Self-Formation Assessed by Cumulative Summation Test Does Not Reach Recommended Thresholds for Optical Diagnosis of Colorectal Polyps ≤ 7 mm

Abstract

Self-formation after a single training session did not allow most evaluators to reach the required accuracy. LC-CUSUM tests did not identify competent evaluators. Despite these results, 86.7% of follow-up intervals would have been corrected or reduced.

Predictive Narrow-Band Imaging of Colonic Polyps: The Optics Are Good

“…Interestingly, in this study the LC-CUSUM analysis identified whether endoscopists became so proficient in achieving the PIVI thresholds that further monitoring of performance was not required. Although in the article by Garcia-Alonso et al [1] the LC-CUSUM was not able to identify competent endoscopists, since those achieving a theoretical competency during the training phase did not reach PIVI thresholds in the accuracy evaluation phase, the authors have to be complimented for choosing a quantitative measure for competency certification. Indeed, the LC-CUSUM produces a learning curve for each endoscopist, which through monitoring can provide information on an endoscopist's learning in a continuous and step-by-step fashion.…”

“…When a paradigm shift occurs, as was the case with the Resect and Discard (R&D) strategy for diminutive polyps, a strategy aimed at avoiding the time and expense of recovering and histologically examining diminutive polyps that have little or no malignant potential, enforcing standards is of the utmost importance. Despite the endorsement of both the American and the European Societies for Gastrointestinal Endoscopy (ASGE and ESGE) for real-time endoscopic prediction of histology of diminutive colorectal polyps, the basis for these endorsements are the high-quality standards that need be achieved, including adequate training and monitoring of the involved endoscopists.In this issue of Digestive Diseases and Sciences, GarciaAlonso et al [1] address the fundamental issues involved with training in the field of optical diagnosis for the histological prediction in diminutive colonic polyps. The authors evaluated whether an ex vivo image-based single session followed by self-education training on 100 lesions, with feedback received after each diagnosis, was able to reach the performance thresholds recommended by the ASGE for < 7 mm polyps.…”

“…In this issue of Digestive Diseases and Sciences, GarciaAlonso et al [1] address the fundamental issues involved with training in the field of optical diagnosis for the histological prediction in diminutive colonic polyps. The authors evaluated whether an ex vivo image-based single session followed by self-education training on 100 lesions, with feedback received after each diagnosis, was able to reach the performance thresholds recommended by the ASGE for < 7 mm polyps.…”