Jacques J G H M Bergman1, A Jeroen de Groof2, O Pech3, K Ragunath4, D Armstrong5, N Mostafavi6, L Lundell7, J Dent8, M Vieth9, G N Tytgat2, P Sharma10. 1. Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. Electronic address: j.j.bergman@amc.uva.nl. 2. Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. 3. Gastroenterology and Interventional Endoscopy, Krankenhaus Barmherzige Brüder, Regensburg, Germany. 4. Nottingham Digestive Diseases Centre, University of Nottingham and National Institute for Health Research, Nottingham Biomedical Research Centre, Nottingham University Hospitals National Health Service Trust, Nottingham, UK. 5. Division of Gastroenterology, McMaster University Medical Centre, Hamilton, Ontario, Canada. 6. Biostatistical Unit, Department of Gastroenterology and Hepatology, Academic Medical Center Amsterdam, University of Amsterdam, Amsterdam, The Netherlands. 7. Department of Surgery, Clinical Science Intervention and Technology, Karolinska Institutet, Stockholm, Sweden. 8. Department of Medicine, University of Adelaide and Royal Adelaide Hospital, Adelaide, South Australia. 9. Institute of Pathology, Otto-von-Guericke University, Magdeburg, Germany. 10. Department of Veterans Affairs Medical Center, University of Kansas School of Medicine, Kansas City, Kansas.
Abstract
BACKGROUND & AIMS: Endoscopic detection of early Barrett's esophagus-related neoplasia (BORN) is a challenge. We aimed to develop a web-based teaching tool for improving detection and delineation of BORN. METHODS: We made high-definition digital videos during endoscopies of patients with BORN and non-dysplastic Barrett's esophagus. Three experts superimposed their delineations of BORN lesions on the videos using special tools. In phase one, 68 general endoscopists from 4 countries assessed 4 batches of 20 videos. After each batch, mandatory feedback compared the assessors' interpretations with those from experts. These data informed the selection of 25 videos for the phase 2 module, which was completed by 121 new assessors from 5 countries. A 5-video test batch was completed before and after scoring of the four 5-video training batches. Mandatory feedback was as in phase 1. Outcome measures were scores for detection, delineation, agreement delineation, and relative delineation of BORN. RESULTS: A linear mixed-effect model showed significant sequential improvement for all 4 outcomes over successive training batches in both phases. In phase 2, median detection rates of BORN in the test batch increased by 30% (P < .001) after training. From baseline to the end of the study, there were relative increases in scores of 46% for detection, 129% for delineation, 105% for agreement delineation, and 106% for relative delineation (all, P < .001). Scores improved independent of assessors' country of origin or level of endoscopic experience. CONCLUSIONS: We developed a web-based teaching tool for endoscopic recognition of BORN that is easily accessible, efficient, and increases detection and delineation of neoplastic lesions. Widespread use of this tool might improve management of Barrett's esophagus by general endoscopists.
RCT Entities:
BACKGROUND & AIMS: Endoscopic detection of early Barrett's esophagus-related neoplasia (BORN) is a challenge. We aimed to develop a web-based teaching tool for improving detection and delineation of BORN. METHODS: We made high-definition digital videos during endoscopies of patients with BORN and non-dysplastic Barrett's esophagus. Three experts superimposed their delineations of BORN lesions on the videos using special tools. In phase one, 68 general endoscopists from 4 countries assessed 4 batches of 20 videos. After each batch, mandatory feedback compared the assessors' interpretations with those from experts. These data informed the selection of 25 videos for the phase 2 module, which was completed by 121 new assessors from 5 countries. A 5-video test batch was completed before and after scoring of the four 5-video training batches. Mandatory feedback was as in phase 1. Outcome measures were scores for detection, delineation, agreement delineation, and relative delineation of BORN. RESULTS: A linear mixed-effect model showed significant sequential improvement for all 4 outcomes over successive training batches in both phases. In phase 2, median detection rates of BORN in the test batch increased by 30% (P < .001) after training. From baseline to the end of the study, there were relative increases in scores of 46% for detection, 129% for delineation, 105% for agreement delineation, and 106% for relative delineation (all, P < .001). Scores improved independent of assessors' country of origin or level of endoscopic experience. CONCLUSIONS: We developed a web-based teaching tool for endoscopic recognition of BORN that is easily accessible, efficient, and increases detection and delineation of neoplastic lesions. Widespread use of this tool might improve management of Barrett's esophagus by general endoscopists.
Authors: M R Struyvenberg; A J de Groof; A Kahn; B L A M Weusten; D E Fleischer; E K Ganguly; V J A Konda; C J Lightdale; D K Pleskow; A Sethi; M S Smith; A J Trindade; M B Wallace; H C Wolfsen; G J Tearney; S L Meijer; C L Leggett; J J G H M Bergman; W L Curvers Journal: Dis Esophagus Date: 2020-12-07 Impact factor: 3.429
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Authors: Sanne van Munster; Esther Nieuwenhuis; Bas L A M Weusten; Lorenza Alvarez Herrero; Auke Bogte; Alaa Alkhalaf; B E Schenk; Erik J Schoon; Wouter Curvers; Arjun D Koch; Steffi Elisabeth Maria van de Ven; Pieter Jan Floris de Jonge; Tjon J Tang; Wouter B Nagengast; Frans T M Peters; Jessie Westerhof; Martin H M G Houben; Jacques Jghm Bergman; Roos E Pouw Journal: Gut Date: 2021-03-22 Impact factor: 23.059