Houwen Britt B S L, Hassan Cesare, Coupé Veerle M H, Greuter Marjolein J E, Hazewinkel Yark, Vleugels Jasper L A, Antonelli Giulio, Bustamante-Balén Marco, Coron Emmanuel, Cortas George A, Dinis-Ribeiro Mario, Dobru Daniela E, East James E, Iacucci Marietta, Jover Rodrigo, Kuvaev Roman, Neumann Helmut, Pellisé Maria, Puig Ignasi, Rutter Matthew D, Saunders Brian, Tate David J, Mori Yuichi, Longcroft-Wheaton Gaius, Bisschops Raf, Dekker Evelien
Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, location AMC, University of Amsterdam, Amsterdam, The Netherlands.
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
Endoscopy. 2022 Jan;54(1):88-99. doi: 10.1055/a-1689-5130. Epub 2021 Dec 6.
The European Society of Gastrointestinal Endoscopy (ESGE) has developed a core curriculum for high quality optical diagnosis training for practice across Europe. The development of easy-to-measure competence standards for optical diagnosis can optimize clinical decision-making in endoscopy. This manuscript represents an official Position Statement of the ESGE aiming to define simple, safe, and easy-to-measure competence standards for endoscopists and artificial intelligence systems performing optical diagnosis of diminutive colorectal polyps (1 - 5 mm). METHODS : A panel of European experts in optical diagnosis participated in a modified Delphi process to reach consensus on Simple Optical Diagnosis Accuracy (SODA) competence standards for implementation of the optical diagnosis strategy for diminutive colorectal polyps. In order to assess the clinical benefits and harms of implementing optical diagnosis with different competence standards, a systematic literature search was performed. This was complemented with the results from a recently performed simulation study that provides guidance for setting alternative competence standards for optical diagnosis. Proposed competence standards were based on literature search and simulation study results. Competence standards were accepted if at least 80 % agreement was reached after a maximum of three voting rounds. RECOMMENDATION 1: In order to implement the leave-in-situ strategy for diminutive colorectal lesions (1-5 mm), it is clinically acceptable if, during real-time colonoscopy, at least 90 % sensitivity and 80 % specificity is achieved for high confidence endoscopic characterization of colorectal neoplasia of 1-5 mm in the rectosigmoid. Histopathology is used as the gold standard.Level of agreement 95 %. RECOMMENDATION 2: In order to implement the resect-and-discard strategy for diminutive colorectal lesions (1-5 mm), it is clinically acceptable if, during real-time colonoscopy, at least 80 % sensitivity and 80 % specificity is achieved for high confidence endoscopic characterization of colorectal neoplasia of 1-5 mm. Histopathology is used as the gold standard.Level of agreement 100 %. CONCLUSION : The developed SODA competence standards define diagnostic performance thresholds in relation to clinical consequences, for training and for use when auditing the optical diagnosis of diminutive colorectal polyps.
欧洲胃肠内镜学会（ESGE）已制定了一项核心课程，用于在全欧洲开展高质量的光学诊断培训。制定易于衡量的光学诊断能力标准可优化内镜检查中的临床决策。本文是ESGE的一份官方立场声明，旨在为内镜医师和对微小结直肠息肉（1-5毫米）进行光学诊断的人工智能系统定义简单、安全且易于衡量的能力标准。
一组欧洲光学诊断专家参与了改良的德尔菲法，就微小结直肠息肉光学诊断策略实施的简单光学诊断准确性（SODA）能力标准达成共识。为评估采用不同能力标准实施光学诊断的临床益处和危害，进行了系统的文献检索。最近进行的一项模拟研究结果对其进行了补充，该研究为设定光学诊断的替代能力标准提供了指导。提议的能力标准基于文献检索和模拟研究结果。如果在最多三轮投票后达成至少80%的一致意见，则能力标准被接受。
建议1：为实施微小结直肠病变（1-5毫米）的原位保留策略，在实时结肠镜检查期间，对直肠乙状结肠1-5毫米的结直肠肿瘤进行高置信度内镜特征识别时，若能达到至少90%的灵敏度和80%的特异度，则在临床上是可接受的。组织病理学用作金标准。一致同意率95%。
建议2：为实施微小结直肠病变（1-5毫米）的切除并丢弃策略，在实时结肠镜检查期间，对1-5毫米的结直肠肿瘤进行高置信度内镜特征识别时，若能达到至少80%的灵敏度和80%特异度，则在临床上是可接受的。组织病理学用作金标准。一致同意率100%。
制定的SODA能力标准定义了与临床后果相关的诊断性能阈值，用于培训以及审核微小结直肠息肉的光学诊断时使用。
