Abstract
Aims
The primary aim of this study was to assess the reliability, intra- and inter-observer
variation of the SPICE, Mucosal protrusion angle (MPA) and SHYUNG scores in differentiating
a subepithelial mass (SEM) from a bulge.
Methods
This retrospective multicentre study analysed the 3 scores, radiological studies,
enteroscopy and/or surgical findings.
Results
100 patients with a potential SEM (mean age 57.6years) were recruited with 75 patients
having pathology. In patients with a SEM the mean SPICE score was 2.04 (95% CI 1.82–2.26)
as compared to 1.16 (95% CI 0.81–1.51) without any pathology (AUC 0.74, p<0.001), with a fair intra-observer agreement (Kappa 0.3, p<0.001) and slight inter-observer agreement (Kappa 0.14, p<0.05). SPICE had a 37.3% sensitivity and 92.0% specificity in distinguishing between
a SEM and bulge, whereas MPA<90˚ had 58.7% and 76.0% respectively, with poor intra-observer(p = 0.05) and interobserver agreement (p = 0.64). The SHYUNG demonstrated a moderate intra-observer (Kappa 0.44, p<0.001) and slight inter-observer reliability (Kappa 0.18, p<0.001). The sensitivity of an elevated SHYUNG score (≥4) in identifying a SEM was
18.7% with a specificity of 92.0% (AUC 0.71, p = 0.002).
Conclusions
Though these scores are easy to use, they have, at best, slight to moderate intra
and inter-observer agreement. Their overall diagnostic performances are limited.
Key Words
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Article info
Publication history
Published online: August 04, 2022
Accepted:
June 29,
2022
Received:
January 31,
2022
Identification
Copyright
© 2022 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
