{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:41:46Z","timestamp":1778805706281,"version":"3.51.4"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,10,25]],"date-time":"2022-10-25T00:00:00Z","timestamp":1666656000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100008672","name":"Wilhelm Sander-Stiftung","doi-asserted-by":"publisher","award":["2019.046.1"],"award-info":[{"award-number":["2019.046.1"]}],"id":[{"id":"10.13039\/100008672","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,4,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Histological disease severity assessment in ulcerative colitis [UC] has become a mainstay in the definition of clinical endpoints [\u2018histological remission\u2019] in clinical trials of UC. Several scores have been established in the microscopic assessment of disease activity, but the Nancy index [NI] stands out as being the histological index with the fewest scoring items. To what extent histological assessment using the NI is affected by interobserver reliability in a real-word setting is poorly understood. We therefore performed a single-centre retrospective analysis of NI assessment in patients with UC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively evaluated the NI in two independent cohorts [total: 1085 biopsies, 547 UC patients] of clinically diagnosed UC patients, who underwent colonoscopy between 2007 and 2020. Cohort #1 consisted of 637 biopsies from 312 patients, while Cohort #2 consisted of 448 biopsies from 235 patients. Two blinded pathologists with different levels of expertise scored all biopsies from each cohort. A consensus conference was held for cases with discrepant scoring results. Finally, an overall consensus scoring was obtained from both cohorts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The interobserver agreement of the NI was substantial after the assessment of 1085 biopsy samples (\u03ba\u2005=\u20050.796 [95% confidence interval, CI: 0.771\u20130.820]). An improvement of the interobserver agreement was found with increasing numbers of samples evaluated by both observers (Cohort #1: \u03ba\u2005=\u20050.772 [95% CI: 0.739\u20130.805]; Cohort #2: \u03ba\u2005=\u20050.829 [95% CI: 0.793\u20130.864]). Interobserver discordance was highest in NI grade 1 [observer 1: n\u2005=\u2005128; observer 2: n\u2005=\u2005236]. Interobserver discordance was lowest in NI grades 0 [observer 1: n\u2005=\u2005504; observer 2: n\u2005=\u2005479] and 3 [observer 1: n\u2005=\u200571; observer 2: n\u2005=\u200566].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The NI is an easy-to-use index with high interobserver reliability for assessment of the histological disease activity of UC patients in a real-world setting. While NI grades 0 and 3 had a high level of agreement between observers, NI grade 1 had a poorer level of agreement. This highlights the clinical need to specify histological characteristics leading to NI grade 1.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ecco-jcc\/jjac146","type":"journal-article","created":{"date-parts":[[2022,10,25]],"date-time":"2022-10-25T18:45:15Z","timestamp":1666723515000},"page":"389-395","source":"Crossref","is-referenced-by-count":11,"title":["Interobserver Reliability of the Nancy Index for Ulcerative Colitis: An Assessment of the Practicability and Ease of Use in a Single-Centre Real-World Setting"],"prefix":"10.1093","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1003-0839","authenticated-orcid":false,"given":"Huy Duc","family":"Le","sequence":"first","affiliation":[{"name":"Institute of Clinical Molecular Biology, Christian-Albrechts-University and University Hospital Schleswig-Holstein , Kiel , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theresa","family":"Pflaum","sequence":"additional","affiliation":[{"name":"Department of Pathology, Christian-Albrechts-University and University Hospital Schleswig-Holstein , Kiel , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes","family":"Labrenz","sequence":"additional","affiliation":[{"name":"Institute of Clinical Molecular Biology, Christian-Albrechts-University and University Hospital Schleswig-Holstein , Kiel , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soner","family":"Sari","sequence":"additional","affiliation":[{"name":"Institute of Clinical Molecular Biology, Christian-Albrechts-University and University Hospital Schleswig-Holstein , Kiel , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabienne","family":"Bretschneider","sequence":"additional","affiliation":[{"name":"Institute of Clinical Molecular Biology, Christian-Albrechts-University and University Hospital Schleswig-Holstein , Kiel , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florian","family":"Tran","sequence":"additional","affiliation":[{"name":"Institute of Clinical Molecular Biology, Christian-Albrechts-University and University Hospital Schleswig-Holstein , Kiel , Germany"},{"name":"Department of Internal Medicine I, Christian-Albrechts-University and University Hospital Schleswig-Holstein , Kiel , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arne","family":"Lassen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Christian-Albrechts-University and University Hospital Schleswig-Holstein , Kiel , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanna","family":"Nikolaus","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Christian-Albrechts-University and University Hospital Schleswig-Holstein , Kiel , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silke","family":"Szymczak","sequence":"additional","affiliation":[{"name":"Institute for Medical Biometry and Statistics, University of Luebeck University Hospital Schleswig-Holstein , Luebeck , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana","family":"Kormilez","sequence":"additional","affiliation":[{"name":"Institute for Medical Biometry and Statistics, University of Luebeck University Hospital Schleswig-Holstein , Luebeck , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip","family":"Rosenstiel","sequence":"additional","affiliation":[{"name":"Institute of Clinical Molecular Biology, Christian-Albrechts-University and University Hospital Schleswig-Holstein , Kiel , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Schreiber","sequence":"additional","affiliation":[{"name":"Institute of Clinical Molecular Biology, Christian-Albrechts-University and University Hospital Schleswig-Holstein , Kiel , Germany"},{"name":"Department of Internal Medicine I, Christian-Albrechts-University and University Hospital Schleswig-Holstein , Kiel , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3482-7316","authenticated-orcid":false,"given":"Konrad","family":"Aden","sequence":"additional","affiliation":[{"name":"Institute of Clinical Molecular Biology, Christian-Albrechts-University and University Hospital Schleswig-Holstein , Kiel , Germany"},{"name":"Department of Internal Medicine I, Christian-Albrechts-University and University Hospital Schleswig-Holstein , Kiel , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6989-8002","authenticated-orcid":false,"given":"Christoph","family":"R\u00f6cken","sequence":"additional","affiliation":[{"name":"Department of Pathology, Christian-Albrechts-University and University Hospital Schleswig-Holstein , Kiel , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,10,25]]},"reference":[{"key":"2023040316012597300_","doi-asserted-by":"crossref","first-page":"1606","DOI":"10.1016\/S0140-6736(12)60150-0","article-title":"Ulcerative colitis","volume":"380","author":"Ord\u00e1s","year":"2012","journal-title":"Lancet"},{"key":"2023040316012597300_","doi-asserted-by":"crossref","first-page":"1713","DOI":"10.1056\/NEJMra1102942","article-title":"Ulcerative colitis","volume":"365","author":"Danese","year":"2011","journal-title":"N Engl J Med"},{"key":"2023040316012597300_","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1093\/gastro\/gou031","article-title":"Histological evaluation in ulcerative colitis","volume":"2","author":"DeRoche","year":"2014","journal-title":"Gastroenterol Rep 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