短期深度预测评分培训对非专家内镜医师诊断分化型早期胃癌浸润深度能力的影响。

The effect of short-term training about depth predicting score on the diagnostic ability of invasion depth for differentiated early gastric Cancer among non-expert endoscopists.

机构信息

Digestive Department, the Second Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, Anhui Province, 230601, China.

Department of Pathophysiology, School of Basic Medical College, Anhui Medical University, Hefei, Anhui Province, 230032, China.

出版信息

BMC Med Educ. 2023 May 17;23(1):347. doi: 10.1186/s12909-023-04230-3.

DOI:10.1186/s12909-023-04230-3

PMID:37198569

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10193744/

Abstract

BACKGROUND

The depth-predicting score (DPS) was proposed based on conventional white-light imaging (C-WLI) endoscopic features of early gastric cancer (EGC) to determine the invasion depth of the neoplasm. However, the effect of DPS on training endoscopists remains unclear. Therefore, we aimed to investigate the effect of short-term DPS training on improving the diagnostic ability of EGC invasion depth and compare the training effect among non-expert endoscopists at different levels.

METHODS

In the training session, the definitions and scoring rules of DPS were instructed, and classic C-WLI endoscopic example graphics were exhibited to the participants. Another C-WLI endoscopic images of 88 cases of histologically proven differentiated EGC were selected as an independent test dataset for evaluating the training effect. Each participant was tested, and the diagnostic accuracy rate of invasion depth was calculated differently one week before the training and after the completion of training.

RESULTS

A total of 16 participants were enrolled and completed the training. Participants were divided into a trainee group and a junior endoscopist group according to the total number of C-WLI endoscopies performed. The total number of C-WLI endoscopies performed showed a significant difference between the trainee group and junior endoscopist group (350 vs. 2500, P = 0.001). No significant difference between the trainee group and junior endoscopist group was observed for pre-training accuracy. The overall diagnostic accuracy of invasion depth was improved significantly after completing DPS training compared with before (68.75 ± 5.71% vs. 61.58 ± 9.61%, P = 0.009). In the subgroup analysis, the post-training accuracy was higher than the pre-training accuracy, but significant improvement was observed only in the trainee group (61.65 ± 7.33% vs. 68.32 ± 5.71%, P = 0.034). In addition, no significant difference in post-training accuracy between the two groups was observed.

CONCLUSION

Short-term DPS training can improve the diagnostic ability of the invasion depth of EGC and homogenize the diagnostic ability of non-expert endoscopists at different levels. The depth-predicting score was convenient and effective for endoscopist training.

摘要

背景

深度预测评分（DPS）是基于早期胃癌（EGC）的常规白光成像（C-WLI）内镜特征提出的，用于确定肿瘤的侵袭深度。然而，DPS 对培训内镜医生的效果尚不清楚。因此，我们旨在研究短期 DPS 培训对提高 EGC 浸润深度诊断能力的影响，并比较不同水平非专家内镜医生的培训效果。

方法

在培训过程中，我们讲解了 DPS 的定义和评分规则，并向参与者展示了经典的 C-WLI 内镜示例图像。另选择 88 例经组织学证实的分化型 EGC 的 C-WLI 内镜图像作为独立测试数据集，用于评估培训效果。每位参与者均进行了测试，在培训前一周和培训完成后分别计算了不同的浸润深度诊断准确率。

结果

共纳入 16 名参与者并完成了培训。根据完成的 C-WLI 内镜总数，将参与者分为学员组和初级内镜医生组。学员组和初级内镜医生组的 C-WLI 内镜总数差异有统计学意义（350 例与 2500 例，P=0.001）。培训前两组间准确率无显著差异。与培训前相比，完成 DPS 培训后，浸润深度的整体诊断准确率显著提高（68.75±5.71%比 61.58±9.61%，P=0.009）。亚组分析显示，培训后准确率高于培训前，但仅在学员组观察到显著提高（61.65±7.33%比 68.32±5.71%，P=0.034）。此外，两组间培训后准确率无显著差异。