Colorectal surveillance interval assignment based on in vivo prediction of polyp histology: impact of endoscopic quality improvement program

Coe, Susan G.; Thomas, Colleen S.; Crook, Julia E.; Ussui, Vivian; Diehl, Nancy N.; Wallace, Michael B.

doi:10.1016/j.gie.2012.03.007

Cited by 10 publications

(5 citation statements)

References 20 publications

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“…Significant improvements in the accuracy of diminutive colonic polyp (DCP) characterization have been demonstrated using advanced endoscopic imaging techniques (narrow-band imaging (NBI), i-Scan) following still image or video-based training interventions lasting 20 – 60 minutes 7 8 9 10 . In contrast, a similar study by Coe et al showed no significant improvement following two 1-hour training sessions on the use of NBI for SCP characterization 11 . The impact of training on high definition white light (HDWL) polyp characterization and its relative performance compared to advanced imaging techniques and chromoendoscopy has not been widely studied.…”

Section: Introductionmentioning

confidence: 75%

“…In contrast, a similar study by Coe et al examined the impact of two 1-hour training sessions on the use of NBI for small colon polyp characterization. They assessed the real-time in vivo characterization accuracy of 15 endoscopists who were split into those receiving training, and a control group, who did not receive training 11 . No significant improvement in prediction of polyp histology, or surveillance intervals, occurred following the training sessions.…”

Section: Discussionmentioning

confidence: 99%

“…In another study using i-Scan, participants achieved 94 % accuracy for the final set of study images 9 . Most other training studies have used NBI and reported that post-training accuracy levels vary from 80 % 11 18 to around 90 % 7 8 10 . Several factors could influence post-training accuracy: ability of participants to acquire new skills, effectiveness of the training module, imaging modality used, and difficulty of the test module.…”

Section: Discussionmentioning

confidence: 99%

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Endoscopic characterization of small colonic polyps: baseline performance of experienced endoscopists is no different to that of medical students

et al. 2019

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Background Studies examining the impact of training modules on characterization of diminutive colonic polyps (DCP) show varying results. Aim We aimed to assess the impact of a novel web-based training module on the accuracy of in vivo characterization of DCPs using different imaging modalities. Differences between groups with varying degrees of endoscopic experience were also assessed. Methods In total, 90 images of 30 DCPs viewed with high definition white light (HDWL), i-Scan, and indigo carmine chromoendoscopy were included in an online test module. Testing was undertaken before and after completing a novel web-based in vivo characterization training module. In total, 21 subjects (medical students (MS), gastroenterology trainees (GT), and gastroenterology consultants (GC)) undertook the tests and training module. Results No statistically significant difference in overall accuracy was found between the three groups either pre- (MS 59.1 %, GR 65.7 %, GC 62.4 %, P = ns for all three comparisons) or post-training (MS 69.2 %, GR 71.1 %, GC 71.3 %, P = ns for all three comparisons). Accuracy improved significantly for all three groups post-training (P < 0.001) as did interobserver agreement. No significant differences in accuracy between modalities were found pre-training (HDWL 64.8 %, i-Scan 60.0 %, chromoendoscopy 62.2 %, P = ns). Post-training accuracy with HDWL and chromoendoscopy was better than with i-Scan (HDWL 72.9 % vs i-Scan 65.1 %, P = 0.002; i-Scan 65.1 % vs chromoendoscopy 73.7 %, P < 0.001). The proportion of high confidence predictions increased from 25.7 % to 41.5 %, with a high confidence prediction accuracy of 81.7 %. Conclusions Skills for in vivo characterization of DCPs are not acquired through endoscopic experience alone. A novel web-based training intervention results in modest improvements in accuracy with further improvements likely to require more prolonged training.

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Section: Introductionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Endoscopic characterization of small colonic polyps: baseline performance of experienced endoscopists is no different to that of medical students

et al. 2019

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“…Unfortunately, conventional white light endoscopy (WLE) has limited accuracy for predicting the histology of adenomas . With the recent progress of colonoscopy techniques, image‐enhanced endoscopy modalities, in particular non‐magnified narrow‐band imaging (NBI), have shown a high accuracy in the optical prediction of adenomas . Therefore, NBI can conceivably avoid unnecessary histological examination and the subsequent in vivo endoscopic assessment.…”

Section: Introductionmentioning

confidence: 99%

“…With strict implementation standards, many studies have been conducted to investigate the efficacy of NBI in the diagnosis of small polyps across the USA and Europe, with most of them reaching the implementation standard in academic centers. Meanwhile, training modules for NBI application have been designed, and diagnostic classifications using NBI have been proposed for the implementation of the “resect and discard” policy. The main classifications used are the NBI International Colorectal Endoscopic (NICE) classification, the vascular pattern intensity (VPI), and the simplified Kudo pit pattern …”

Section: Introductionmentioning

confidence: 99%

Feasibility of using narrow band imaging international colorectal endoscopic classification for diagnosing colorectal neoplasia in China: A multicenter pilot observational study

Zhang

Yang

et al. 2020

J of Digest Diseases

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Objective We aimed to investigate whether Chinese endoscopists without narrow‐band imaging (NBI) experiences could achieve high accuracy in the real‐time diagnosis of colorectal polyps using NBI International Colorectal Endoscopic (NICE) classification after web‐based training. Methods Altogether 15 endoscopists from five centers with no NBI experiences followed a short, web‐based training program on the NICE classification and took web‐based test. Their performances were compared with 15 matched experienced endoscopists with no NBI experience who received no NBI training. These 15 trained endoscopists then made real‐time diagnoses of colorectal neoplasia. A logistic regression was used to assess potential predictors of diagnostic performance. Results Compared with those who received no training, trained endoscopists achieved comparable overall accuracy (85.3% vs 83.1%, P = 0.408) and accuracy at a high‐confidence level (87.0% vs 86.0%, P = 0.670), but had a higher confidence rate (86.1% vs 83.7%, P = 0.004) for the diagnosis of neoplasia. Real‐time diagnostic accuracy, sensitivity and specificity were 94.3% (95% confidence interval [CI] 91.5%‐96.2%), 96.2% (95% CI 93.4%‐97.9%) and 85.3% (95% CI 74.8%‐92.1%) at high‐confidence level. The high‐confidence level was the strongest predictor of real‐time diagnostic accuracy (odds ratio 12.66, P < 0.001). Conclusions Web‐based training can improve the confidence level of endoscopists in accurately diagnosing colorectal polyps using the NICE classification. Chinese endoscopists can achieve high accuracy in diagnosing colorectal neoplasia at a high confidence level (ClinicalTrials ID: NCT02033980).

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Management of Diminutive Colon Polyps Based on Endoluminal Imaging

Lieberman

Brill

Canto

et al. 2015

Clinical Gastroenterology and Hepatology

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Colorectal surveillance interval assignment based on in vivo prediction of polyp histology: impact of endoscopic quality improvement program

Cited by 10 publications

References 20 publications

Endoscopic characterization of small colonic polyps: baseline performance of experienced endoscopists is no different to that of medical students

Endoscopic characterization of small colonic polyps: baseline performance of experienced endoscopists is no different to that of medical students

Feasibility of using narrow band imaging international colorectal endoscopic classification for diagnosing colorectal neoplasia in China: A multicenter pilot observational study

Management of Diminutive Colon Polyps Based on Endoluminal Imaging

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