Optical diagnosis of colorectal polyps using novel blue light imaging classification among trainee endoscopists.

Autor: Koehn C; Division of Gastroenterology, Hepatology and Motility, University of Kansas School of Medicine, Kansas City, KS, USA., Rex DK; Division of Gastroenterology and Hepatology, Indiana University Medical Center, Indianapolis, IN, USA., Allen J; Division of Gastroenterology, Hepatology and Motility, University of Kansas School of Medicine, Kansas City, KS, USA., Bhatti U; Division of Gastroenterology and Hepatology, Indiana University Medical Center, Indianapolis, IN, USA., Bhavsar-Burke I; Division of Gastroenterology and Hepatology, Indiana University Medical Center, Indianapolis, IN, USA., Thoguluva Chandrasekar V; Division of Gastroenterology, Hepatology and Motility, University of Kansas School of Medicine, Kansas City, KS, USA., Challa A; Division of Gastroenterology, Hepatology and Motility, University of Kansas School of Medicine, Kansas City, KS, USA., Duvvuri A; Division of Gastroenterology, Hepatology and Motility, University of Kansas School of Medicine, Kansas City, KS, USA., Dakhoul L; Division of Gastroenterology and Hepatology, Indiana University Medical Center, Indianapolis, IN, USA., Ha J; Division of Gastroenterology and Hepatology, Indiana University Medical Center, Indianapolis, IN, USA., Hamade N; Division of Gastroenterology and Hepatology, Indiana University Medical Center, Indianapolis, IN, USA., Hicks SB; Division of Gastroenterology and Hepatology, Indiana University Medical Center, Indianapolis, IN, USA., Jansson-Knodell C; Division of Gastroenterology and Hepatology, Indiana University Medical Center, Indianapolis, IN, USA., Krajicek E; Division of Gastroenterology and Hepatology, Indiana University Medical Center, Indianapolis, IN, USA., Das Kundumadam S; Division of Gastroenterology and Hepatology, Indiana University Medical Center, Indianapolis, IN, USA., Nutalapati V; Division of Gastroenterology, Hepatology and Motility, University of Kansas School of Medicine, Kansas City, KS, USA., Phatharacharukul PP; Division of Gastroenterology and Hepatology, Indiana University Medical Center, Indianapolis, IN, USA., Razmdjou S; Division of Gastroenterology, Hepatology and Motility, University of Kansas School of Medicine, Kansas City, KS, USA., Saito A; Division of Gastroenterology and Hepatology, Indiana University Medical Center, Indianapolis, IN, USA., Sarkis F; Division of Gastroenterology, Hepatology and Motility, University of Kansas School of Medicine, Kansas City, KS, USA., Sutton R; Division of Gastroenterology, Hepatology and Motility, University of Kansas School of Medicine, Kansas City, KS, USA., Wehbeh A; Division of Gastroenterology and Hepatology, Indiana University Medical Center, Indianapolis, IN, USA., Sharma P; Division of Gastroenterology, Hepatology and Motility, University of Kansas School of Medicine, Kansas City, KS, USA.; Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, MO, USA., Desai M; Division of Gastroenterology, Hepatology and Motility, University of Kansas School of Medicine, Kansas City, KS, USA.; Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, MO, USA.
Jazyk: angličtina
Zdroj: Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society [Dig Endosc] 2022 Jan; Vol. 34 (1), pp. 191-197. Date of Electronic Publication: 2021 Jun 18.
DOI: 10.1111/den.14050
Abstrakt: Background: Blue light imaging (BLI) has been shown to improve the characterization of colorectal polyps among the endoscopy experts. We aimed to determine if this technology could be taught to endoscopy trainees while maintaining high accuracy and interobserver agreement.
Methods: Twenty-one gastroenterology trainees (fellows) from two academic institutions participated in this prospective study. Each trainee completed a web-based learning comprising four modules: pre-test, didactic videos explaining the BLI Adenoma Serrated International Classification (BASIC), interactive examples, and post-test assessment. The pre- and post-test modules consisted of reviewing video images of colon polyps in high definition white light imaging and BLI and then applying the BASIC classification to determine if the polyps were likely to be adenomatous. Confidence in adenoma identification (rated '1' to '5'), accuracy in polyp (adenoma vs. non-adenoma) identification, and agreement in characterization per BASIC criteria were derived.
Results: Trainee accuracy in the adenoma diagnosis improved from 74.7% (pre-test) to 85.4% (post-test) (P < 0.01). There was a trend towards higher accuracy in polyp characterization with subsequent years of training (1st year fellows 77.4%, 2nd year 88.5%, and final year 94.0%) with consistent improvements after the e-learning across years of trainees. Overall, trainees were able to identify adenoma with a high sensitivity of 86.9%, specificity 83.9%, positive predictive value of 84.4%, and negative predictive value of 86.5%. However, their interobserver agreement in adenoma diagnosis was moderate (k = 0.52).
Conclusion: The novel BLI classification can be easily taught to gastroenterology trainees using an online module and accuracy improves with years of training reaching >90% for colorectal polyp characterization.
(© 2021 Japan Gastroenterological Endoscopy Society.)
Databáze: MEDLINE
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