The learning effect of a training programme on the diagnosis of oesophageal lesions by narrow band imaging magnification among endoscopists of varying experience.
BACKGROUND
Magnifying narrow-band imaging using intra-epithelial papillary capillary loop analysis has been confirmed as a promising diagnostic modality for oesophageal lesions. Little is known about its learning curve.


OBJECTIVE
To evaluate the effect of a training programme on the diagnosis of oesophageal lesions by different modalities among endoscopists of varying experience.


METHODS
We divided endoscopists into three groups based on their experience. A 2-h training programme on magnifying narrow-band imaging and intra-epithelial papillary capillary loop patterns was provided to trainees. They evaluated the test images and suggested diagnoses both before and after training. Diagnostic accuracy and interobserver agreement of three modalities were analysed.


RESULTS
The diagnostic accuracies of magnifying narrow-band imaging for differentiating oesophageal neoplastic lesions and predicting lesion depth were significantly improved in less-experienced (92.8% vs. 55.9%, 63.8% vs. 17.5%) and non-experienced endoscopist groups (84.2% vs. 47.4%, 50% vs. 10%), and kappa (κ) values for both groups achieved good agreement after training (0.76 vs. 0.43, 0.68 vs. 0.24, respectively), all P<0.05.


CONCLUSIONS
Magnifying narrow-band imaging could be learnt easily and rapidly by beginners. For diagnosis of oesophageal neoplastic lesions, our training programme improved the diagnostic skill of less-experienced endoscopists to the level of highly experienced endoscopists.
Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai Institute of Digestive Disease, Shanghai, China.
Hanbing
H
Xue
Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai Institute of Digestive Disease, Shanghai, China.
Shuai
S
Gong
Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai Institute of Digestive Disease, Shanghai, China.
Yufeng
Y
Shen
Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai Institute of Digestive Disease, Shanghai, China.
Honghong
H
Tan
Department of Endoscopy and Endoscopic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Mitsuhiro
M
Fujishiro
Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai Institute of Digestive Disease, Shanghai, China.
Jun
J
Dai
Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai Institute of Digestive Disease, Shanghai, China.
Yunjia
Y
Zhao
Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai Institute of Digestive Disease, Shanghai, China. Electronic address: zhizhengge@aliyun.com.
Zhizheng
Z
Ge
D000328:Adult; D000368:Aged; D001706:Biopsy; D002983:Clinical Competence; D004502:Education, Medical, Continuing; D004938:Esophageal Neoplasms / Q000473:pathology*; D004945:Esophagoscopy / Q000193:education*; D004947:Esophagus / Q000473:pathology*; D005260:Female; D006801:Humans; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D062048:Narrow Band Imaging; D015588:Observer Variation; D011446:Prospective Studies
Endoscopy; Intra-epithelial papillary capillary loop; Learning curve