Premium
Randomized controlled study of the prediction of diminutive/small colorectal polyp histology using didactic versus computer‐based self‐learning module in gastroenterology trainees
Author(s) -
Smith Samuel C. L.,
Saltzman John,
Shivaji Uday N.,
Lethebe Brendan C.,
Cannatelli Rosanna,
Ghosh Subrata,
Iacucci Marietta
Publication year - 2019
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.13389
Subject(s) - diminutive , medicine , randomized controlled trial , nice , colorectal polyp , endoscopy , gastroenterology , confidence interval , colorectal cancer , colonoscopy , cancer , computer science , philosophy , linguistics , programming language
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.