Randomized controlled study of the prediction of diminutive/small colorectal polyp histology using didactic versus computer‐based self‐learning module in gastroenterology trainees. Issue 5 (8th April 2019)

• Record Type: Journal Article
• Authors: Smith, Samuel C. L.; Saltzman, John; Shivaji, Uday N.; Lethebe, Brendan C.; Cannatelli, Rosanna; Ghosh, Subrata; Iacucci, Marietta
• Other Names: Baker G investigator.; Bannaga A investigator.; Fowler H investigator.; Geh D investigator.; Gupta T investigator.; Harvey PR investigator.; Khan S investigator.; Kumar A investigator.; Lim P investigator.; McCulloch A investigator.; O'Rourke J investigator.; Polewiczowska B investigator.; Qurashi M investigator.; Tahir F investigator.; Widlak MM investigator.
• Is Part Of: Digestive endoscopy. Volume 31:Issue 5(2019)
• Page Start: 535
• Page End: 543
• Publication Date: 2019-04-08
• Subjects: colonic polyp -- optical enhancement -- polyp characterization -- training module -- virtual chromoendoscopy; Digestive organs -- Diseases -- Periodicals; Digestive organs -- Diseases -- Diagnosis -- Periodicals; Endoscopy -- Periodicals; Digestive System Diseases -- diagnosis -- Periodicals; Digestive System Diseases -- therapy -- Periodicals; Endoscopy -- Periodicals; 616.3
• DOI: 10.1111/den.13389
• Languages: English
• ISSNs: 0915-5635

Abstract

Abstract : Background and Aim: The aim of this randomized trial was to evaluate the performance of self‐training versus didactic training in order to increase the diagnostic accuracy of diminutive/small colonic polyp histological prediction by trainees. Methods: Sixteen trainees reviewed 78 videos (48 iSCAN‐OE and 30 NBI) of diminutive/small polyps in a pretraining assessment. Trainees were randomized to receive computer‐based self‐learning ( n = 8) or didactic training ( n = 8) using identical teaching materials and videos. The same 78 videos, in a different randomized order, were assessed. The NICE (NBI International Colorectal Endoscopic) and SIMPLE (Simplified Identification Method for Polyp Labeling during Endoscopy) classification systems were used to classify diminutive/small polyps. Results: A higher proportion of high‐confidence predictions of polyps was made by the self‐training group versus the didactic group using both the SIMPLE classification (77.1% [95% CI 73.4–80.3] vs 69.9% [95% CI 66.1–73.5%] [ P = 0.005]) and the NICE classification (77% [95% CI 73.2–80.4%] vs 69.8% [95% CI 66–73.4%] [ P = 0.006]). When using NICE, sensitivity of the self‐training group compared with the didactic group was 72% versus 83% ( P = 0.0005), and the accuracy was 66.1% versus 69.1%. The training improved the confidence of participants and SIMPLE was preferred over NICE. Conclusion: Self‐learning for the prediction of diminutive/small polyp histology is a method of training that can achieve results similar to didactic training. Availability of adequate self‐learning teaching modules could enable widespread implementation of optical diagnosis in clinical practice.