Original articleClinical endoscopyImpact of a computer-based teaching module on characterization of diminutive colon polyps by using narrow-band imaging by non-experts in academic and community practice: a video-based study
Section snippets
Teaching module
An audiovisual teaching presentation was prepared in Power Point (Microsoft Corp, Redmond, Wash) by one investigator with experience in polyp histology characterization with NBI (A.R.). This presentation included 34 slides and was approximately 20 minutes in duration. The contents of this presentation included a brief introduction on NBI, followed by a demonstration of the different NBI surface patterns that can help differentiate between hyperplastic and adenomatous polyps. The NBI patterns
Statistical analysis
We assumed that the accuracy of the non-experts (groups B and C) in histology characterization of diminutive polyps with NBI in the pretest would be 60%. This was estimated to improve to 75% in the posttest after participants reviewed the teaching module. A sample size of 200 observations (40 videos × 5 reviewers) was calculated to be adequate to detect this difference with 80% power and an alpha of 0.05. The performance characteristics of the reviewers were calculated by comparing the
Reviewers
There were 5 reviewers in each of the 3 groups. Group A included experts in NBI who had been in gastroenterology practice for a mean of 6 years (range 2-12 years) and who performed 400 to 1000 colonoscopies annually. All of them had experience in polyp histology characterization, having performed more than 500 procedures with NBI. The time taken to review the pretest and posttest videos was 37 minutes and 29.8 minutes, respectively.
Group B included non-experts in academics who had been in
Discussion
The ability to accurately characterize the histology of diminutive polyps in real time during colonoscopy can lead to a paradigm shift from the current practice of resecting and submitting all diminutive polyps to pathology. This practice of submitting all diminutive polyps to pathology is a significant drain to our health care resources, with very limited clinical benefits in return. Therefore, a change in practice that is economically more efficient without jeopardizing patient outcomes would
Acknowledgments
We acknowledge Drs Mukul Khandelwal, Gary Payman, Sreekant Chandrupatla, Jyotsana Talapenini, and Syed F. Jafri for their participation in this study.
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DISCLOSURE: This work was supported by the Michael V. Sivak, Jr., MD, Endoscopic Research Award and the Endoscopic Research Career Development Award from theAmerican Society for Gastrointestinal Endoscopyto A. Rastogi. A. Rastogi also received a research grant from Olympus America. E. Dekker received equipment on loan and research support from Olympus. T. Kaltenbach received a research grant from and is a consultant for Olympus America. P. Sharma received a research grant from Olympus America. All other authors disclosed no financial relationships relevant to this publication.
See CME section; p. 498.
If you would like to chat with an author of this article, you may contact Dr Rastogi at [email protected].