January 18, 2019
1 min read

Online training module could improve Barrett’s management

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An online teaching tool helped endoscopists improve detection of Barrett’s esophagus-related neoplasia, according to research published in Gastroenterology.

J.J. Bergman, MD, PhD, director of endoscopy at Academic Medical Center in Amsterdam, the Netherlands, developed the program with the help of a group of expert endoscopists who helped delineate lesions on recorded upper endoscopy videos.

“To our knowledge, this is the first validated online, interactive endoscopic training program in our field. Crucial to the project was its use of high-resolution endoscopic video recordings, with replay and methods of delivery to assessors that fully preserved the resolution of the live images,” the researchers wrote. “The project depended on the highly disciplined commitment of 189 volunteer general endoscopist assessors from five countries.”

To develop the program, researchers sent high-definition videos of endoscopies of patients with Barrett’s esophagus-related neoplasia (BORN) and non-dysplastic BE to three experts who used special tools to add their delineations of lesions. Then, 68 general endoscopists assessed four batches of 20 videos and provided feedback that was compared with the perspectives of the initial experts.

Investigators used these data to pick 25 videos for the second phase of development, which comprised assessment from an additional 121 endoscopists. The participants received scores before and after four five-video training batches.

In the second phase, median detection rates of BORN in the test batch increased by 30% (P < .001) after training.

Between baseline and the end of the trial, detection increased by 46%, delineation increased by 129%, agreement delineation increased by 105% and relative delineation increased by 106% (all, P < .001).

Bergman and colleagues wrote that this training program could help improve the management of patients with BE.

“The results of this study demonstrate that by completing the BORN training module, general endoscopists with a wide range of experience and from different countries of origin can substantially and conveniently increase their skills for detection and delineation of early BORN lesions,” they wrote. “Therefore, the module could provide training in an essential upper [gastrointestinal] endoscopic skill that is not otherwise readily available.” – by Alex Young

Disclosures: The authors report no relevant financial disclosures.