Department of Gastroenterology, Veterans Affairs Medical Center, Kansas City, Missouri, United States; Department of Gastroenterology, University of Kansas School of Medicine, Kansas City, Kansas, United States.
Department of Pathology, University of Kansas School of Medicine, Kansas City, Kansas, United States.
Gastrointest Endosc. 2014 Mar;79(3):390-8. doi: 10.1016/j.gie.2013.07.032. Epub 2013 Sep 8.
Experts can accurately characterize the histology of diminutive polyps with narrow-band imaging (NBI). There are limited data on the performance of non-experts.
To assess the impact of a computer-based teaching module on the accuracy of predicting polyp histology with NBI by non-experts (in academics and community practice) by using video clips.
Prospective, observational study.
Academic and community practice.
A total of 15 gastroenterologists participated-5 experts in NBI, 5 non-experts in academic practice, and 5 non-experts in community practice.
Participants reviewed a 20-minute, computer-based teaching module outlining the different NBI features for hyperplastic and adenomatous polyps.
Performance characteristics in characterizing the histology of diminutive polyps with NBI by using short video clips before (pretest) and after (posttest) reviewing the teaching module.
Non-experts in academic practice showed a significant improvement in the sensitivity (54% vs 79%; P < .001), accuracy (64% vs 81%; P < .001), and proportion of high-confidence diagnoses (49% vs 69%; P < .001) in the posttest. Non-experts in community practice had significantly higher sensitivity (58% vs 75%; P = .004), specificity (76% vs 90%; P = .04), accuracy (64% vs 81%; P < .001), and proportion of high-confidence diagnoses (49% vs 72%; P < .001) in the posttest. Performance of experts in NBI was significantly better than non-experts in both academic and community practice.
Selection bias in selecting good quality videos. Performance not assessed during live colonoscopy.
Academic and community gastroenterologists without prior experience in NBI can achieve significant improvements in characterizing diminutive polyp histology after a brief computer-based training. The durability of these results and applicability in everyday practice are uncertain.
专家可以通过窄带成像（NBI）准确描述微小息肉的组织学特征。关于非专家（学术和社区实践中的）使用视频片段预测息肉组织学的表现的数据有限。
使用视频片段评估基于计算机的教学模块对非专家（学术和社区实践中的 5 名专家、5 名非专家）使用 NBI 预测息肉组织学的准确性的影响。
前瞻性、观察性研究。
学术和社区实践。
共有 15 名胃肠病学家参与-5 名 NBI 专家，5 名学术实践中的非专家，5 名社区实践中的非专家。
参与者查看了 20 分钟的基于计算机的教学模块，其中概述了增生性和腺瘤性息肉的不同 NBI 特征。
使用短视频片段在查看教学模块之前（预测试）和之后（后测试）对 NBI 描述微小息肉组织学的性能特征。
学术实践中的非专家在 NBI 后测试中的敏感性（54%对 79%；P<0.001）、准确性（64%对 81%；P<0.001）和高置信度诊断的比例（49%对 69%；P<0.001）显著提高。社区实践中的非专家在后测试中的敏感性（58%对 75%；P=0.004）、特异性（76%对 90%；P=0.04）、准确性（64%对 81%；P<0.001）和高置信度诊断的比例（49%对 72%；P<0.001）显著更高。NBI 专家的表现明显优于学术和社区实践中的非专家。
选择高质量视频时存在选择偏倚。未在实际结肠镜检查期间评估性能。
没有 NBI 经验的学术和社区胃肠病学家在接受简短的基于计算机的培训后，可以显著提高对微小息肉组织学的描述能力。这些结果的持久性和在日常实践中的适用性尚不确定。
