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Feasibility of using narrow band imaging international colorectal endoscopic classification for diagnosing colorectal neoplasia in China: A multicenter pilot observational study
Author(s) -
Zhang Qing Wei,
Zhang Jing Jing,
Yang Ai Ming,
Sheng Jian Qiu,
Liu Yu Lan,
Li Zhao Shen,
Chen Hai Ying,
Feng Nan,
Jiang Qing Wei,
Jin Peng,
Zhang Li Ming,
Fu Hong Yu,
Gao Yun Jie,
Ge Zhi Zheng,
Li Xiao Bo
Publication year - 2020
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/1751-2980.12841
Subject(s) - medicine , confidence interval , odds ratio , narrow band imaging , logistic regression , receiver operating characteristic , colorectal cancer , nice , medical diagnosis , diagnostic accuracy , colorectal polyp , radiology , colorectal cancer screening , endoscopy , colonoscopy , cancer , computer science , programming language
Objective We aimed to investigate whether Chinese endoscopists without narrow‐band imaging (NBI) experiences could achieve high accuracy in the real‐time diagnosis of colorectal polyps using NBI International Colorectal Endoscopic (NICE) classification after web‐based training. Methods Altogether 15 endoscopists from five centers with no NBI experiences followed a short, web‐based training program on the NICE classification and took web‐based test. Their performances were compared with 15 matched experienced endoscopists with no NBI experience who received no NBI training. These 15 trained endoscopists then made real‐time diagnoses of colorectal neoplasia. A logistic regression was used to assess potential predictors of diagnostic performance. Results Compared with those who received no training, trained endoscopists achieved comparable overall accuracy (85.3% vs 83.1%, P = 0.408) and accuracy at a high‐confidence level (87.0% vs 86.0%, P = 0.670), but had a higher confidence rate (86.1% vs 83.7%, P = 0.004) for the diagnosis of neoplasia. Real‐time diagnostic accuracy, sensitivity and specificity were 94.3% (95% confidence interval [CI] 91.5%‐96.2%), 96.2% (95% CI 93.4%‐97.9%) and 85.3% (95% CI 74.8%‐92.1%) at high‐confidence level. The high‐confidence level was the strongest predictor of real‐time diagnostic accuracy (odds ratio 12.66, P < 0.001). Conclusions Web‐based training can improve the confidence level of endoscopists in accurately diagnosing colorectal polyps using the NICE classification. Chinese endoscopists can achieve high accuracy in diagnosing colorectal neoplasia at a high confidence level (ClinicalTrials ID: NCT02033980).