In-class didactic versus self-directed teaching of the probe-based confocal laser endomicroscopy (pCLE) criteria for Barrett’s esophagus

Rzouq, Fadi; Vennalaganti, Prashanth; Pakseresht, Kavous; Kanakadandi, Vijay; Parasa, Sravanthi; Mathur, Sharad C.; Alsop, Benjamin R.; Hornung, Benjamin; Gupta, Neil; Sharma, Prateek

doi:10.1055/s-0034-1393118

Cited by 14 publications

(18 citation statements)

References 7 publications

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“…10,11,[13][14][15] interobserver agreement relative to their counterparts receiving self-directed learning. 19,21 We assessed the impact of feedback among the sixteen study observers by Barrett's esophagus showed that following feedback, the overall diagnostic accuracy for dysplasia using pCLE image criteria significantly improved in both didactic and self-directed learning groups. 19 While other similar studies did not find a significant improvement in the accuracy of diagnosis or interobserver agreement following a feedback session for participants, their sample sizes were small, consisting of less than 10 total participants.…”

Section: Discussionmentioning

confidence: 99%

Confocal Laser Endomicroscopy Interpretation and Differentiation of Pancreatic Cysts: A Randomized Trial of Teaching Modalities

Luthra

Pusateri

Pfeil

et al. 2021

Techniques and Innovations in Gastrointestinal Endoscopy

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Section: Discussionmentioning

confidence: 99%

Confocal Laser Endomicroscopy Interpretation and Differentiation of Pancreatic Cysts: A Randomized Trial of Teaching Modalities

Luthra

Pusateri

Pfeil

et al. 2021

Techniques and Innovations in Gastrointestinal Endoscopy

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“…The reproducibility of luminal CLE parameters has been extensively studied for Barrett’s esophagus, IBD and colorectal polyps. In general, the results have been suitable for a clinical setting with acceptable inter- and intra-observer values 26 27 28 29 30 31 . Recently, the nCLE criteria for pancreatic cystic neoplasms have been evaluated.…”

Section: Discussionmentioning

confidence: 85%

Endoscopic ultrasound guided needle-based confocal laser endomicroscopy in solid pancreatic masses – a prospective validation study

et al. 2018

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Background and study aims Endoscopic ultrasound fine-needle aspiration (EUS-FNA) is a keystone in diagnosing and staging of pancreatic masses. Recently, a microfiber that can pass through a 19-gauge needle has been introduced for confocal laser endomicroscopy (nCLE). The aims of this study were to evaluate the diagnostic value and the reproducibility of nCLE criteria for solid malignant lesions. Patients and methods This prospective dual-center study included patients with pancreatic masses suspicious of malignancy referred for EUS-FNA. Endomicroscopic imaging was performed under EUS-guidance until organ-specific structures were obtained. Afterwards, standard cytology was obtained and patients were followed for up to 12 months. All nCLE parameters included in former studies were correlated with the final diagnosis (dark lobular structures/normal acinar cells, dark cell aggregates > 40 µm, dilated irregular vessels with fluorescein leakage, fine white fibrous bands, small black cell movements, pseudoglandular structures). Finally, three CLE novices and three CLE experts assessed the unedited movies from all patients. Results Twenty-eight patients were enrolled in the study. A final diagnosis was obtained in 24 patients (86 %). One patient (3 %) died before a diagnosis was obtained, while 3 were lost to follow-up (11 %). In 18/24 patients (74 %) the diagnosis was malignant. The mean sensitivity, specificity, and accuracy for the nCLE parameters ranged from 19 – 93 %, 0 – 56 %, 26 – 69 %, respectively. The inter-observer values ranged from κ = 0.20 – 0.41 for novices and κ = –0.02 – 0.38 for experts. Conclusions The diagnostic value of nCLE in solid pancreatic masses is questionable and the inter-observer agreement for both novices and CLE experts appears limited.

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“…In learning to characterize Barrett's esophagus, randomized controlled trials have found no difference between inclassroom training and self-directed training programs for learning to use NBI, but found superiority of inclassroom training when learning to use CLE. 18,19 It remains unclear whether training requirements are different based on the imaging technology or disease application. What is clear is that every person's learning modality of choice and uptake are different.…”

Section: Trainingmentioning

confidence: 99%

AGA White Paper: Training and Implementation of Endoscopic Image Enhancement Technologies

Gupta

Brill

Canto

et al. 2017

Clinical Gastroenterology and Hepatology

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Endoscopic image-enhancement technologies provide opportunities to visualize normal and abnormal tissues within the gastrointestinal (GI) tract in a manner that complements conventional white light endoscopic imaging. The additional information that is obtained enables the endoscopist to better identify, delineate, and characterize lesions and can facilitate targeted biopsies or, in some cases, eliminate the need to send samples for histologic analysis. Some of these technologies have been available for more than a decade, but despite this fact, there is limited use of these technologies by endoscopists. Lack of formalized training in their use and a scarcity of guidelines on implementation of these technologies into clinical practice are contributing factors. In November 2014, the American Gastroenterological Association's Center for GI Innovation and Technology conducted a 2-day workshop to discuss endoscopic image-enhancement technologies. This article represents the third of 3 separate documents generated from the workshop and discusses the published literature pertaining to training and outlines a proposed framework for the implementation of endoscopic image-enhancement technologies in clinical practice. There was general agreement among participants in the workshop on several key considerations. Training and competency assessment for endoscopic image-enhancement technologies should incorporate competency-based education paradigms. To facilitate successful training, multiple different educational models that can cater to variations in learning styles need to be developed, including classroom-style and self-directed programs, in-person and web-based options, image and video atlases, and endoscopic simulator programs. To ensure safe and appropriate use of these technologies over time, refresher courses, skill maintenance programs, and options for competency reassessment should be established. Participants also generally agreed that although early adopters of novel endoscopic image-enhancement modalities can successfully implement these technologies by pursuing training and ensuring self-competency, widespread implementation is likely to require support from GI societies and buy-in from other key stakeholders including payors/purchasers and patients. Continued work by manufacturers and the GI societies in providing training programs and patient education, working with payors and purchasers, and creating environments and policies that motivate endoscopists to adopt new practices is essential in creating widespread implementation.

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In-class didactic versus self-directed teaching of the probe-based confocal laser endomicroscopy (pCLE) criteria for Barrett’s esophagus

Cited by 14 publications

References 7 publications

Confocal Laser Endomicroscopy Interpretation and Differentiation of Pancreatic Cysts: A Randomized Trial of Teaching Modalities

Confocal Laser Endomicroscopy Interpretation and Differentiation of Pancreatic Cysts: A Randomized Trial of Teaching Modalities

Endoscopic ultrasound guided needle-based confocal laser endomicroscopy in solid pancreatic masses – a prospective validation study

AGA White Paper: Training and Implementation of Endoscopic Image Enhancement Technologies

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