Curriculum for optical diagnosis training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Abstract

Main RecommendationsThis manuscript represents an official Position Statement of the European Society of Gastrointestinal Endoscopy (ESGE) aiming to guide general gastroenterologists to develop and maintain skills in optical diagnosis during endoscopy. In general, this requires additional training beyond the core curriculum currently provided in each country. In this context, ESGE have developed a European core curriculum for optical diagnosis practice across Europe for high quality optical diagnosis training. 1 ESGE suggests that every endoscopist should have achieved general competence in upper and/or lower gastrointestinal (UGI/LGI) endoscopy before commencing training in optical diagnosis of the UGI/LGI tract, meaning personal experience of at least 300 UGI and/or 300 LGI endoscopies and meeting the ESGE quality measures for UGI/LGI endoscopy. ESGE suggests that every endoscopist should be able and competent to perform UGI/LGI endoscopy with high definition white light combined with virtual and/or dye-based chromoendoscopy before commencing training in optical diagnosis. 2 ESGE suggests competency in optical diagnosis can be learned by attending a validated optical diagnosis training course based on a validated classification, and self-learning with a minimum number of lesions. If no validated training course is available, optical diagnosis can only be learned by attending a non-validated onsite training course and self-learning with a minimum number of lesions. 3 ESGE suggests endoscopists are competent in optical diagnosis after meeting the pre-adoption and learning criteria, and meeting competence thresholds by assessing a minimum number of lesions prospectively during real-time endoscopy. ESGE suggests ongoing in vivo practice by endoscopists to maintain competence in optical diagnosis. If a competent endoscopist does not perform in vivo optical diagnosis on a regular basis, ESGE suggests repeating the learning and competence phases to maintain competence.Key areas of interest were optical diagnosis training in Barrett’s esophagus, esophageal squamous cell carcinoma, early gastric cancer, diminutive colorectal lesions, early colorectal cancer, and neoplasia in inflammatory bowel disease. Condition-specific recommendations are provided in the main document.

Definition of competence standards for optical diagnosis of diminutive colorectal polyps: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

“…A panel of European experts in optical diagnosis was asked to participate in a modified Delphi process to reach consensus on competence standards for the optical diagnosis of diminutive colorectal lesions (the SODA competence standards) [13][14][15]. This panel consisted of experts from the 2019 ESGE guideline group on advanced imaging for the detection and differentiation of colorectal neoplasia [11] and the ESGE Curriculum Working Group on optical diagnosis training [2]. During an online meeting, experts were introduced to the methodology of the Delphi procedure [13][14][15].…”

“…The European Society of Gastrointestinal Endoscopy (ESGE) has a vision to create a thriving community of endoscopy services and endoscopists in Europe, to provide a high quality of endoscopy care. ESGE has developed a core curriculum for optical diagnosis practice across Europe for high quality optical diagnosis training [1,2]. The development of easy-to-measure competence standards for optical diagnosis that are focused on clinical consequences could help to optimize clinical management in gastrointestinal endoscopy.…”

Chromoendoscopy Techniques in Imaging of Colorectal Polyps and Cancer: Overview and Practical Applications for Detection and Characterization

“…Regardless the VCE technology, the OD proficiency in clinical practice should be supported by a dedicated training based on a validated classifications, that should include videos, real time OD and self-learning by assessing a minimum number of lesions prospectively evaluated during realtime endoscopy with histopathology as the reference to achieve required thresholds 62 .…”

Systematic Review on Optical Diagnosis of Early Gastrointestinal Neoplasia

“…A recent initiative by the European Society of Gastrointestinal Endoscopy (ESGE) focuses on the criteria for optical diagnosis proficiency and training methods. Their position statement [54] defines the prerequisites for competency, proficiency, and competence thresholds in optical diagnosis. However, in a former guideline, ESGE suggests that routine use of advanced imaging for detection and differentiation of colorectal neoplasia in average-risk patients has to be balanced against costs and practical considerations [55].…”