Department of Surgery and Cancer, Imperial College London, St. Mary's Hospital, London, United Kingdom.
Instituto Nacional de Astrofisica, Optica y Electronica (INAOE), Mexico.
Endoscopy. 2018 Jul;50(7):701-707. doi: 10.1055/s-0044-101026. Epub 2018 Feb 7.
The adenoma detection rate (ADR) is an important quality indicator in colonoscopy. The aim of this study was to evaluate the changes in visual gaze patterns (VGPs) with increasing polyp detection rate (PDR), a surrogate marker of ADR.
18 endoscopists participated in the study. VGPs were measured using eye-tracking technology during the withdrawal phase of colonoscopy. VGPs were characterized using two analyses - screen and anatomy. Eye-tracking parameters were used to characterize performance, which was further substantiated using hidden Markov model (HMM) analysis.
Subjects with higher PDRs spent more time viewing the outer ring of the 3 × 3 grid for both analyses (screen-based: r = 0.56, = 0.02; anatomy: r = 0.62, < 0.01). Fixation distribution to the "bottom U" of the screen in screen-based analysis was positively correlated with PDR (r = 0.62, = 0.01). HMM demarcated the VGPs into three PDR groups.
This study defined distinct VGPs that are associated with expert behavior. These data may allow introduction of visual gaze training within structured training programs, and have implications for adoption in higher-level assessment.
腺瘤检出率（ADR）是结肠镜检查的一个重要质量指标。本研究旨在评估随着息肉检出率（PDR）的增加，即 ADR 的替代标志物，视觉注视模式（VGP）的变化。
18 名内镜医师参与了这项研究。在结肠镜检查的退镜阶段，使用眼动追踪技术测量 VGPs。使用两种分析 - 屏幕和解剖学来描述 VGPs。使用眼动追踪参数来描述性能，进一步使用隐马尔可夫模型（HMM）分析来证实。
在两种分析中，PDR 较高的受试者在观看 3x3 网格的外环时花费的时间更多（基于屏幕的分析：r=0.56，P=0.02；解剖学：r=0.62，P<0.01）。在基于屏幕的分析中，“底部 U”区域的注视点分布与 PDR 呈正相关（r=0.62，P=0.01）。HMM 将 VGPs 分为三个 PDR 组。
本研究定义了与专家行为相关的独特 VGPs。这些数据可能允许在结构化培训计划中引入视觉注视训练，并对采用更高水平的评估具有影响。
