Inter- and intra-observer variability of the Los Angeles classification: a reassessment

Siavosh Nasseri-Moghaddam, Hadi Razjouyan, Mehdi Nouraei, Maysam Alimohammadi, Mansoureh Mamarabadi, Homayoon Vahedi, Akram Pourshams, Mehdi Mohamadnejad, Farhad Zamani, Farhad Sadr, Sodaif Darvish-Moghaddam, Pantea Farsi (+1 others)
2007 Archives of Iranian medicine  
Los Angeles classification is widely adopted for reporting endoscopic gastroesophageal reflux disease. We assessed the inter- and intra-observer variability of the Los Angeles classification. Still images (n = 254) of the lower esophagus were presented to 9 gastroenterologists (6 experts and 3 trainees) and they were asked to report the images according to the Los Angeles classification. After 2 weeks the images were reordered and they were asked to report them again. Kappa statistic was
more » ... tatistic was calculated for intra- and inter-observer variability. The kappa for intra-observer agreement was 0.54 (attendings: 0.54; trainees; 0.55; P = not significant) and the inter-observer agreement was 0.22 (attendings: 0.20; trainees: 0.31; P = 0.027). The inter- and intra-observer kappa values in differentiating nonerosive from erosive cases were 0.22 (attendings: 0.21; trainees: 0.31, P = not significant) and 0.57 (attendings: 0.58; trainees: 0.55, P = not significant), respectively. According to our data, the Los Angeles classification has acceptable intra-observer variability, both for detecting presence or absence of erosions and for differentiating between different degrees of esophagitis, while its inter-observer performance seems to be less acceptable. It may be reasonable and timely to have another look at the Los Angeles classification to see whether its performance can be improved even further.
pmid:17198454 fatcat:jkzowkfqwncypeblmejbcfruam