Colorectal polyps: mixed-modality training improves PIVI performance

  • Bae JH & al.
  • Clin Gastroenterol Hepatol
  • 14 févr. 2019

  • Par David Reilly
  • Résumés d'articles
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Takeaway

  • A mixed-modality training program for the real-time optical diagnosis of colorectal polyps significantly improved the ability of endoscopists to achieve PIVI (Preservation and Incorporation of Valuable Endoscopic Innovations) benchmarks.

Why this matters

  • There is an unmet need for improved training in endoscopic characterization of colorectal polyps using narrow-band imaging (NBI) and optical diagnosis of sessile serrated lesions (SSLs).

Study design

  • Study to asses a quality improvement program in 15 endoscopists with limited experience in NBI-based prediction of polyp histology.
  • The study comprised 2 phases:
    • Phase 1: Ex vivo self-training module for basic skills before in vivo real-time optical diagnosis.
    • Phase 2: Results disseminated from in vivo phase 1, email-based ex vivo training for reeducation before a second round of real-time in vivo optical diagnosis.
  • Funding: Seoul National University Hospital Research Fund.

Key results

  • Accuracy with high confidence was 79.4% in phase 1 and 85.1% in phase 2 (P<.001>
  • Negative predictive values (NPV) for diminutive neoplastic polyps were 82.1% in phase 1 and 92.5% in phase 2.
  • 80.7% concordance of (optical/histology-based) surveillance intervals in phase 1; 89.7% in phase 2.

Limitations

  • Limited sample size.