The DICA Endoscopic Classification for Diverticular Disease of the Colon Shows a Significant Interobserver Agreement among Community Endoscopists: an International Study.

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Publicated to:Journal Of Gastrointestinal And Liver Diseases. 28 (suppl. 4): 39-44 - 2019-12-01 28(suppl. 4), DOI: 10.15403/jgld-558

Authors: Tursi A; Brandimarte G; Di Mario F; Lanas A; Scarpignato C; Bafutto M; Barbara G; Bassotti G; Binda GA; Biondi A; Biondo S; Cassieri C; Crucitti A; Dumitrascu DL; Elisei W; Escalante R; Herszènyi L; Kruis W; Kupcinskas J; Lahat A; Lecca PG; Maconi G; Malfertheiner P; Mazzari A; Mearìn F; Milosavljeviċ T; Nardone G; Chavez De Oliveira E; Papa A; Papagrigoriadis S; Pera M; Persiani R; Picchio M; Regula J; Štimac D; Stollman N; Strate LL; Walker MM

Affiliations

- Author

2nd Department of Medicine, Semmelweis University, H-1088 Budapest, Hungary. herszenyi.laszlo@gmail.com. - Author

2nd Medical Department, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Romania. ddumitrascu@umfcluj.ro. - Author

Av, 470 - Hosp. Ort. de Goiania (St Aeroporto), Goiânia, Goiás (GO), Brazil. eco1.br@gmail.com. - Author

Clinical Centre of Serbia, University of Belgrade, Serbia. tommilos@hotmail.com. - Author

Consultório, R, 46 - 25 Clin de Gastroentero (St Coimbra) Goiânia, Goiás (GO), Brazil. maurobafutto@yahoo.com.br. - Author

Department of Clinical and Experimental Medicine, Gastroenterology and Hepatology Section, "Santa Maria della Misericordia" Hospital, University of Perugia, San Sisto (PG), Italy. gabassot@tin.it. - Author

Department of Clinical and Experimental Medicine, University "Federico II", Naples, Italy. nardone@unina.it. - Author

Department of Clinical Medicine, Section of Gastroenterology, "S. Orsola" Hospital, University of Bologna, Bologna, Italy. giovanni.barbara@unibo.it. - Author

Department of Colorectal Surgery, King's College Hospital, London, United Kingdom. lapasurgeon@gmail.com. - Author

Department of Gastroenterology, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan 52651, Israel. zokadi@gmail.com. - Author

Department of Gastroenterology, Hepatology and Clinical Oncology, Medical Postgraduate Education Centre; Department of Gastrointestinal Oncology, Maria Sklodowska-Curie Clinical Oncology Institute, Warsaw, Poland. jregula@coi.waw.pl. - Author

Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University Hospital, Magdeburg, Germany. peter.malfertheiner@med.ovgu.de. - Author

Department of Gastroenterology, Lithuanian University of Health Sciences, Kaunas, Lithuania. juozas.kupcinskas@lsmuni.lt. - Author

Department of General and Digestive Surgery, Colorectal Unit, Bellvitge University Hospital and IDIBELL, University of Barcelona, Barcelona, Spain. sbn.biondo@gmail.com. - Author

Department of Medicine and Surgery, Gastroenterology Unit, University of Parma, Parma, Italy. francesco.dimario@unipr.it. - Author

Department of Surgery, "Galliera" Hospital, Genoa, Italy. gianbinda1@me.com. - Author

Department of Surgical Sciences, First General Surgery Unit, Catholic University - "A. Gemelli" University Hospital, Rome, Italy. alberto.biondi@policlinicogemelli.it. - Author

Department of Surgical Sciences, First General Surgery Unit, Catholic University - "A. Gemelli" University Hospital, Rome, Italy. roberto.persiani@unicatt.it. - Author

Division of Gastroenterology, Alta Bates Summit Medical Center, East Bay Center for Digestive Health, 300 Frank H Ogawa Plaza, Oakland, CA, USA. neil@stollman.com. - Author

Division of Gastroenterology, ASL Roma 6, Albano Laziale (Roma), Italy. walter_elisei@hotmail.com. - Author

Division of Gastroenterology, Department of Medicine, Harborview Medical Center, University of Washington Medical School, Seattle, Washington, USA. lisas@medicine.washington.edu. - Author

Division of General Surgery, "Cristo Re" Hospital, Rome, Italy. and.mazzari@gmail.com. - Author

Division of General Surgery, "Cristo Re" Hospital, Rome, Italy. antonio.crucitti@unicatt.it. - Author

