Scaffidi Michael A, Li Juana, Genis Shai, Tipton Elizabeth, Khan Rishad, Pattni Chandni, Gimpaya Nikko, Bradley-Ridout Glyneva, Walsh Catharine M, Grover Samir C
Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Canada.
Faculty of Health Sciences, School of Medicine, Queen's University, Toronto, Canada.
Endoscopy. 2023 Feb;55(2):176-185. doi: 10.1055/a-1929-1318. Epub 2022 Sep 26.
Assessment is necessary to ensure both attainment and maintenance of competency in gastrointestinal (GI) endoscopy, and this can be accomplished through self-assessment. We conducted a systematic review with meta-analysis to evaluate the accuracy of self-assessment among GI endoscopists.
This was an individual participant data meta-analysis of studies that investigated self-assessment of endoscopic competency. We performed a systematic search of the following databases: Ovid MEDLINE, Ovid EMBASE, Wiley Cochrane CENTRAL, and ProQuest Education Resources Information Center. We included studies if they were primary investigations of self-assessment accuracy in GI endoscopy that used statistical analyses to determine accuracy. We conducted a meta-analysis of studies using a limits of agreement (LoA) approach to meta-analysis of Bland-Altman studies.
After removing duplicate entries, we screened 7138 records. After full-text review, we included 16 studies for qualitative analysis and three for meta-analysis. In the meta-analysis, we found that the LoA were wide (-41.0 % to 34.0 %) and beyond the clinically acceptable difference. Subgroup analyses found that both novice and intermediate endoscopists had wide LoA (-45.0 % to 35.1 % and -54.7 % to 46.5 %, respectively) and expert endoscopists had narrow LoA (-14.2 % to 21.4 %).
GI endoscopists are inaccurate in self-assessment of their endoscopic competency. Subgroup analyses demonstrated that novice and intermediate endoscopists were inaccurate, while expert endoscopists have accurate self-assessment. While we advise against the sole use of self-assessment among novice and intermediate endoscopists, expert endoscopists may wish to integrate it into their practice.
评估对于确保胃肠（GI）内镜检查能力的获得和维持是必要的，这可以通过自我评估来实现。我们进行了一项系统评价和荟萃分析，以评估胃肠内镜医师自我评估的准确性。
这是一项对研究内镜检查能力自我评估的研究进行的个体参与者数据荟萃分析。我们对以下数据库进行了系统检索：Ovid MEDLINE、Ovid EMBASE、Wiley Cochrane CENTRAL和ProQuest教育资源信息中心。如果研究是对胃肠内镜检查自我评估准确性的初步调查，并使用统计分析来确定准确性，我们就将其纳入。我们使用一致性界限（LoA）方法对Bland-Altman研究进行荟萃分析。
去除重复条目后，我们筛选了7138条记录。经过全文审查，我们纳入了16项研究进行定性分析，3项进行荟萃分析。在荟萃分析中，我们发现一致性界限很宽（-41.0%至34.0%），超出了临床可接受的差异范围。亚组分析发现，新手和中级内镜医师的一致性界限都很宽（分别为-45.0%至35.1%和-54.7%至46.5%），而专家内镜医师的一致性界限较窄（-14.2%至21.4%）。
胃肠内镜医师对其内镜检查能力的自我评估不准确。亚组分析表明，新手和中级内镜医师的自我评估不准确，而专家内镜医师的自我评估准确。虽然我们建议新手和中级内镜医师不要仅依靠自我评估，但专家内镜医师可能希望将其纳入实践中。
