Inter-rater Reliability and Accuracy of NBI Score for Activity Evaluation in Ulcerative Colitis

Gianpiero Stefanelli; Marco Valvano; Annalisa Capannolo; Stefano Necozione; Angelo Viscido; Giovanni Latella; Michele Marchese

doi:10.2174/0115748871367645250623062144

Inter-rater Reliability and Accuracy of NBI Score for Activity Evaluation in Ulcerative Colitis

Rev Recent Clin Trials. 2025 Jul 3. doi: 10.2174/0115748871367645250623062144. Online ahead of print.

Authors

Gianpiero Stefanelli¹, Marco Valvano^{2

3}, Annalisa Capannolo⁴, Stefano Necozione⁵, Angelo Viscido³, Giovanni Latella³, Michele Marchese⁴

Affiliations

¹ Gastroenterology Unit, Ente Ospedaliero Galliera, Via delle Mura Cappuccine, 14, 16128Genova, Italy.
² Gastroenterology Unit, Ente Ospedaliero Galliera, Via delle Mura Cappuccine, 14, 16128 Genova, Italy.
³ Gastroenterology Unit, Department of Life, Health and Environmental Sciences, University of L'Aquila, Piazzale Salvatore Tommasi 1, 67100 L'Aquila, Italy.
⁴ Diagnostic and Surgical Endoscopy Unit, San Salvatore Academic Hospital, 67100 L'Aquila, Italy.
⁵ Epidemiology Unit, Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy.

PMID: 40619668
DOI: 10.2174/0115748871367645250623062144

Abstract

Background: Colonoscopy is a critical tool for the management of Ulcerative Colitis (UC). In this study, we aim to explore the accuracy of Virtual Chromoendoscopy (VCE) using Narrow Banding Imaging (NBI), and magnification using Near Focus (NF) for a better definition of endoscopic inflammation grade in UC patients compared to standard white light (WL) endoscopy alone.

Methods: This is a non-randomized prospective study including all the patients who underwent a colonoscopy (for any reason) between April and September 2023 (with protocol number n. 60/2019.20). During the endoscopic evaluation, at least one image with white light - evaluated using the Mayo Endoscopic Score (MES), one image with NBI, one image with NBI plus NF, and a biopsy were obtained in each colonic tract (cecum, ascending colon, transverse colon, descending colon, sigmoid colon, and rectum). All the stored images were evaluated by three endoscopists separately and compared with the results of the histological evaluation.

Results: A total of 31 UC patients were included. The inter-rater reliability concerning the different scores used (MES, NBI score, and NBI plus NF score), which was evaluated with Cohen's kappa coefficient, was good for the MES, good to excellent for the NBI score, and good for the NBI plus NF score. The concordance between histological evaluation (using the Nancy Index) and the MES was unsatisfactory for all the endoscopists, while the concordance between the NBI evaluation score and the Nancy Index was good to excellent.

Conclusion: The results in the present study suggest that the new endoscopic technologies could be useful to better define disease activity in IBD patients driving better therapeutic strategy.

Keywords: Inflammatory bowel disease; endoscopy.; narrow banding imaging (NBI); ulcerative colitis; virtual chromoendoscopy.