Impact of a computer-based teaching module on characterization of diminutive colon polyps by using narrow-band imaging by non-experts in academic and community practice: a video-based study.

BACKGROUND

Experts can accurately characterize the histology of diminutive polyps with narrow-band imaging (NBI). There are limited data on the performance of non-experts.

OBJECTIVE

To assess the impact of a computer-based teaching module on the accuracy of predicting polyp histology with NBI by non-experts (in academics and community practice) by using video clips.

DESIGN

Prospective, observational study.

SETTING

Academic and community practice.

PARTICIPANTS

A total of 15 gastroenterologists participated-5 experts in NBI, 5 non-experts in academic practice, and 5 non-experts in community practice.

INTERVENTION

Participants reviewed a 20-minute, computer-based teaching module outlining the different NBI features for hyperplastic and adenomatous polyps.

MAIN OUTCOME MEASUREMENTS

Performance characteristics in characterizing the histology of diminutive polyps with NBI by using short video clips before (pretest) and after (posttest) reviewing the teaching module.

RESULTS

Non-experts in academic practice showed a significant improvement in the sensitivity (54% vs 79%; P  .001), accuracy (64% vs 81%; P  .001), and proportion of high-confidence diagnoses (49% vs 69%; P  .001) in the posttest. Non-experts in community practice had significantly higher sensitivity (58% vs 75%; P = .004), specificity (76% vs 90%; P = .04), accuracy (64% vs 81%; P  .001), and proportion of high-confidence diagnoses (49% vs 72%; P  .001) in the posttest. Performance of experts in NBI was significantly better than non-experts in both academic and community practice.

LIMITATIONS

Selection bias in selecting good quality videos. Performance not assessed during live colonoscopy.

CONCLUSION

Academic and community gastroenterologists without prior experience in NBI can achieve significant improvements in characterizing diminutive polyp histology after a brief computer-based training. The durability of these results and applicability in everyday practice are uncertain.