Evaluation of an e-learning system for diagnosis of gastric lesions using magnifying narrow-band imaging: a multicenter randomized controlled study

Abstract

Magnifying narrow-band imaging (M-NBI) is useful for the accurate diagnosis of early gastric cancer (EGC). However, acquiring skill at M-NBI diagnosis takes substantial effort. An Internet-based e-learning system to teach endoscopic diagnosis of EGC using M-NBI has been developed. This study evaluated its effectiveness. This study was designed as a multicenter randomized controlled trial. We recruited endoscopists as participants from all over Japan. After completing Test 1, which consisted of M-NBI images of 40 gastric lesions, participants were randomly assigned to the e-learning or non-e-learning groups. Only the e-learning group was allowed to access the e-learning system. After the e-learning period, both groups received Test 2. The analysis set was participants who scored< 80 % accuracy on Test 1. The primary end point was the difference in accuracy between Test 1 and Test 2 for the two groups. A total of 395 participants from 77 institutions completed Test 1 (198 in the e-learning group and 197 in the non-e-learning group). After the e-learning period, all 395 completed Test 2. The analysis sets were e-learning group: n = 184; and non-e-learning group: n = 184. The mean Test 1 score was 59.9 % for the e-learning group and 61.7 % for the non-e-learning group. The change in accuracy in Test 2 was significantly higher in the e-learning group than in the non-e-learning group (7.4 points vs. 0.14 points, respectively; < 0.001). This study clearly demonstrated the efficacy of the e-learning system in improving practitioners' capabilities to diagnose EGC using M-NBI.Trial registered at University Hospital Medical Information Network Clinical Trials Registry (UMIN000008569).

Short educational video to improve the accuracy of colorectal polyp size estimation: Multicenter prospective study

“…The range of confidence intervals was calculated based on the results of each participant. The multivariable logistic regression analysis of factors that contributed to an increase of ≥10% in the accuracy was conducted based on classification of endoscopists (non‐beginners or beginners), sex (male or female), total number of endoscopies conducted, number of endoscopies conducted in the last year, pretest score (30 points at maximum), and number of views of the educational video 15. In the logistic regression analysis, regression coefficients (β) were also calculated to facilitate comparison of each factor.…”

Curriculum for optical diagnosis training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

“…Multiple online training courses have however been developed. Two image-based studies demonstrated the efficacy of dedicated online training courses in improving practitioners' abilities to distinguish between gastric cancer and non-cancer using magnifying NBI with the validated VS classification [49,50]. Another study with high definition NBI videos showed a 10 % increase in global accuracy after an online training course on a simplified NBI classification [52].…”

Training for Advanced Endoscopic Imaging in Gastrointestinal Diseases

“…In upper gastrointestinal (GI) endoscopy, learning curves of VC are investigated in various settings, such as the assessment of BE and esophageal and gastric lesions. [13][14][15][16][17][18][19][20] One study investigated the learning curve of BE assessment using magnified NBI (M-NBI) in endoscopists with-and without previous M-NBI experience. 15 Before the onset of the study, the participants underwent a structured learning program and received histological feedback after every assessed video.…”