Web-based system for training and dissemination of a magnification chromoendoscopy classification

Abstract

AIM:To evaluate the use of web-based technologies to assess the learning curve and reassess reproducibility of a simplified version of a classification for gastric magnification chromoendoscopy (MC). METHODS: As part of a multicenter trial, a hybrid approach was taken using a CD-ROM, with 20 films of MC lasting 5 s each and an "autorun" file triggering a local HTML frameset referenced to a remote questionnaire through an Internet connection. Three endoscopists were asked to prospectively and independently classify 10 of these films randomly selected with at least 3 d apart. The answers were centrally stored and returned to participants together with adequate feedback with the right answer. RESULTS: For classification in 3 groups, both intra-[Cohen's kappa (κ) = 0.79-1.00 to 0.89-1.00] and inter-observer agreement increased from 1st (moderate) to 6th observation (κ = 0.94). Also, agreement with reference increased in the last observations (0.90, 1.00 and 1.00, for observers A, B and C, respectively). Validity of 100% was obtained by all observers at their 4th observation. When a 4th (sub)group was considered, inter-observer agreement was almost perfect (κ = 0.92) at 6th observation. The relation with reference clearly improved into κ (0.93-1.00) and sensitivity (75%-100%) at their 6th observations. CONCLUSION: This MC classification seems to be easily explainable and learnable as shown by excellent intra-and inter-observer agreement, and improved agreement with reference. A web system such as the one used in this study may be useful for endoscopic or other image based diagnostic procedures with respect to definition, education and dissemination.

Evaluation of an e-learning system for diagnosis of gastric lesions using magnifying narrow-band imaging: a multicenter randomized controlled study

“…It was reported that there was no difference in the accuracy between in-classroom and self-directed didactic training programs of NBI for diagnosis of Barrett's esophagusassociated neoplasia [26]. An Internet-based e-learning system for training in the endoscopy field has been reported, and is expected to become a promising training resource [19,20]. With the recent development of the Internet learning environment, there is no limit to the number of learners to whom it is now possible to transmit the latest knowledge combined with numerous images.…”

Non-guided self-learning program for high-proficiency optical diagnosis of diminutive and small colorectal lesions: A single-endoscopist pilot study

“…We used a validated set of still pictures followed by a practice on real colonoscopies with auto-administered feedback, hypothesizing that the latter would ease the transition from still pictures to real practice and shorten the learning curve. For the initial learning steps, several training modules have been used in the literature, including classroom-type[ 8 , 18 ], computer training[ 19 ] and web-based[ 20 ] modules. All systems may have similar efficacy as it has been suggested in a recent report showing that self-learning using a computer-based program with pictures and videos is as efficient as a classroom-type teaching session for learning OD[ 21 ].…”

Assessment of Still and Moving Images in the Diagnosis of Gastric Lesions Using Magnifying Narrow-Band Imaging in a Prospective Multicenter Trial

“…In general, there are almost no records of moving images when an observer wants to recheck the lesion and when endoscopists other than the observer want to diagnose the lesion. In contrast, with the widespread availability of Internet resources, learning programs with web-based videos are becoming a great tool to improve the diagnostic yield with endoscopy [22] , [23] , [24] . To our knowledge, the difference between still images and moving images has not been adequately evaluated.…”