Introduction Narrow band imaging (NBI) with magnification (NBI-zoom) has been shown to be highly sensitive and specific in identifying dysplasia in Barrett's oeosphagus (BO). These studies have been done using experts and there is limited data on how these techniques can be taught. Recently studies have demonstrated that identifying adenomatous pit patterns in colonic polyps using NBI can be easily taught by short training sessions. The aim of this study was to prospectively evaluate the utility of a short training session on the ability of endoscopists to identify dysplastic patterns in NBI-zoom images from patients with BO.
Methods A prospective observational study was done on 28 endoscopists (10 novices, 10 with prior exposure to NBI and 10 experienced in the use of NBI-zoom) who attended a national level symposium on BO. A pre-test with 15 NBI-zoom images was followed by a 15 min training session where the endoscopic criteria for making a diagnosis of dysplasia on NBI-zoom images were described and demonstrated. The post-test had 25 NBI-zoom images. Images were projected using a high definition projector system and participants were given 45 s per image to make a diagnosis. Overall accuracy in detecting dysplasia was calculated and the inter-observer reliability of the groups was determined using bias corrected κ statistics.
Results Abstract PWE-216 table 1 provides the accuracy of classification of mucosal and vascular patterns and identifying the presence of dysplasia in the three groups of endoscopists. Significant improvement was noted after the training session in the group with prior NBI exposure but not in novices. The κ value for inter-observer reliability significantly (p=0.01) improved among those with prior NBI exposure from 0.238 (0.082–0.453) to 0.650 (0.421–0.836) after the training sessions but not in novices (p=0.4) 0.280 (0.084–0.532) to 0.374 (0.251–0.517) or experienced endoscopists (p=0.08) 0.505 (0.273–0.708) to 0.779 (0.552–0.929).
Conclusion A short didiactic teaching session can achieve high accuracy and good interobsever agreement in identifying dysplastic patterns in NBI-zoom images from BO in those with some prior NBI experience but not in novices.
Competing interests V Subramanian: None declared, K Ragunath Grant/Research Support from: Olympus Medical.