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PTH-121 Development and Validation of A Training Module on The Use of Acetic Acid Chromoendoscopy (AAC) to Detect Barrett’s Neoplasia
  1. F Chedgy,
  2. K Kandiah,
  3. G Longcroft-Wheaton,
  4. P Bhandari,
  5. on behalf of the ABBA study group
  1. Gastroenterology, Queen Alexandra Hospital, Portsmouth, UK

Abstract

Introduction Acetic acid chromoendoscopy (AAC) is increasingly used by both expert and non-expert endoscopists for detection of Barrett’s neoplasia. However, there is no validated training strategy to achieve competence. The aim of this study was to identify the need for training, develop a validated training tool in the use of AAC and evaluate its impact on neoplasia detection, degree of confidence of the endoscopists & attitude towards switching to AAC from conventional Barrett’s surveillance strategy.

Methods A validated assessment tool of 40 images and 20 videos was developed. 13 endoscopists experienced in Barrett’s endoscopy and no formal training in AAC (7 consultants, 6 nurse endoscopists) underwent training. Participants underwent: 1. baseline assessment→online-training→2.assessment→ interactive seminar with live cases→3.assessment.

Results Experienced endoscopists lack lesion recognition skills with AAC, Consultants perform no better than nurse-endoscopists. There were significant increases in accuracy, sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) following the online training module (Table 1) to a level that meets ASGE PIVI requirements. There was additional gain from the interactive workshop with live & inter-observer agreement improved.

Abstract PTH-121 Table 1

Performance of educational intervention at each stage of training tool

The training intervention led to an improvement in the endoscopist’s confidence in AAC, with the mean pre-training confidence level rising from 2.5 (5 point scale) to 3.9 post-training (p < 0.001). The training module improved the willingness of the endoscopists in changing practice from Seattle protocol to AAC-targeted biopsy with mean pre-training confidence score of 2.6 (5 point scale) rising to 3.8 post-training(p < 0.001).

Conclusion

  • Our data demonstrates the need for training as baseline performance, even by experts, was poor

  • We were successful in developing a validated online training and testing tool for AAC

  • Our training tool improved performance of all endoscopists to a clinically significant (PIVI standard) level & improved their confidence & willingness in the use of AAC.

Disclosure of Interest None Declared

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