- Title
- The Toronto Upper Gastrointestinal Cleaning Score: a prospective validation study
- Creator
- Khan, Rishad; Gimpaya, Nikko; Bollipo, Steven; Kral, Jan; Lui, Rashid; Pawlak, Katarzyna M.; Sandhu, Dalbir S.; Bilal, Mohammad; de-Madaria, Enrique; Siau, Keith; Charabaty, Aline; Hashim, Almoutaz; Vargas, Jose I.; Sánchez-Luna, Sergio A.; Teshima, Christopher W.; May, Gary R.; Mosko, Jeffrey D.; Walsh, Catharine M.; Grover, Samir C.; Ramkissoon, Anushka; Seleq, Samir; Gholami, Reza; Akhtar, Hisham J.; Bansal, Rishi; Scaffidi, Michael A.; Amin, Sunil
- Relation
- Endoscopy Vol. 55, Issue 2, p. 121-128
- Publisher Link
- http://dx.doi.org/10.1055/a-1865-4180
- Publisher
- Georg Thieme Verlag
- Resource Type
- journal article
- Date
- 2023
- Description
- Background: Assessment of mucosal visualization during esophagogastroduodenoscopy (EGD) can be improved with a standardized scoring system. To address this need, we created the Toronto Upper Gastrointestinal Cleaning Score (TUGCS). Methods: We developed the TUGCS using Delphi methodology, whereby an international group of endoscopy experts iteratively rated their agreement with proposed TUGCS items and anchors on a 5-point Likert scale. After each Delphi round, we analyzed responses and refined the TUGCS using an 80 % agreement threshold for consensus. We used the intraclass correlation coefficient (ICC) to assess inter-rater and test–retest reliability. We assessed internal consistency with Cronbach’s alpha and item-total and inter-item correlations with Pearson’s correlation coefficient. We compared TUGCS ratings with an independent endoscopist’s global rating of mucosal visualization using Spearman’s ρ. Results: We achieved consensus with 14 invited participants after three Delphi rounds. Inter-rater reliability was high at 0.79 (95 %CI 0.64–0.88). Test–retest reliability was excellent at 0.83 (95 %CI 0.77–0.87). Cronbach’s α was 0.81, item-total correlation range was 0.52–0.70, and inter-item correlation range was 0.38–0.74. There was a positive correlation between TUGCS ratings and a global rating of visualization (r = 0.41, P = 0.002). TUGCS ratings for EGDs with global ratings of excellent were significantly higher than those for EGDs with global ratings of fair (P = 0.01). Conclusion: The TUGCS had strong evidence of validity in the clinical setting. The international group of assessors, broad variety of EGD indications, and minimal assessor training improves the potential for dissemination.
- Identifier
- http://hdl.handle.net/1959.13/1479813
- Identifier
- uon:50382
- Identifier
- ISSN:0013-726X
- Language
- eng
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