Division of General Surgery, "P. Colombo" Hospital, ASL Roma 6, Velletri (Roma), Italy. marcello.picchio.63@alice.it. - Author

Division of Internal Medicine and Gastroenterology, "Cristo Re" Hospital, Rome, Italy. claudio.cassieri@libero.it. - Author

Division of Internal Medicine and Gastroenterology, "Cristo Re" Hospital, Rome, Italy. giovannibrandimarte56@gmail.com. - Author

Division of Internal Medicine and Gastroenterology, "Cristo Re" Hospital, Rome, Italy. giusilecca76@yahoo.it. - Author

Division of Internal Medicine and Gastroenterology, C.I. "Columbus", Catholic University - "A. Gemelli" University Hospital, Rome, Italy. alfredo.papa@unicatt.it. - Author

Division of Internal Medicine, University Hospital, Rijeka, Croatia. davor.stimac@ri.t-com.hr. - Author

Faculty of Medical Sciences, United Campus of Malta, San Ġiljan, Malta. scarpi@tin.it. - Author

Gastroenterology Service, ASL BAT, Andria (BT), Italy. antotursi@tiscali.it. - Author

Gastrointestinal Unit, Department of Clinical Sciences, "L.Sacco" University Hospital, Milan, Italy. giovanni.maconi@unimi.it. - Author

Innere Medizin, Evangelische Krankenhaus Kalk, Cologne, Germany. wolfgang.kruis@googlemail.com. - Author

Sección de Cirugía Gastrointestinal, Hospital Universitari del Mar, Barcelona, Spain. mpera@hospitaldelmar.cat. - Author

Service of Digestive Diseases, University Clinic Hospital Lozano Blesa, University of Zaragoza, IIS Aragón, Zaragoza, Spain. angel.lanas@gmail.com. - Author

Servicio Aparato Digestivo, Centro Médico Teknon, Barcelona, Spain. mearin@dr.teknon.es. - Author

Universidad Central de Venezuela, Loira Medical Center, Caracas, Venezuela. r_escalanteg@hotmail.com. - Author

University of Newcastle, Faculty of Health and Medicine, School of Medicine and Public Health, Australian Gastrointestinal Research Alliance, Callaghan NSW 2308, Australia. marjorie.walker@newcastle.edu.au. - Author

Abstract

Background and aimsThe Diverticular Inflammation and Complication Assessment (DICA) endoscopic classification of diverticulosis and diverticular disease (DD) is currently available. It scores severity of the disease as DICA 1, DICA 2 and DICA 3. Our aim was to assess the agreement on this classification in an international endoscopists community setting.MethodsA total of 96 doctors (82.9% endoscopists) independently scored a set of DD endoscopic videos. The percentages of overall agreement on DICA score and a free-marginal multirater kappa (κ) coefficient were reported as statistical measures of interrater agreement.ResultsOverall agreement in using DICA was 91.8% with a free-marginal kappa of 88% (95% CI 80-95). The overall agreement levels were: DICA 1, 85.2%; DICA 2, 96.5%; DICA 3, 99.5%. The free marginal κ was: DICA 1 = 0.753, DICA 2 = 0.958, DICA 3 = 0.919. The agreement about the main endoscopic items was 83.4% (k 67%) for diverticular extension, 62.6% (k 65%) for number of diverticula for each district, 86.8% (k 82%) for presence of inflammation, and 98.5 (k 98%) for presence of complications.ConclusionsThe overall interrater agreement in this study ranges from good to very good. DICA score is a simple and reproducible endoscopic scoring system for diverticulosis and DD.

Keywords

Colonic diseasesColonoscopyCommunity health servicesDiverticular diseasesDiverticulosis, colonicHumansObserver variationReproducibility of resultsSeverity of illness indexVideo recording

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Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Journal Of Gastrointestinal And Liver Diseases due to its progression and the good impact it has achieved in recent years, according to the agency Scopus (SJR), it has become a reference in its field. In the year of publication of the work, 2019, it was in position , thus managing to position itself as a Q2 (Segundo Cuartil), in the category Medicine (Miscellaneous). Notably, the journal is positioned en el Cuartil Q4 for the agency WoS (JCR) in the category Gastroenterology & Hepatology.

From a relative perspective, and based on the normalized impact indicator calculated from the Field Citation Ratio (FCR) of the Dimensions source, it yields a value of: 1.46, which indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: Dimensions May 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-05-17, the following number of citations:

Europe PMC: 3
OpenCitations: 2

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Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: Australia; Brazil; Croatia; France; Germany; Hungary; Israel; Italy; Lithuania; Malt; Oman; Poland; Serbia; United Kingdom; United States of America; Venezuela.

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