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ID 52740
FullText URL
Author
Higashi, Reiji
Uraoka, Toshio
Kato, Jun
Ishikawa, Shin
Saito, Yutaka
Matsuda, Takahisa
Ikematsu, Hiroaki
Sano, Yasushi
Suzuki, Seiyuu
Murakami, Yoshitaka
Abstract
Background: Previous reports assessing diagnostic skill using narrow-band imaging (NBI) and pit pattern analysis for colorectal polyps involved only highly experienced endoscopists. Objective: To evaluate diagnostic skills of less-experienced endoscopists (LEE group) for. differentiation of diminutive colorectal polyps by using NBI and pit pattern analysis with and without magnification after an expanded training program. Design: Prospective study. Patients: This study involved 32 patients with 44 colorectal polyps (27 adenomas and 17 hyperplastic polyps) of 5 mm that were identified and analyzed by using conventional colonoscopy as well as non-magnification and magnification NBI and chromoendoscopy followed by endoscopic removal for histopathological analysis. Intervention: Before a training course, 220 endoscopic images were distributed in randomized order to residents with no prior endoscopy experience (NEE group) and to the LEE group, who had performed colonoscopies for more than 5 years but had never used NBI. The 220 images were also distributed to highly experienced endoscopists (HEE group) who had routinely used NBI for more than 5 years. The images were distributed to the NEE and LEE groups again after a training class. Magnification NBI and chromoendoscopy images were assessed by using the Sano and Kudo classification systems, respectively. Main Outcome Measurements: Diagnostic accuracy and interobserver agreement for each endoscopic modality in each group. Results: Diagnostic accuracy was significantly higher, and kappa (kappa) values improved in the LEE group for NBI with high magnification after expanded training. Diagnostic accuracy and kappa values when using high-magnification NBI were highest among endoscopic techniques for the LEE group after such training and the HEE group (accuracy 90% vs 93%; kappa = 0.79 vs 0.85, respectively). Limitations: Study involved only polyps of <= 5 mm. Conclusion: Using high-magnification NBI increased the differential diagnostic skill of the LEE group after expanded training so that it was equivalent to that of the HEE group.
Published Date
2010-07
Publication Title
Gastrointestinal Endoscopy
Volume
volume72
Issue
issue1
Start Page
127
End Page
135
ISSN
0016-5107
Content Type
Journal Article
Related Url
http://ousar.lib.okayama-u.ac.jp/metadata/52506
language
英語
File Version
author
Refereed
True
DOI
Web of Sience KeyUT