TY - JOUR
T1 - Analysis of factors related to poor outcome after e-learning training in endoscopic diagnosis of early gastric cancer using magnifying narrow-band imaging
AU - Ikehara, Hisatomo
AU - Doyama, Hisashi
AU - Nakanishi, Hiroyoshi
AU - Hatta, Waku
AU - Gotoda, Takuji
AU - Ishikawa, Hideki
AU - Yao, Kenshi
N1 - Funding Information:
This work was supported by a research grant from the Japanese Foundation for Research and Promotion of Endoscopy and the Central Research Institute for Endoscopy, Fukuoka University.
Funding Information:
This work was supported by a research grant from the Japanese Foundation for Research and Promotion of Endoscopy and the Central Research Institute for Endoscopy, Fukuoka University. DISCLOSURE: All authors disclosed no financial relationships relevant to this publication. Research support for this study (H.D.) was provided by a grant from the Japanese Foundation for Research and Promotion of Endoscopy and the Central Research Institute for Endoscopy, Fukuoka University.
Publisher Copyright:
© 2019
PY - 2019/9
Y1 - 2019/9
N2 - Background and Aims: An e-learning system teaching endoscopic diagnostic process for early gastric cancer using magnifying endoscopy with narrow-band imaging (M-NBI) was established, and its efficacy in improving the diagnostic performance for early gastric cancer was proven in a multicenter randomized controlled trial. The aim of this study was to clarify the difference in learning effect in each lesion characteristic. Methods: Three hundred sixty-five participants diagnosed 40 gastric lesions based on M-NBI findings using the vessel-plus-surface classification system. The diagnosis data collected from each participant were assessed in this study. The accuracy of NBI cancer diagnosis was assessed using area under the receiver operating characteristics curve (AUC/ROC) analysis. AUC/ROCs were separately calculated in each lesion characteristic (shape and size), and the data were compared between tests 1 and 3. Results: Continuous net reclassification improvement (cNRI) analysis of all lesions revealed significant improvement in reclassification when participants underwent e-learning (cNRI, 1.17; P < .01). The integrated discrimination improvement analysis demonstrated that the e-learning system improved diagnostic ability (.19; P < .01). According to the analysis depending on the lesion's characteristics, high AUC/ROCs were demonstrated in depressed and small lesions (<10 mm; .90 and .93, respectively). The cNRI analysis showed remarkable e-learning improvement in both depressed (cNRI, 1.33; P < .01) and small lesions (cNRI, 1.46; P < .01). However, no significant e-learning improvement was observed in elevated or flat lesions. Conclusions: In M-NBI education for endoscopists, a good learning outcome was obtained in depressed and small lesions, but a poor learning outcome was demonstrated in elevated and flat lesions. (Clinical trial registration number: UMIN000008569.)
AB - Background and Aims: An e-learning system teaching endoscopic diagnostic process for early gastric cancer using magnifying endoscopy with narrow-band imaging (M-NBI) was established, and its efficacy in improving the diagnostic performance for early gastric cancer was proven in a multicenter randomized controlled trial. The aim of this study was to clarify the difference in learning effect in each lesion characteristic. Methods: Three hundred sixty-five participants diagnosed 40 gastric lesions based on M-NBI findings using the vessel-plus-surface classification system. The diagnosis data collected from each participant were assessed in this study. The accuracy of NBI cancer diagnosis was assessed using area under the receiver operating characteristics curve (AUC/ROC) analysis. AUC/ROCs were separately calculated in each lesion characteristic (shape and size), and the data were compared between tests 1 and 3. Results: Continuous net reclassification improvement (cNRI) analysis of all lesions revealed significant improvement in reclassification when participants underwent e-learning (cNRI, 1.17; P < .01). The integrated discrimination improvement analysis demonstrated that the e-learning system improved diagnostic ability (.19; P < .01). According to the analysis depending on the lesion's characteristics, high AUC/ROCs were demonstrated in depressed and small lesions (<10 mm; .90 and .93, respectively). The cNRI analysis showed remarkable e-learning improvement in both depressed (cNRI, 1.33; P < .01) and small lesions (cNRI, 1.46; P < .01). However, no significant e-learning improvement was observed in elevated or flat lesions. Conclusions: In M-NBI education for endoscopists, a good learning outcome was obtained in depressed and small lesions, but a poor learning outcome was demonstrated in elevated and flat lesions. (Clinical trial registration number: UMIN000008569.)
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U2 - 10.1016/j.gie.2019.04.230
DO - 10.1016/j.gie.2019.04.230
M3 - Article
C2 - 31034809
AN - SCOPUS:85067102721
VL - 90
SP - 440-447.e1
JO - Gastrointestinal Endoscopy
JF - Gastrointestinal Endoscopy
SN - 0016-5107
IS - 3
ER -
