Development and validation of a video-based cold snare polypectomy assessment tool (with videos) - 17/05/19

Doi : 10.1016/j.gie.2019.02.018

Swati G. Patel, MD, MS ^1,^2,^⁎^{^{∗
Drs Patel and Duloy and Keswani and Wani contributed equally to this article.}}, Anna Duloy, MD ^1,^3,^{^{∗
Drs Patel and Duloy and Keswani and Wani contributed equally to this article.}}, Tonya Kaltenbach, MD ⁴, Matt Hall, PhD ⁵, Charles Kahi, MD ⁶, Heiko Pohl, MD ⁷, Amit Rastogi, MD ⁸, Hazem Hammad, MD ^1,², Roy Soetikno, MD ⁹, Amandeep Shergill, MD ⁴, Violette Simon, MS ¹, Tiffany Nguyen, BA ⁴, Eze Ezekwe, MS ¹, Tara Ahi, BS ⁴, Rajesh N. Keswani, MD, MS ^3,^{^{∗
Drs Patel and Duloy and Keswani and Wani contributed equally to this article.}}, Sachin Wani, MD ^1,^{^{∗
Drs Patel and Duloy and Keswani and Wani contributed equally to this article.}}
¹ University of Colorado Anschutz Medical Center, Aurora, Colorado, USA
² Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA
³ Northwestern University, Chicago, Illinois, USA
⁴ Veterans Affairs Medical Center, San Francisco, California, USA
⁵ Children's Hospital Association, Lenexa, Kansas, USA
⁶ Indiana University, Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana, USA
⁷ Veterans Affairs Medical Center, White River Junction, Vermont, USA
⁸ University of Kansas, Kansas City, Kansas, USA
⁹ Singapore General Hospital, Singapore, Singapore

^∗Reprint requests: Swati G. Patel, MD MS, University of Colorado Anschutz Medical Center, 12631 East 17th Ave, Room 7614, Campus Box 158, Aurora, CO 80045.University of Colorado Anschutz Medical Center12631 East 17th Ave, Room 7614Campus Box 158AuroraCO80045

Abstract

Background and Aims

Polyps <1 cm are the most commonly found polyps during colonoscopy. Cold snare removal is preferred given the significantly higher rate of incomplete resection associated with piecemeal biopsy forceps resection. There are currently no standardized tools to assess competence in cold snare polypectomy. This study aimed to develop and validate a cold snare polypectomy assessment tool (CSPAT).

Methods

Experts in cold snare polypectomy used a Delphi method to develop the CSPAT. Metrics with a greater than 85% agreement as being “important” or “very important” were included in the CSPAT. The tool included evaluation of polyp inspection, positioning, appropriate ensnarement of tissue to ensure a rim of normal tissue, tissue retrieval, and postpolypectomy site inspection. Experts in cold snare polypectomy used the CSPAT to evaluate preselected videos that were previously evaluated using the Direct Observation of Polypectomy Skills (DOPyS) tool. Interobserver agreement was evaluated. CSPAT scores were compared with DOPyS scores to assess content validity.

Results

Sixteen experts developed the 12-item CSPAT, and 13 experts reviewed 55 videos. There was a moderate degree of agreement in 10 metrics (κ = .52-.59) and a substantial degree of agreement (κ = .61-.63) in the other 2. There was a strong correlation between the mean of individual metrics 1 to 12 compared with the global competence assessment (ρ = .88, P < .001). There was a moderate correlation between the average overall DOPyS score and the overall CSPAT competence score (ρ = .56, P < .001).

Conclusions

We have developed and validated a customized CSPAT that can be easily applied to video-based assessments to assess competence in training and among practicing endoscopists.

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Abbreviations : CRC, CSPAT, DOPyS

Plan

Methods

Study setting

Study materials

Construct validity framework and definitions

Study design and participants

Data management and statistical analysis

Results

Phase I: CSPAT development (content validity)

Phase II: response process validity and internal structure validity

Phase III: relationship to other variables validity

Discussion

DISCLOSURE: The following authors disclosed financial relationships relevant to this publication: T. Kaltenbach: Consultant for Olympus America and Aries Pharmaceutical. H. Pohl: Research grant recipient from Boston Scientific, US Endoscopy, and Aries/Cosmos Pharmaceuticals. A. Rastogi: Consultant for Olympus, Boston Scientific, Cook, and Medtronic; research grant recipient from Olympus. H. Hammad: Consultant for Olympus, Cook, and Medtronic. R. Soetikno: Consultant for Olympus. A. Shergill: Research grant recipient from Pentax. R. N. Keswani: Consultant for Boston Scientific, Medtronic, and Motus-GI. S. Wani: Consultant for Boston Scientific and Medtronic. All other authors disclosed no financial relationships relevant to this publication. Research support for this study was provided by ASGE Quality in Endoscopy Award COMPLETE Study, 2017.

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Vol 89 - N° 6

P. 1222 - juin 2019 Retour au numéro

Article précédent

Colon polypectomy report card improves polypectomy competency: results of a prospective quality improvement study (with video)
Anna M. Duloy, Tonya R. Kaltenbach, Mariah Wood, Dyanna L. Gregory, Rajesh N. Keswani

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Video-based assessments: a promising step in improving polypectomy competency
Thurarshen Jeyalingam, Catharine M. Walsh

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Development and validation of a video-based cold snare polypectomy assessment tool (with videos) - 17/05/19

Abstract

Background and Aims

Methods

Results

Conclusions

Plan

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