Interactive Training Versus Self-driven Training in the Prediction of Colorectal Polyp Histology by Trainees Using the NICE Classification

Overview

Journal BMC Gastroenterol

Publisher Biomed Central

Specialty Gastroenterology

Date 2023 Feb 24

PMID 36823614

Authors

Jia Wang

Wei-Guang Qiao

Yu-Tang Ren

Yu Chen

Wei Gong

Affiliations

Soon will be listed here.

Abstract

Background: The COVID-19 pandemic has impacted endoscopic training of the Narrow Band Imaging International Colorectal Endoscopic (NICE) classification, which could accurately predict pathology of colorectal polyps. This study aimed to evaluate the diagnostic performance by trainees of self-driven training vs. interactive training in the prediction of colorectal polyp histology.

Methods: This was a prospective randomized controlled study at five academic centers from January 1, 2021 to May 31, 2021. Trainees with no previous formal training of narrow band imaging or blue light imaging for prediction of colorectal polyp histology were randomly allocated to the self-driven training group or interactive training group. Before and after the training, all trainees were given 20 selected cases of colorectal polyp for testing. Their diagnostic performance was analyzed.

Results: Overall, the two training groups showed similar accuracy of NICE classification (79.3% vs. 78.1%; P = 0.637), vessel analysis (77.8% vs. 77.6%, P = 0.939), and surface pattern analysis (78.1% vs. 76.9%, P = 0.616). The accuracy of color analysis in the interactive training group was better (74.4% vs. 80.0%, P = 0.027). For high-confidence predictions, the self-driven training group showed higher accuracy of NICE classification (84.8% vs. 78.7%, P < 0.001) but no difference for analysis of color (79.6% vs. 81.0%), vessel pattern (83.0% vs. 78.5%), and surface pattern (81.8% vs. 78.5%).

Conclusions: Overall, self-driven training showed comparable accuracy of NICE classification, vessel pattern, and surface pattern to interactive training, but lower accuracy of color analysis. This method showed comparable effectiveness and is more applicable than interactive training. It is worth spreading during the COVID-19 pandemic. Trial registration Name of the registry: Chinese Clinical Trial Registry, Trial registration number: ChiCTR2000031659, Date of registration: 06/04/2020, URL of trial registry record: http://www.chictr.org.cn/showproj.aspx?proj=51994.

Citing Articles

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References

Hewett D, Kaltenbach T, Sano Y, Tanaka S, Saunders B, Ponchon T . Validation of a simple classification system for endoscopic diagnosis of small colorectal polyps using narrow-band imaging. Gastroenterology. 2012; 143(3):599-607.e1. DOI: 10.1053/j.gastro.2012.05.006. View

Mallon D, Pohl J, Phatak U, Fernandes M, Rosen J, Lusman S . Impact of COVID-19 on Pediatric Gastroenterology Fellow Training in North America. J Pediatr Gastroenterol Nutr. 2020; 71(1):6-11. PMC: 7273936. DOI: 10.1097/MPG.0000000000002768. View

Jafar W . COVID-19 and endoscopy training. Frontline Gastroenterol. 2020; 11(5):413-414. PMC: 7447273. DOI: 10.1136/flgastro-2020-101573. View

Bhandari P, Subramaniam S, Bourke M, Alkandari A, Chiu P, Brown J . Recovery of endoscopy services in the era of COVID-19: recommendations from an international Delphi consensus. Gut. 2020; 69(11):1915-1924. DOI: 10.1136/gutjnl-2020-322329. View

Pawlak K, Kral J, Khan R, Amin S, Bilal M, Lui R . Impact of COVID-19 on endoscopy trainees: an international survey. Gastrointest Endosc. 2020; 92(4):925-935. PMC: 7287420. DOI: 10.1016/j.gie.2020.06.010. View

Chiu P, Ng S, Inoue H, Reddy D, Ling Hu E, Cho J . Practice of endoscopy during COVID-19 pandemic: position statements of the Asian Pacific Society for Digestive Endoscopy (APSDE-COVID statements). Gut. 2020; 69(6):991-996. PMC: 7211066. DOI: 10.1136/gutjnl-2020-321185. View

