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Training program helps improve optical polyp diagnosis
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A comprehensive training program helped improve real-time optical diagnosis of colorectal polyps and reduce individual variability in less experienced endoscopists, according to results of a study published in Clinical Gastroenterology and Hepatology.
Joo Sung Kim, MD, PhD, of the department of medicine at Seoul National University College of Medicine in South Korea, and colleagues wrote that advances in endoscope technology has allowed for the potential of real-time characterization of polyps, but concerns remain about the reproducibility and generalizability of real-time optical diagnosis. Their study looked at the Seoul National University Hospital’s Gangnam-REA1 time optical Diagnosis (Gangnam-READI) program, designed as a quality improvement program for less experienced endoscopists.
“Gangnam-READI is a comprehensive program that combines multiple training modalities such as a computerized self-training module, in vivo simulation, and email-based retraining,” they wrote. “We speculated that these multiple training methods would lead to a general improvement in optical diagnosis performance and a decrease in operator dependency, across multiple settings.”
Researchers performed a single-center prospective study that included 15 endoscopists trained in the Workgroup Serrated Polyps and Polyposis classification system. They evaluated the endoscopists’ performance after the first phase of in vivo optical diagnosis and then again after they were re-educated for insufficient competency.
The endoscopists improved in overall accuracy of diagnosis from 73.5% in the first phase to 77.1% in the second, with accuracy with high confidence improving from 79.4% to 85.1%. In assessing for diminutive neoplastic polyps, negative predictive value for the first and second phases were 82.1% and 92.5%, respectively.
After the second phase, eight endoscopists achieved benchmarks for the preservation and incorporation of valuable endoscopic innovations compared with none after the first phase.
Kim and colleagues wrote that developing training modules for endoscopists can be difficult because people have different learning styles and learning curves.
“However, sophisticated e-learning system, theory-based approach to evoke motivation to training, and computer-aided diagnosis using artificial intelligence have showed promising results for novice training,” they wrote. “These training methods should be developed further and evaluated in future studies.” – by Alex Young
Disclosures: The authors report no relevant financial disclosures.
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