ABSTRACT
The purpose of this study was to evaluate the clinical significance of visualized area percentage assessment of cleansing score [AAC] and computed assessment of cleansing score [CAC] of these two small bowel cleanliness scores systems for capsule endoscopy [CE]. The reliability and consistency of the AAC and CAC scores were evaluated by comparing the scores by two examiners [one expert, one without any training in CE]. Reliability was determined using the intraclass correlation coefficient [ICC] and consistency was determined using the kappa statistic. The inter-observer agreement was excellent for both the AAC and CAC scores. For AAC, the ICC was 0.791 [95% confidence interval: 0.677-0.868], and for CAC the ICC was 1.000. Using 1.5 as the cutoff, there was no significant difference between AAC and CAC results by the expert examiner [kappa 0.756, P 0.000] or the non-expert examiner [kappa 0.831, P 0.000]. Evaluation of small bowel cleanliness using AAC took 15-30 min, and evaluation using CAC took about 2-3 min. The overall adequacy assessment [OAA] using the AAC was not significantly different between the two examiners [chi[2] 0.586, P 0.444]. There were also no significant differences between the OAA using the AAC and the OAA using the CAC by the expert examiner [chi[2] 1.730, P 0.188] or the non-expert examiner [chi[2] 1.124, P 0.289]. Both of these scores for assessment of small bowel cleanliness can be useful in clinical practice, but the CAC is simpler to use