Differentiating adenomas from hyperplastic colorectal polyps: narrow-band imaging can be learned in 20 minutes - 24/08/11
Reprint requests: Douglas K. Rex, MD, Indiana University Hospital #4100, 550 N. University Boulevard, Indianapolis, IN 46202Riassunto |
Background |
Colonoscopy with narrow-band imaging can allow real-time determination of polyp histology.
Objective |
To determine whether physicians with varying levels of experience can learn and apply endoscopic criteria to distinguish between adenomas and hyperplastic polyps.
Design |
Prospective observational study.
Setting |
University teaching hospital.
Participants |
This study involved 37 physicians (medical residents, N = 12; gastroenterology fellows, N = 12; and gastroenterology faculty, N = 13).
Intervention |
Small-group, 20-minute, didactic teaching sessions in which the endoscopic criteria for determining polyp histology by using narrow-band imaging were described and demonstrated.
Main Outcome Measurements |
Learning outcomes were evaluated by using written pretests and posttests in which participants scored pathologically verified, high-definition polyp photographs as adenomas or hyperplastic polyps.
Results |
The mean overall scores increased significantly from 47.6% correct on the pretest to 90.8% correct on the posttest (P = .0001). The overall mean percentage of responses answered don't know was significantly lower on the posttest (0.6%) compared with the pretest (20.5%, P < .0001). After training, the level of agreement was substantial (κ = 0.69 for all participants, κ = 0.79 for fellows).
Limitations |
Our study did not assess for sustained improvement with time or in vivo accuracy of histological prediction during live colonoscopy. Further validation in a sample of community physicians is required.
Conclusion |
A short, didactic teaching session can achieve high accuracy and good interobserver agreement in the use of narrow-band imaging for determining the histology of colorectal polyps.
Il testo completo di questo articolo è disponibile in PDF.Abbreviations : NBI
Mappa
| DISCLOSURE: D.K. Rex disclosed a speakers' bureau relationship with Olympus America, Inc. All other authors disclosed no financial relationships relevant to this publication. |
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| See CME section; p. 600 |
Vol 72 - N° 3
P. 572-576 - settembre 2010 Ritorno al numero
Articolo precedente
- Not everything is celiac disease
- Eric Hassall
- Narrow-band imaging for colorectal polyps: it can be taught but will it be used?
- Brooks D. Cash
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