{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T11:19:43Z","timestamp":1789816783278,"version":"4.0.1"},"reference-count":20,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T00:00:00Z","timestamp":1743033600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003130","name":"Fonds Wetenschappelijk Onderzoek","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003130","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002347","name":"Bundesministerium f\u00fcr Bildung und Forschung","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002347","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001711","name":"Schweizerischer Nationalfonds zur F\u00f6rderung der Wissenschaftlichen Forschung","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004784","name":"Novartis Stiftung\u00a0f\u00fcr\u00a0Medizinisch-Biologische Forschung","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004784","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and Study Aims<\/jats:title><jats:p>Probe\u2010based confocal laser endomicroscopy (pCLE) enables real\u2010time microscopic visualization of the duodenal mucosa and has shown acute food\u2013triggered disruption of the duodenal epithelial barrier of patients with irritable bowel syndrome (IBS). The interpretation of the recordings is subjective, with unknown agreement rates. The aim of this study was to investigate the intra\u2010 and interobserver variability of this technique.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p>An international multicenter study was performed, including pCLE recordings from three centers. Recordings were randomized and re\u2010evaluated by five blinded experienced assessors. Low\u2010quality recordings were excluded. The mucosa was considered altered if both fluorescein leakage and luminal particles were observed. Agreement was quantified using Fleiss' and Cohen's kappa (<jats:italic>\u03ba<\/jats:italic>). Reference videos (i.e., videos with 100% agreement) were used to assess the optimal characteristics of videos needed to make a judgment based on the optimal receiver operating characteristic curve cutoff.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 119 individual recordings, 87 could be used for analyses (total of 86,408 frames). Intraindividual agreement rate was 80%\u2013100%, whereas the interindividual agreement rate was 85% (<jats:italic>\u03ba<\/jats:italic>\u2009=\u20090.68). The agreement rate with the endoscopist ranged 54%\u201395% (<jats:italic>\u03ba<\/jats:italic>\u2009=\u20090.15\u20130.89). The optimal cutoff to distinguish altered from unaltered was by observing alterations in \u2265\u20092 out of 6 mucosal spots (100% sensitivity and specificity).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study showed a substantial to perfect intraobserver agreement and a substantial interobserver agreement for the judgment of acute food\u2010triggered disruption of the duodenal epithelial barrier by pCLE, confirming that this real\u2010time readout is reliable and reproducible.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.70031","type":"journal-article","created":{"date-parts":[[2025,3,30]],"date-time":"2025-03-30T06:31:52Z","timestamp":1743316312000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Intra\u2010 and Interobserver Variability of Acute Food\u2013Induced Reactions During Confocal Laser Endomicroscopy: An International Multicenter Validation Study"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7399-8500","authenticated-orcid":false,"given":"Lukas Michaja","family":"Balsiger","sequence":"first","affiliation":[{"name":"Translational Research Center for Gastrointestinal Disorders KU Leuven  Leuven Belgium"},{"name":"Department for Biomedical Research University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"van Gils","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine Institute of Medicine, Sahlgrenska Academy, University of Gothenburg  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaser","family":"Hatem","sequence":"additional","affiliation":[{"name":"University of Luebeck Institute of Nutritional Medicine University Hospital of Schleswig\u2010Holstein, Campus L\u00fcbeck and University of L\u00fcbeck  L\u00fcbeck Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Blomsten","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine Institute of Medicine, Sahlgrenska Academy, University of Gothenburg  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0520-4734","authenticated-orcid":false,"given":"Karlien","family":"Raymenants","sequence":"additional","affiliation":[{"name":"Translational Research Center for Gastrointestinal Disorders KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cedric","family":"Van de Bruaene","sequence":"additional","affiliation":[{"name":"Translational Research Center for Gastrointestinal Disorders KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila","family":"Juvyns","sequence":"additional","affiliation":[{"name":"Translational Research Center for 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