title: Effectiveness of systematic training in the application of narrow-band imaging international colorectal endoscopic (NICE) classification for optical diagnosis of colorectal polyps: Experience from a single center in China.
abstract: OBJECTIVE
  To evaluate the effectiveness of systematic training in the application of narrow-band imaging (NBI) International Colorectal Endoscopic (NICE) classification for the prediction of the histology of colorectal polyps.
  
  
  METHODS
  This is a single-center study. In total, 260 still images of colorectal polyps from 225 patients were included. Two series of 130 images obtained using NBI and white light without magnification were distributed to 10 endoscopists-five highly experienced endoscopists (HEE group) and five less experienced endoscopists (LEE group)-for assessment using the NICE classification, before and after systematic training.
  
  
  RESULTS
  Before systematic training, accuracy in both groups was 79.54% and specificity was relatively poor (HEE: 62.46%, LEE: 69.23%, P = 0.297). After systematic training, specificity significantly improved (HEE: 96.61%, LEE: 97.54%, P = 0.000 and P = 0.013, respectively). Accuracy also significantly increased to 94.93% and 96.46% in the HEE and LEE groups, respectively. Sensitivity and negative predictive value did not significantly improve in the post-test; however, both were high in both the pre- and post-test. The κ-values in both groups were excellent (HEE: 0.93, LEE: 0.91). Among the components of the NICE classification, surface pattern yielded the highest performance, whereas color yielded the lowest.
  
  
  CONCLUSIONS
  Systematic, feedback-based, training programs can help achieve high accuracy and good interobserver agreement in the application of the NICE classification for the prediction of the histology of colorectal polyps by endoscopists with different levels of experience.
authors.affiliation: Department of Gastroenterology, Beijing Shijitan Hospital Capital Medical University, Beijing, China.|Department of Gastroenterology, Qilu Hospital of Shandong University (Qingdao), Qingdao, China.
authors.forename: Yinhe
authors.initials: Y
authors.lastname: Sikong
authors.affiliation: Department of Gastroenterology, Beijing Shijitan Hospital Capital Medical University, Beijing, China.
authors.forename: Xiangchun
authors.initials: X
authors.lastname: Lin
authors.affiliation: Department of Gastroenterology, Beijing Shijitan Hospital Capital Medical University, Beijing, China.
authors.forename: Kuiliang
authors.initials: K
authors.lastname: Liu
authors.affiliation: Department of Gastroenterology, Beijing Shijitan Hospital Capital Medical University, Beijing, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Wu
authors.affiliation: Department of Gastroenterology, Beijing Shijitan Hospital Capital Medical University, Beijing, China.
authors.forename: Wu
authors.initials: W
authors.lastname: Lin
authors.affiliation: Department of Gastroenterology, Beijing Shijitan Hospital Capital Medical University, Beijing, China.
authors.forename: Nan
authors.initials: N
authors.lastname: Wei
authors.affiliation: Department of Gastroenterology, Beijing Shijitan Hospital Capital Medical University, Beijing, China.
authors.forename: Guojun
authors.initials: G
authors.lastname: Jiang
authors.affiliation: Department of Gastroenterology, Beijing Shijitan Hospital Capital Medical University, Beijing, China.
authors.forename: Weiping
authors.initials: W
authors.lastname: Tai
authors.affiliation: Department of Gastroenterology, Beijing Shijitan Hospital Capital Medical University, Beijing, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Su
authors.affiliation: Department of Gastroenterology, Beijing Shijitan Hospital Capital Medical University, Beijing, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Gastroenterology, Beijing Shijitan Hospital Capital Medical University, Beijing, China.
authors.forename: Mingming
authors.initials: M
authors.lastname: Meng
mesh_terms: D000328:Adult; D000368:Aged; D002681:China; D002983:Clinical Competence; D003111:Colonic Polyps / Q000145:classification / Q000000981:diagnostic imaging* / Q000601:surgery*; D003113:Colonoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062048:Narrow Band Imaging; D015588:Observer Variation; D011237:Predictive Value of Tests
keywords: China; colorectal neoplasms; diagnosis; endoscopic; narrow-band imaging international colorectal endoscopic (NICE) classification