UNASSIGNED: Background and study aims: The Lewis score was developed to measure mucosal inflammatory activity as detected by small-bowel capsule endoscopy (SBCE). The aim of the current study was to validate the Lewis score by assessing interobserver correlation and level of agreement in a clinical setting. @entity1 and methods: This was a retrospective, single-center, double-blind study including @entity1 with isolated small-bowel @entity30 who underwent SBCE. The Lewis score was calculated using a software application, based on the characteristics of @entity4 , @entity1066 , and stenoses. The Lewis score was independently calculated by one of three investigators and by a central reader (gold standard). Interobserver agreement was assessed using intraclass correlation (ICC) coefficient and Bland-Altman plots. Results: A total of 70 @entity1 were consecutively included (mean age 33.9  11.7 years). The mean Lewis score was 1265 and 1320 for investigators and the central reader, respectively. There was a high correlation, both for scores obtained for each tertile (first tertile r=0.659-0.950, second tertile r=0.756-0.906, third tertile r=0.750-0.939), and for the global score (r=0.745-0.928) (P<0.0001). Interobserver agreement was almost perfect between the investigators and the central reader (first tertile ICC=0.788-0.971, second tertile ICC=0.824-0.943, third tertile ICC=0.857-0.968, global score ICC=0.852-0.960; P<0.0001). The inflammatory activity was classified as normal (score<135) in 2.9% vs. 2.9%, mild (score>= 135-<790) in 51.4% vs. 55.7%, and moderate to severe (score>= 790) in 45.8% vs. 41.4% of @entity1 , respectively (P<0.001). Conclusion: A strong interobserver agreement was demonstrated for the determination of the Lewis score in a practical clinical setting, validating this score for the reporting of small-bowel inflammatory activity. The Lewis score might be used for diagnosing, staging, follow-up, and therapeutic assessment of @entity1 with isolated small-bowel @entity30 .

Validation of the Lewis score for the evaluation of small-bowel XXXX activity.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity4 :: ('MESH:D004487', 'Disease') :: ['villous edema'] @entity1066 :: ('MESH:D014456', 'Disease') :: ['ulcers'] @entity30 :: ('MESH:D003424', 'Disease') :: ["Crohn's disease"]
@entity30 :: (MESH:D003424,Disease) :: ['Crohn's disease']
