Amit Rastogi1, Deepthi S Rao2, Neil Gupta3, Scott W Grisolano4, Daniel C Buckles4, Elena Sidorenko4, John Bonino4, Takahisa Matsuda5, Evelien Dekker6, Tonya Kaltenbach7, Rajvinder Singh8, Sachin Wani9, Prateek Sharma1, Mojtaba S Olyaee4, Ajay Bansal1, James E East10. 1. Department of Gastroenterology, Veterans Affairs Medical Center, Kansas City, Missouri, United States; Department of Gastroenterology, University of Kansas School of Medicine, Kansas City, Kansas, United States. 2. Department of Pathology, University of Kansas School of Medicine, Kansas City, Kansas, United States. 3. Department of Gastroenterology, Loyola University Medical Center, Maywood, Illinois, United States. 4. Department of Gastroenterology, University of Kansas School of Medicine, Kansas City, Kansas, United States. 5. Department of Gastroenterology, National Cancer Center Hospital, Tokyo, Japan. 6. Gastroenterology, Academic Medical Center, Amsterdam, The Netherlands. 7. Department of Gastroenterology, Veterans Affairs Medical Center Palo Alto, Stanford University School of Medicine, Palo Alto, California, United States. 8. Department of Gastroenterology, Lyell McEwin Hospital, Elizabeth Vale, SA, Australia. 9. Department of Gastroenterology, University of Colorado, Denver, Colorado, United States. 10. Department of Gastroenterology, John Radcliffe Hospital, Oxford, United Kingdom.
Abstract
BACKGROUND: Experts can accurately characterize the histology of diminutive polyps with narrow-band imaging (NBI). There are limited data on the performance of non-experts. OBJECTIVE: To assess the impact of a computer-based teaching module on the accuracy of predicting polyp histology with NBI by non-experts (in academics and community practice) by using video clips. DESIGN: Prospective, observational study. SETTING: Academic and community practice. PARTICIPANTS: A total of 15 gastroenterologists participated-5 experts in NBI, 5 non-experts in academic practice, and 5 non-experts in community practice. INTERVENTION: Participants reviewed a 20-minute, computer-based teaching module outlining the different NBI features for hyperplastic and adenomatous polyps. MAIN OUTCOME MEASUREMENTS: Performance characteristics in characterizing the histology of diminutive polyps with NBI by using short video clips before (pretest) and after (posttest) reviewing the teaching module. RESULTS: Non-experts in academic practice showed a significant improvement in the sensitivity (54% vs 79%; P < .001), accuracy (64% vs 81%; P < .001), and proportion of high-confidence diagnoses (49% vs 69%; P < .001) in the posttest. Non-experts in community practice had significantly higher sensitivity (58% vs 75%; P = .004), specificity (76% vs 90%; P = .04), accuracy (64% vs 81%; P < .001), and proportion of high-confidence diagnoses (49% vs 72%; P < .001) in the posttest. Performance of experts in NBI was significantly better than non-experts in both academic and community practice. LIMITATIONS: Selection bias in selecting good quality videos. Performance not assessed during live colonoscopy. CONCLUSION: Academic and community gastroenterologists without prior experience in NBI can achieve significant improvements in characterizing diminutive polyp histology after a brief computer-based training. The durability of these results and applicability in everyday practice are uncertain. Published by Mosby, Inc.
BACKGROUND: Experts can accurately characterize the histology of diminutive polyps with narrow-band imaging (NBI). There are limited data on the performance of non-experts. OBJECTIVE: To assess the impact of a computer-based teaching module on the accuracy of predicting polyp histology with NBI by non-experts (in academics and community practice) by using video clips. DESIGN: Prospective, observational study. SETTING: Academic and community practice. PARTICIPANTS: A total of 15 gastroenterologists participated-5 experts in NBI, 5 non-experts in academic practice, and 5 non-experts in community practice. INTERVENTION: Participants reviewed a 20-minute, computer-based teaching module outlining the different NBI features for hyperplastic and adenomatous polyps. MAIN OUTCOME MEASUREMENTS: Performance characteristics in characterizing the histology of diminutive polyps with NBI by using short video clips before (pretest) and after (posttest) reviewing the teaching module. RESULTS: Non-experts in academic practice showed a significant improvement in the sensitivity (54% vs 79%; P < .001), accuracy (64% vs 81%; P < .001), and proportion of high-confidence diagnoses (49% vs 69%; P < .001) in the posttest. Non-experts in community practice had significantly higher sensitivity (58% vs 75%; P = .004), specificity (76% vs 90%; P = .04), accuracy (64% vs 81%; P < .001), and proportion of high-confidence diagnoses (49% vs 72%; P < .001) in the posttest. Performance of experts in NBI was significantly better than non-experts in both academic and community practice. LIMITATIONS: Selection bias in selecting good quality videos. Performance not assessed during live colonoscopy. CONCLUSION: Academic and community gastroenterologists without prior experience in NBI can achieve significant improvements in characterizing diminutive polyp histology after a brief computer-based training. The durability of these results and applicability in everyday practice are uncertain. Published by Mosby, Inc.
Authors: Pushpak Taunk; Christopher D Atkinson; David Lichtenstein; Eladio Rodriguez-Diaz; Satish K Singh Journal: Int J Colorectal Dis Date: 2019-11-06 Impact factor: 2.571
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