Self-study of the non-extension sign in an e-learning program improves diagnostic accuracy of invasion depth of early gastric cancer

Abstract

Background and study aims We developed an e-learning program for endoscopic diagnosis of invasion depth of early gastric cancer (EGC) using a simple diagnostic criterion called non-extension sign, and the contribution of self-study quizzes to improvement of diagnostic accuracy was evaluated. Methods We conducted a prospective randomized controlled study that recruited endoscopists throughout Japan. After completing a pretest, the participants watched video lectures and undertook post-test 1. The participants were then randomly allocated to either the self-study or non-self-study group, and participants in the first group completed the self-study program that comprised 100-case quizzes. Finally, participants in both groups undertook post-test 2. The primary endpoint was the difference in post-test 2 scores between the groups. The perfect score for the tests was set as 100 points. Results A total of 423 endoscopists completed the pretest and were enrolled. Post-test 1 was completed by 415 endoscopists and 208 were allocated to the self-study group and 207 to the non-self-study group. Two hundred and four in the self-study group and 205 in the non-self-study group were included in the analysis. Video lectures improved the mean score of post-test 1 from 72 to 77 points. Participants who completed the self-study quizzes showed significantly better post-test 2 scores compared with the non-self-study group (80 vs. 76 points, respectively, P < 0.0001). Conclusions Our e-learning program showed that self-study quizzes consolidated knowledge of the non-extension sign and improved diagnostic ability of endoscopists for invasion depth of EGC.

Endoscopic Submucosal Dissection for Early Gastric Cancer in Patients Aged 85 Years Old or Older Is Associated with a Good Prognosis Compared to Conservative Treatment without Any Invasive Procedure

“…However, longer term follow-up is difficult, particularly in super-elderly patients because their prognoses are understandably not very long. Third, the cancer invasion depth in the conservative treatment group was diagnosed endoscopically only, although accuracy for diagnosis of invasion depth of EGC by conventional endoscopy was relatively high, reported to be around 75–80% in Japan [34]. In this study, 39 cases (84.8%) of the ESD group were diagnosed as cT1a at the time of initial diagnosis, and the positive predictive value was 76.9%, similar to previously reported.…”

E-learning system to improve the endoscopic diagnosis of early gastric cancer

“…9). 7 Assessed for eligibility (n=439) The third study showed that the "accumulation of experi ence", achieved by repeated practice using the 100-case self-study training, consolidated the learning "technique" and "knowledge" and increased the diagnostic ability of endoscopists of EGC.…”

“…5 To address these difficulties, we developed three types of web-based e-learning systems, tested each through randomized controlled trials (RCTs), and demonstrated their usefulness in ensuring correct and precise endoscopic diagnosis of EGC. [5][6][7] In this review, we introduce the basic diagnostic systems employed in e-learning, the outcomes of RCTs testing the usefulness of these three e-learning systems, and our future projects.…”

Management of Superficial Esophageal Squamous Cell Carcinoma and Early Gastric Cancer following Non-Curative Endoscopic Resection

“…Indeed, preoperative CT could not detect LNM in 90% of patients with LNM who underwent additional gastrectomy after non-curative ER [ 84 ]. Non-extension sign is considered a reliable finding for pT1b-SM2 by non-magnifying endoscopy, but its diagnostic accuracy in a prospective e-learning study was 80% at most [ 107 ]. The efficacy of EUS for diagnosing invasion depth of EGC is controversial [ 108 , 109 ]; however, these are retrospective studies, and a prospective study is required to accurately identify its diagnostic utility.…”