Hanbing Xue1, Shuai Gong1, Yufeng Shen1, Honghong Tan1, Mitsuhiro Fujishiro2, Jun Dai1, Yunjia Zhao1, Zhizheng Ge3. 1. Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai Institute of Digestive Disease, Shanghai, China. 2. Department of Endoscopy and Endoscopic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. 3. Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai Institute of Digestive Disease, Shanghai, China. Electronic address: zhizhengge@aliyun.com.
Abstract
BACKGROUND: Magnifying narrow-band imaging using intra-epithelial papillary capillary loop analysis has been confirmed as a promising diagnostic modality for oesophageal lesions. Little is known about its learning curve. AIM: To evaluate the effect of a training programme on the diagnosis of oesophageal lesions by different modalities among endoscopists of varying experience. METHODS: We divided endoscopists into three groups based on their experience. A 2-h training programme on magnifying narrow-band imaging and intra-epithelial papillary capillary loop patterns was provided to trainees. They evaluated the test images and suggested diagnoses both before and after training. Diagnostic accuracy and interobserver agreement of three modalities were analysed. RESULTS: The diagnostic accuracies of magnifying narrow-band imaging for differentiating oesophageal neoplastic lesions and predicting lesion depth were significantly improved in less-experienced (92.8% vs. 55.9%, 63.8% vs. 17.5%) and non-experienced endoscopist groups (84.2% vs. 47.4%, 50% vs. 10%), and kappa (κ) values for both groups achieved good agreement after training (0.76 vs. 0.43, 0.68 vs. 0.24, respectively), all P<0.05. CONCLUSION: Magnifying narrow-band imaging could be learnt easily and rapidly by beginners. For diagnosis of oesophageal neoplastic lesions, our training programme improved the diagnostic skill of less-experienced endoscopists to the level of highly experienced endoscopists.
BACKGROUND: Magnifying narrow-band imaging using intra-epithelial papillary capillary loop analysis has been confirmed as a promising diagnostic modality for oesophageal lesions. Little is known about its learning curve. AIM: To evaluate the effect of a training programme on the diagnosis of oesophageal lesions by different modalities among endoscopists of varying experience. METHODS: We divided endoscopists into three groups based on their experience. A 2-h training programme on magnifying narrow-band imaging and intra-epithelial papillary capillary loop patterns was provided to trainees. They evaluated the test images and suggested diagnoses both before and after training. Diagnostic accuracy and interobserver agreement of three modalities were analysed. RESULTS: The diagnostic accuracies of magnifying narrow-band imaging for differentiating oesophageal neoplastic lesions and predicting lesion depth were significantly improved in less-experienced (92.8% vs. 55.9%, 63.8% vs. 17.5%) and non-experienced endoscopist groups (84.2% vs. 47.4%, 50% vs. 10%), and kappa (κ) values for both groups achieved good agreement after training (0.76 vs. 0.43, 0.68 vs. 0.24, respectively), all P<0.05. CONCLUSION: Magnifying narrow-band imaging could be learnt easily and rapidly by beginners. For diagnosis of oesophageal neoplastic lesions, our training programme improved the diagnostic skill of less-experienced endoscopists to the level of highly experienced endoscopists.