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Related Experiment Videos

The Leech method for diagnosing constipation: intra- and interobserver variability and accuracy.

Fleur de Lorijn1, Rick R van Rijn, Jarom Heijmans

  • 1Department of Paediatric Gastroenterology and Nutrition, Emma Children's Hospital, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands f.delorijn@amc.uva.nl

Pediatric Radiology
|November 12, 2005
PubMed
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The Leech method for assessing childhood constipation shows significant variability among scorers and poor diagnostic accuracy. This scoring system is of limited value for diagnosing functional constipation in children.

Area of Science:

  • Pediatric Gastroenterology
  • Diagnostic Imaging
  • Clinical Assessment

Background:

  • Plain abdominal radiographs are inconsistently valued for diagnosing childhood constipation.
  • A new radiographic scoring system, the Leech method, has shown potential for assessing fecal loading.

Purpose of the Study:

  • To evaluate the intra- and interobserver variability of the Leech method.
  • To determine the diagnostic accuracy of the Leech method in identifying functional constipation (FC) in children.

Main Methods:

  • 89 children with functional gastrointestinal disorders were analyzed.
  • Three scorers assessed abdominal radiographs twice using the Leech method.
  • ROC analysis determined diagnostic accuracy for differentiating FC from controls.

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Main Results:

  • Significant intraobserver variability was noted for two scorers (P=0.005 and P<0.0001).
  • Scores between scorers showed systematic differences and large variability.
  • The Leech method demonstrated poor diagnostic accuracy with an area under the ROC curve of 0.68.

Conclusions:

  • The Leech scoring method has limited value in diagnosing functional constipation in children.
  • The method exhibits significant variability and poor diagnostic performance.