title: An educational intervention to improve the endoscopist's ability to correctly diagnose small gastric lesions using magnifying endoscopy with narrow-band imaging.
abstract: BACKGROUND
  Magnifying endoscopy with narrow-band imaging (ME-NBI) and a simple and systematic classification system based on microvascular and microsurface patterns, the "VS" classification system (VSCS), have been shown to be useful for the diagnosis of early gastric cancer. The aim of this study was to clarify whether an educational lecture about the VSCS improves performance with ME-NBI.
  
  
  METHODS
  Sixty-four gastrointestinal endoscopists took the 1st exam before receiving the lecture about the VSCS, the 2nd exam immediately after the lecture, and the 3rd exam 2 months after the lecture. We compared the VSCS-based diagnostic accuracy among the participants before and after the lecture.
  
  
  RESULTS
  The proportion of correct diagnoses was significantly higher, at 70.8% in the 2nd exam than in the 1st exam, at 53.1% (P<0.001). The correct diagnosis rate in the 3rd exam was significantly lower than that in the 2nd exam (60.9% vs. 70.8%; P<0.001) but was still higher than that in the 1st exam (60.9% vs. 53.1%; P<0.001). The difference in proportion of correct diagnosis between the 2nd and the 3rd exams was smaller among routine ME-NBI practitioners (n=6; 79.2% and 76.1%, respectively), compared to that among non-routine practitioners (n=34; 71.6% and 59.8%, respectively) or non-practitioners (n=24; 67.5% and 58.8%, respectively).
  
  
  CONCLUSIONS
  This study revealed that an educational intervention increased correct diagnosis rate of small gastric lesions using the VSCS, diagnosis criteria based on ME-NBI and also showed that the routine use of the modality and the diagnosis criteria was necessary to maintain diagnostic skills.
authors.affiliation: Division of Endoscopy, Hokkaido University Hospital, Sapporo city, Hokkaido (Katsuhiro Mabe, Mototsugu Kato).
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Mabe
authors.affiliation: Department of Endoscopy, Fukuoka University Chikushi Hospital, Chikushino city, Fukuoka (Kenshi Yao).
authors.forename: Kenshi
authors.initials: K
authors.lastname: Yao
authors.affiliation: Department of Public Health, Sapporo Medical University, Sapporo city, Hokkaido (Masanori Nojima) ; Division of Advanced Medicine Promotion, The Advanced Clinical Research Center, Institute of Medical Science, University of Tokyo, Tokyo (Masanori Nojima), Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Nojima
authors.affiliation: Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo city, Hokkaido (Tokuma Tanuma).
authors.forename: Tokuma
authors.initials: T
authors.lastname: Tanuma
authors.affiliation: Division of Endoscopy, Hokkaido University Hospital, Sapporo city, Hokkaido (Katsuhiro Mabe, Mototsugu Kato).
authors.forename: Mototsugu
authors.initials: M
authors.lastname: Kato
keywords: Magnifying endoscopy; diagnostic performance; educational intervention; gastric cancer; narrow-band imaging
references.citation: Gastrointest Endosc. 2008 Oct;68(4):635-41
references.pmid: 18561923
references.citation: Gastrointest Endosc. 2010 Mar;71(3):477-84
references.pmid: 20189506
references.citation: Endoscopy. 2009 May;41(5):462-7
references.pmid: 19418401
references.citation: Endoscopy. 2004 Dec;36(12):1080-4
references.pmid: 15578298
references.citation: Endoscopy. 2006 Sep;38(9):891-5
references.pmid: 16981105
references.citation: Gastrointest Endosc Clin N Am. 2008 Jul;18(3):415-33, vii-viii
references.pmid: 18674694
references.citation: Gastrointest Endosc. 2005 Oct;62(4):521-8
references.pmid: 16185965
references.citation: Endoscopy. 2012 Jan;44(1):74-94
references.pmid: 22198778
references.citation: J Gastroenterol Hepatol. 2009 Oct;24(10):1625-30
references.pmid: 19788603
references.citation: Endoscopy. 2002 Oct;34(10):772-7
references.pmid: 12244497
references.citation: Clin Gastroenterol Hepatol. 2010 Oct;8(10):843-7
references.pmid: 20601133
references.citation: Gastrointest Endosc. 2008 Mar;67(3):430-7
references.pmid: 18294504
references.citation: Gastrointest Endosc. 2011 Jan;73(1):128-33
references.pmid: 21184878
references.citation: Orv Hetil. 2002 Jan 6;143(1):25-9
references.pmid: 11816375
references.citation: World J Gastroenterol. 2008 Dec 14;14(46):7086-92
references.pmid: 19084915
references.citation: Gastrointest Endosc. 2002 Aug;56(2):279-84
references.pmid: 12145613
references.citation: J Gastroenterol Hepatol. 2010 Oct;25(10):1636-41
references.pmid: 20880172
references.citation: Am J Gastroenterol. 1975 Apr;63(4):316-20
references.pmid: 48340
references.citation: Gastroenterology. 2011 Dec;141(6):2017-2025.e3
references.pmid: 21856268
references.citation: Gastrointest Endosc. 2010 Jul;72(1):127-35
references.pmid: 20493482
references.citation: Gastrointest Endosc. 2010 May;71(6):1070-5
references.pmid: 20438898
references.citation: J Clin Oncol. 2010 Mar 20;28(9):1566-72
references.pmid: 20177025
references.citation: Ann Gastroenterol. 2013;26(1):11-22
references.pmid: 24714327