Ungureanu B, Vladut C, Bende F, Sandru V, Tocia C, Turcu-Stiolica R . Impact of the COVID-19 Pandemic on Health-Related Quality of Life, Anxiety, and Training Among Young Gastroenterologists in Romania. Front Psychol. 2021; 11:579177. PMC: 7785580. DOI: 10.3389/fpsyg.2020.579177. View

Karampekos G, Gkolfakis P, Tziatzios G, Apostolopoulos P, Vlachogiannakos J, Thomopoulos K . Differences between fellows and fellowship program directors in their perception of the impact of the COVID-19 pandemic on gastroenterology training: results from a nationwide survey in Greece. Ann Gastroenterol. 2020; 33(6):680-686. PMC: 7599356. DOI: 10.20524/aog.2020.0546. View

Clarke K, Bilal M, Sanchez-Luna S, Dalessio S, Maranki J, Siddique S . Impact of COVID-19 Pandemic on Training: Global Perceptions of Gastroenterology and Hepatology Fellows in the USA. Dig Dis Sci. 2020; 66(10):3307-3311. PMC: 7569007. DOI: 10.1007/s10620-020-06655-y. View

10.

Hayashi N, Tanaka S, Hewett D, Kaltenbach T, Sano Y, Ponchon T . Endoscopic prediction of deep submucosal invasive carcinoma: validation of the narrow-band imaging international colorectal endoscopic (NICE) classification. Gastrointest Endosc. 2013; 78(4):625-32. DOI: 10.1016/j.gie.2013.04.185. View

11.

Khan T, Cinnor B, Gupta N, Hosford L, Bansal A, Olyaee M . Didactic training vs. computer-based self-learning in the prediction of diminutive colon polyp histology by trainees: a randomized controlled study. Endoscopy. 2017; 49(12):1243-1250. DOI: 10.1055/s-0043-116015. View

12.

Allen J, Vennalaganti P, Gupta N, Hornung B, Choudhary A, Titi M . Randomized Controlled Trial of Self-directed Versus In-Classroom Education of Narrow Band Imaging in Diagnosing Colorectal Polyps Using the NICE Criteria. J Clin Gastroenterol. 2017; 52(5):413-417. DOI: 10.1097/MCG.0000000000000791. View

13.

Barberio B, Massimi D, Dipace A, Zingone F, Farinati F, Savarino E . Medical and gastroenterological education during the COVID-19 outbreak. Nat Rev Gastroenterol Hepatol. 2020; 17(8):447-449. PMC: 7262487. DOI: 10.1038/s41575-020-0323-7. View

14.

Sano Y, Tanaka S, Kudo S, Saito S, Matsuda T, Wada Y . Narrow-band imaging (NBI) magnifying endoscopic classification of colorectal tumors proposed by the Japan NBI Expert Team. Dig Endosc. 2016; 28(5):526-33. DOI: 10.1111/den.12644. View

15.

Tanaka S, Kashida H, Saito Y, Yahagi N, Yamano H, Saito S . Japan Gastroenterological Endoscopy Society guidelines for colorectal endoscopic submucosal dissection/endoscopic mucosal resection. Dig Endosc. 2019; 32(2):219-239. DOI: 10.1111/den.13545. View

16.

Bergman J, de Groof A, Pech O, Ragunath K, Armstrong D, Mostafavi N . An Interactive Web-Based Educational Tool Improves Detection and Delineation of Barrett's Esophagus-Related Neoplasia. Gastroenterology. 2019; 156(5):1299-1308.e3. DOI: 10.1053/j.gastro.2018.12.021. View

17.

Smith S, Saltzman J, Shivaji U, Lethebe B, Cannatelli R, Ghosh S . Randomized controlled study of the prediction of diminutive/small colorectal polyp histology using didactic versus computer-based self-learning module in gastroenterology trainees. Dig Endosc. 2019; 31(5):535-543. DOI: 10.1111/den.13389. View