
88.6%
Diagnosis
96.2%
97.0%
93.3%
98.3%
CD disease localization
90.6%
94.2%
90.0%
87.5%
CD upper gastrointestinal
94.8%
91.8%
100.0%
92.5%
CD perianal disease
98.9%
98.5%
98.3%
100.0%
CD disease behavior
93.0%
92.3%
96.7%
90.0%
CD severity (mild, moderate, severe)
69.9%
73.1%
70.0%
66.7%
UC disease extent
86.6%
86.2%
85.3%
88.3%
UC disease severity colitis
48.0%
56.2%
37.7%
50.0%
EIM
83.4%
82.7%
81.6%
86.0%
Table 5 Inter-rater agreement kappa for all items of all categories of Montreal classification
Item Montreal classification
Overall kappa
Age of onset
0.67 (n = 28)
Diagnosis
0.96 (n = 28)
CD disease localization
0.82 (n = 28)
CD upper gastrointestinal
0.62 (n = 28)
CD perianal disease
0.91 (n = 28)
CD disease behavior
0.79 (n = 26)
CD severity (mild, moderate, severe)
0.44 (n = 24)
UC disease extent
0.65 (n = 21)
UC disease severity colitis
0.23 (n = 20)
EIM
0.68 (n = 28)
Citation: Spekhorst LM, Visschedijk MC, Alberts R, Festen EA, van der Wouden EJ, Dijkstra G, (ICC) RKWDIOCAC. Performance of the Montreal classification for inflammatory bowel diseases. World J Gastroenterol 2014; 20(41): 15374-15381